More than 115 Green Guide for Health Care pilot projects, representing more than 30 million square feet of construction, are raising the bar for building green and healthy hospitals. Their shared knowledge is reflected in the newly revised Green Guide for Health Care Version 2.2, launched on the GGHC web site ( on January 31.

The free, downloadable PDF toolkit boasts a substantially revised Construction Section and several clarifying changes to the Operations section. The most significant revisions respond to feedback from Green Guide Pilot projects and, where appropriate, align with LEED for New Construction Version 2.2.

The Green Guide, a project of the Center for Maximum Potential Building Systems and Health Care Without Harm, is a voluntary self-certifying system modeled with permission after the U.S. Green Building Council's LEED rating system, with 12 mandatory prerequisites and 97 voluntary credits focused on design and construction, and 10 prerequisites and 72 credits covering facility operations.

Green Guide Pilots include some of the largest health care construction projects in the United States, such as Boston's Brigham and Women's Hospital 350,000-square-foot Carl J. and Ruth Shapiro Cardiovascular Center and Spaulding Rehabilitation Hospital, both members of Partners HealthCare. The Spaulding project—a 240,000-square-foot replacement hospital on a brownfield site at the Boston Naval Ship Yard scheduled for completion in 2010—is exploring high performance facade treatment, operable windows, green roofs, highly efficient mechanical systems, green materials, and on-site power generation. As major hospitals in Boston compete to achieve more than 50 credits in the Green Guide Construction section, Boston Mayor Thomas Menino has issued a challenge to other cities across the country, declaring Boston at the forefront of green building and the emerging field of green health care.

Likewise, Kaiser Permanente, the largest nonprofit health system in the nation, is using the Green Guide to facilitate the design and construction of some 30 million square feet of construction over the next decade. Kaiser's support for continued market transformation has led them to work with manufacturers to develop safer finish materials, participate in groundbreaking research on natural and displacement ventilation in the health care environment, and to systematize a process that encourages construction projects to establish a business case for implementing innovative green features in new facilities.

The newly released Green Guide Version 2.2 incorporates lessons learned from leading hospitals across the country, and those that are at the forefront of research in areas of study as diverse as mercury reduction, lighting for circadian rhythm and acoustic design. The result is a toolkit that is better attuned to the opportunities and challenges of the healthcare sector—such as energy and water reduction—as well as emerging areas of interest, particularly green design elements that promote a healthy, healing environment.

Many of the credits introduced for the initial Green Guide Version 1.0 in 2003 have been substantially revised in Version 2.2, reflecting a groundswell of interest among Pilot projects, as well as research conducted by nonprofits such as The Center for Health Design, universities, and governmental agencies. For example, the single credit awarded in Version 2.1 for places of respite has been greatly expanded in Version 2.2.

Drawing from Pilot experience, the credit has been divided into three points: one focused on outdoor places of respite, a second encouraging direct access to the exterior from inpatient units and some outpatient areas, and a third inserted into the daylight and views series under the Environmental Quality section that encourages indoor places of respite.

Other major innovations include a more comprehensive approach to water efficiency; greater emphasis on promoting renewable energy; establishing a correlation between building material content and emissions; an expanded approach to mercury elimination in building equipment and fluorescent lamps; and holistic approaches to acoustic design and lighting design for circadian rhythm in the healthcare environment.

The roll out of Green Guide for Health Care Version 2.2 marks the end of the Pilot program and the next step in the Green Guide's evolution. Projects currently enrolled in the Pilot are encouraged to remain active participants in the Green Guide community. Pilot projects will automatically be re-registered as Green Guide Version 2.2 projects, and registration for Green Guide Version 2.2 projects will open to the general public in March 2007. All projects using the Green Guide are welcome to register and to participate in building a body of knowledge on current best practices in the green health care design, construction and operations industry.

For more information about how to get involved, to download the Green Guide, or to register a project, visit