Because hospitals and healthcare facilities accommodate considerable technology, they typically consume massive amounts of energy, making building green in the healthcare industry particularly challenging. Additionally, healthcare facilities have different building regulations than standard construction projects—regulations that don’t necessarily focus on sustainable aspects of the design.

Recently, though, more industry leaders have recognized that sustainable design affects the health of the earth, which in turn impacts the health of its people—exactly the reason why healthcare facilities should concentrate on sustainability. With the increasing emphasis on sustainable design and construction, a greening of the healthcare industry is emerging, causing builders to change their construction tactics.

Case study: La Maestra Community Health Center

La Maestra Community Health Center, a planned three-story, 34,660-square-foot facility located in the City Heights area of San Diego, is leading the green movement through example. Because of its anticipated USGBC LEED Gold certification, the new facility is expected to be among the first facilities of its kind in the country, featuring state-of-the-art, energy-efficient, and environmentally responsible materials, fixtures, and operations.

Orange County, California-based Consolidated Contracting Services, Inc., is finalizing preconstruction services for the nonprofit community health center, with construction anticipated to begin in mid-2008. The facility’s cutting-edge design was created by San Diego-based Richard Yen & Associates.

La Maestra Community Health Center currently houses a family practice and wellness clinic, vision clinic, laboratory, pharmacy, walk-in clinic, pediatrics, OB-GYN, senior medical unit, dental clinic, mental health office, food pantry, children’s literacy program, job training, health promotions office, and a demonstration kitchen—all within 14 residential buildings on a city block. These services will be expanded and additional services offered in the new facility. Administrative offices are planned for the third floor, with 7,500 square feet of retail space available on the first floor. Additionally, the facility will house two levels of mechanically ventilated belowground parking. The challenge facing Consolidated Contracting is figuring out how to assemble all of these moving parts while adhering to the facility’s lofty green goals.

More than just a healthcare facility

The new center will serve the more than 78,000 residents living in the City Heights area, one of the most ethnically diverse communities in the nation. Those residents soon will discover that La Maestra is far more than just a healthcare center—it also will provide job training and placement, housing assistance, food pantry, interpretation and translation, and acculturation training and classes in financial literacy for City Heights residents and burgeoning immigrant population so they can become self-sufficient. In short, the center will serve as a dynamic “hub” of learning, entrepreneurship, and health and well-being for families, youth, seniors, businesses, and all who live in the community.

The overall vision for the center is to create a building that has a high level of comfort and low total energy consumption during its lifetime, and that will reduce fossil fuel consumption, plant emissions, and dependence on foreign oil. Another important mission of the project team is to acquaint the community with the concepts, materials and methods used in the construction of a showcase green building.

Additionally, the project team aims to develop a high-profile, optimally healthy facility for its patients, employees, volunteers, and guests that will significantly improve indoor air quality and reduce air pollution. The goal is a facility that is energy-efficient; uses low-cost, sustainable building products and techniques; and raises the awareness that healthier healthcare facilities can be an integral part of a patient’s healthcare plan and a community’s commitment to the environment.

Energy conservation

Several energy-conserving and environmentally friendly features of the project that follow the LEED Gold certification criteria include extensive energy-saving materials and systems, such as high-performance insulated glass; highly efficient HVAC equipment and delivery systems; and roof-mounted photovoltaic panels that will capture sunlight and produce electricity while providing as much as 15% of the annual energy requirement for the facility.

La Maestra’s design also will incorporate aluminum sun shades to provide additional shading on the south and east exposures; extensive use of recycled and regionally extracted and/or manufactured materials such as concrete, steel, drywall, metal studs, and carpet; finish materials that use no or low volatile organic compounds (VOCs); and extensive natural daylighting throughout.

To meet the goal of educating the community on sustainable technologies, an innovative touch-screen information kiosk in the lobby will provide visitors with information about the building’s features, with real-time reporting of energy usage and renewable energy output, and effective wayfinding.

Challenges of building green

Building green often presents challenges. The following are some examples of how building green differs from standard construction.

Materials Selection. When choosing materials such as paint, carpet, and glue for the construction of a green building, each individual purchase must be analyzed to determine where and how the product was made. To meet LEED requirements, the products had to have been produced within 500 miles of the job site, minimizing the carbon footprint left by the transportation process. Additionally, what goes into the material itself needs to be considered. Acceptable green products contain no or low levels of VOCs, which pollute the earth and can be harmful to humans. All of these considerations impact the building process because to achieve LEED certification, they must be fully documented. For instance, when a company that produces low-VOC paint makes a delivery to the job site, it must sign a document that explains what was delivered and where it came from—proof that the builders are following the green requirements. Most contractors will note, however, that this documentation process is more a minor annoyance than a significant challenge to building green.

Site Selection. In the past, many new construction sites were chosen simply because there was nothing yet built on the particular piece of land. But, with the greening of the industry, sites now are being reused to more effectively utilize the space. For example, the site for La Maestra previously was a neglected parking lot, one that many homeless called “home.” With the new facility being built, however, those homeless will have access to healthcare at a reduced cost, as well as counseling and job training that could potentially get them off the streets. In addition to where the property is located, site selection takes into consideration how the building will be positioned on the property. For example, windows were placed on the north and east sides of La Maestra to increase natural lighting while minimizing the amount of heat absorbed by the structure.

Green Demolition. Typical construction projects in the past would discard all the waste from construction and demolition into the same trash bin to be hauled to the nearest landfill. These days, however, contractors are thinking green, even in the earliest phases of their projects. Now during demolition, waste is sorted into various bins by type of material. The recyclable materials then are taken to a waste recycling company to be processed and reused. Although it takes additional time to sort through the materials and to teach subcontractors the process of separating them, it often costs less to use the recycling services than paying for landfill space—not to mention it’s much more beneficial to the environment.

Air Quality. An easy aspect to overlook after construction is the quality of the air inside the new building. Now, before inhabitants can move in, air quality tests are administered. This affects many aspects of construction because it forces workers to pay close attention to each object they put into the building. For example, an air conditioning unit installed 20 years ago might have sat around a dusty job site for days until it was finally installed. However, with the new LEED requirements for air quality, the air conditioning unit and duct work now must be wrapped and sealed from the moment it is manufactured until installation, ensuring that no external contaminants enter the ducts and reduce air quality.

These are just a few of the many examples of how the green movement is changing the building industry. Overall, building green doesn’t mean sacrificing massive amounts of time or money. The key is to be conscious of those measures that can be taken at each step of the building process to meet the ultimate goal of sustainability. HD