It's interesting: Healthcare designers can talk ad infinitum about a world of issues—evidence-based design, patient- /staff-centric concepts, patient room attributes and appurtenances, wayfinding, technology planning, MEP, art, etc., etc. And then someone comes up with this conversation-stopper: "Did you know that buildings have accounted for nearly half of the United States' increase in carbon emissions since 1990?"

Particularly considering that most members of the healthcare design field are undoubtedly as environmentally sensitive as anyone, it can't be easy to learn that Architecture, as represented by its products, is one of our country's chief polluters. Most ironically, healthcare Architecture is no exception. And yet, when one thinks about how buildings (including hospitals) function, not to mention the messy process of their construction and its impact on landfills and air quality, it makes unfortunate sense.

Recent years have seen a rapid upsurge in awareness, interest, and activity in sustainable healthcare design. The most recent fruit of that, from our bailiwick, is the special Clean Design and Operations supplement you'll find in the following pages. Read how two leading lights of the design world are pushing sustainable healthcare design beyond even the famous and increasingly accepted LEED (Leadership in Energy and Environmental Design) rating system. Or how one facility has embodied the inspiration of the patron saint of ecology, St. Francis of Assisi, in its design. Or how another facility has developed an engineering marvel to go green in its energy consumption.

It took a while to get here, but the impact of environmentalism on design has been huge. This elephant in the room will be a significant part of the professional conversation among healthcare designers for years to come. We hope you enjoy this sampling.



RICHARD L. PECK, EDITOR-IN-CHIEF