Healthcare Design - December 2015 - 27

Setting aggressive energy goals and efficiency standards is one thing;
meeting them is another. Healthcare Design revisits some of the industry's
most notable green healthcare projects to find out what happened on their
journey-and where they stand today By Anne DiNardo
if at first you don't succeed, try, try again. That's

one of the lessons gleaned from projects that healthcare organizations launched over the past decade to
achieve some major sustainable design goals.
Some had their eyes on never-before-seen levels of
energy efficiency, while others introduced unfamiliar
systems as part of a new facility design. In several
cases, these projects didn't hit their anticipated marks
when they first opened their doors. But through a
commitment to both sustainability and the bottom
line, as well as to positively impact their communities, the providers continued to adjust, tweak, and
redesign, helping to raise the bar and set an example
for all.
Regarded as one of the industry's green leaders,
Gundersen Health System began testing the limits
on attainable energy targets in healthcare (or how
much energy a building uses for a given size) when it
recently built its 427,000-square-foot Legacy Building
in La Crosse, Wis. "Our goal was to achieve 115 kBtu
per square foot per year," says Alan Eber, manager of
engineering and energy at Gundersen Health System.
"The average for hospitals in our region is about
250 kBtu, so it was well below half of what the average hospital uses."
To figure out how to deliver that efficiency,
Gundersen and its project team put together a list of
methods to reduce energy inside the building, from
added insulation to efficient lighting to a geothermal
heat pump. "There were a number of different criteria
that we used to rank those choices, starting with
payback," he says. "The second one was how far
of a step it was toward achieving our goal. Then we
looked at things like additional maintenance and will it
allow us to expand and grow, or are we pigeonholing
ourselves by doing this?"
The hospital opened in 2014 and was achieving
129 kBtu per square foot after its first year of operation, Eber says-not quite where it wants to be, so it's
continuing to adjust its systems and revisit energy use
throughout the building in an ongoing effort to bring
that number down. One of the biggest design lessons
on the project was the potential to reduce energy use

he says. "Every hospital has the opportunity and it
takes some effort and a little bit of TLC to get it working
correctly, but once it does, there's almost no better way
to save energy than there."
Other organizations, such as Ascension Health (St.
Louis), took advantage of downtime during the Great
Recession to look for inventive ways to save money
through new building and operating standards. In 2010,
Ascension announced that all new hospitals would
be designed to achieve an Energy Star rating of 75 or
better. Its Clay County Hospital in Middleburg, Fla., one
of the system's first to use the new design standards,
exceeded that goal, earning an Energy Star score of 97
through a combination of technologies such as energy
recovery air handling units and a variable air volume
turndown in non-critical spaces to minimize fan, cooling, and reheat energy.
Gerry Kaiser, senior director in the facilities resource
group at Ascension, says the organization uses a lifecycle approach to justify what might be a "slight upfront
premium" to put in the kind of equipment that it does.
"Once the hospital is open, it's very difficult to get money
spent on upgrading equipment, whether it's five or 20
years old," he says. "We try to design our hospitals to
last and to perform knowing that no one wants to spend
money on unglamorous things in the future."
Reflecting on Palomar Medical Center (PMC) in
Escondido, Calif., which set out to become "the
hospital of the future" when design work started on the
project in 2002, Thomas Chessum, a principal at CO
Architects (Los Angeles), says it's easy to see how far
the industry has come. He says PMC took advantage
of the technology of the time, such as passive shading systems, heat-load reduction, and daylighting, to
reduce its energy consumption, since LED lighting was
still cost-prohibitive and active building programs like
chilled beam systems weren't yet mainstream. "Now
we're getting to the point where you don't have to ask
the trade contractor if they've done [chilled beams as
a mechanical system] before," he says. "They've either
done it or they've dying to do it because they see
where it's going."
On the following pages, Healthcare Design looks

with the geothermal heat pump, Eber says. The system takes excess heat in the hospital and puts it back
into the system so burning fossil fuels isn't required to
heat the hospital, resulting in "a huge energy savings,"

back on these industry-leading projects to dig more
into what they did, how those design initiatives have
worked, and the lessons they can impart to the industry
at large.

HCDmagazine.com 12.15

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Healthcare Design - December 2015

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