Presumably within a matter of days, if it hasn't happened already, the United States Green Building Council (USGBC) will publish the final version of the long-awaited LEED for Healthcare. For the first time since its inception 10 years ago, the Leadership in Energy and Environmental Design, or LEED, process for guiding and recognizing levels of excellence in sustainable building design will have a rating system tailored specifically for the healthcare field. This builds on the early groundbreaking work of the Green Guide for Health Care, a project of the Center for Maximum Potential Building Systems and Health Care Without Harm.

After several halting years during which a handful of healthcare institutions attempted to conform to the basic LEED criteria, with more than 20 achieving LEED certification, it became generally acknowledged that the LEED for New Construction rating system designed for commercial structures presented challenges to the healthcare industry. These facilities employ specialized staff and high technology to medical diagnosis and treatment 24 hours a day under unique regulatory requirements.

Nevertheless, a few healthcare facilities did follow the LEED guidelines to achieve Silver and even Gold recognition. However, to ease the transition of more healthcare facilities into the green building era, the Center for Maximum Potential Building Systems, under a Merck Family Fund grant, convened the Green Guide for Health Care, developed by a voluntary steering committee and first published in 2003. With its more relevant criteria and health facility-based pilot projects—ultimately numbering 115 nationwide—the interest in green building within the healthcare sector grew significantly.

The final boost needed to accelerate the greening of healthcare design is to be provided by LEED for Healthcare, scheduled for publication this year after an initial 30-day comment period that ended December 15 and a second public comment period addressing all credits for which draft language was changed as a result of the original comments. What will LEED for Healthcare do that the Green Guide doesn't? What will become of the Green Guide and its pilot projects? What will this mean for those facilities that have used the Green Guide for their initial planning and development? Gail Vittori, co-director of the Center for Maximum Potential Building Systems, one of the co-coordinators of the Green Guide, and chair of the LEED for Healthcare core committee, responded recently to these and other questions from HEALTHCARE DESIGN Editor-in-Chief Richard L. Peck.


Peck: What is the background of the Green Guide versus LEED for Healthcare—is the LEED system pre-empting the Green Guide?

Vittori: No, there has been collaboration between the USGBC and the Green Guide since the Green Guide's inception in 2002. The Green Guide has served as a catalyst for a developing a “best practices” tool kit pending the development of LEED for Healthcare. With the understanding that there wasn't much aimed at healthcare construction in the original LEED rating systems, the Green Guide tried to jump start the process toward a more healthcare-oriented tool.

Peck: What will happen to the Green Guide after LEED for Healthcare is finalized?

Vittori: It will continue but in somewhat different form. The original Green Guide had two sections—“design/construction” and “operations.” Design/construction guidelines are being used as a foundational reference for consideration in LEED for Healthcare, and that portion of the Green Guide would then sunset. However, LEED for Healthcare won't deal with operations in its initial release, and the Green Guide will go on to develop new tools and best practices across the board.

Peck: What will happen to the Green Guide's 115 pilot projects?

Vittori: The learnings from these projects became part of Green Guide 2.2, the current version. Many of these pilots—now registered projects—are in early stages but not yet constructed, so they might have a leg up for LEED for Healthcare and transition into it perhaps more easily than projects just starting out.

Peck: Interestingly, some healthcare projects have been using the LEED framework to guide their project development in sustainable directions but are not going to the extent of applying for LEED registration and certification. Do you think that will continue with LEED for Healthcare?

Vittori: For many projects, including healthcare, certification has been shown to hold tremendous value. Yes, it can represent an expense but, from the marketplace point of view, it pays off significantly. Certification verifies that the LEED process was used to achieve important goals, and this has an established return on investment: higher resale value, listing as a top-tier property, more efficient and cost-effective energy use—these add up to real economic value. I think the case for this has been made very well.

Peck: Some have said that LEED has been more applicable to new construction than to renovation. Will that change under LEED for Healthcare?

Vittori: The Green Guide has tried to offer special accommodations for renovation of healthcare facilities. We'll see if this carries over to LEED for Healthcare.

Peck: What is the current time frame for LEED for Healthcare?

Vittori: The first comment period closed on December 15, 2007. There were some 2,100 comments, so the committee is working on developing responses for every comment, as part of the standard LEED rating system development process. This will be followed by a second public comment period addressing the credit changes resulting from the first comment period. We anticipate that LEED for Healthcare will be released this year. HD

Gail Vittori, LEED AP, Co-Director of the Center for Maximum Potential Building Systems, is chair of the LEED for Healthcare core committee and co-coordinator of the Green Guide for Health Care.

For further information, visit http://www.gghc.org. The Center for Maximum Building Performance Systems is based in Austin, Texas. For further information, phone 512.928.4786.