It is interesting to observe that among the first projects to fully embrace the more sustainable or “green” building types, institutional—primarily educational—projects lead the way to LEED certification. But, until recently, very few of these more sustainable institutional buildings were hospital or healthcare related. The trend toward greener, more sustainable projects has been catching up with the hospital and healthcare community for some time.
In the years since the inception of the LEED program in 2000, the criteria has evolved from building systems to embracing more site and environmental characteristics, as well. We all know the three E's of sustainability: ecology, economy, and equity. As LEED has evolved, these three elements are being more fully embraced. But how do they equate with hospital and healthcare campuses?
Ecology:Sustainable planning and design must recognize the intrinsic value of nature and encourage the identification and preservation of high-quality habitats that can reconnect people and nature, as well as the preservation and restoration of natural processes.
Economy:Sustainable planning and design must recognize the need to eliminate waste, the evaluation of the full life cycle of materials, and the financial viability of a project.
Equity:Sustainable planning and design must recognize the impact of design decisions on human well-being, the responsibility to create relevant designs, and to provide for all communities. This, in turn, encourages the protection of public health, safety, and welfare, as well as promoting greenspace conservation.
Much has been written about the benefits of exterior natural spaces on human well-being, but how should planners and designers integrate the basic infrastructure required for today's hospital projects into a sustainable site plan that also incorporates natural areas or greenspace? What are the costs and long-term benefits of green site planning?
During the planning and design process, it is important to study ways to integrate sustainable elements, such as recycling materials, innovative stormwater management, sensitive site layout, native (or naturalized) landscape materials, and site lighting into a complete site package.
The process starts by selecting a facility site that is compatible with the land-use patterns and then using that site to dictate the layout of the facility, rather than trying to force a site to fit a given building (figure 1). Placement of the facility can take advantage of topography, prevailing drainage patterns, existing vegetation, access, view, and sun angles to create better passive solar conditions that save on energy usage. Existing canopy trees and/or natural areas on the site should be saved whenever possible. Existing vegetation and landscape can decrease heat-island effects around a facility. Construction costs can be lessened by working with the site contours rather than mass grading, which creates air pollution (dust), erosion potential, and ecosystem loss.
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