Viken Djaferian/Fotografix

Viken Djaferian/Fotografix

Sometimes the best cure for a patient has nothing to do with medicine and a lot to do with the surroundings. The “prescription” for patients at Affinity Medical Group's clinic in Greenville, Wisconsin, included a healthy dose of sustainable construction.

The clinic is part of a system that includes a broad spectrum of care delivery, including hospitals, clinics, nursing facilities, and medical offices. When the system considered renovations to existing structures and new sites, they colored their goals “green.”

Their new 12,000-square-foot clinic incorporated pioneering design and construction elements built according to LEED-NC Rating System guidelines. A prototype for new clinic construction within the Affinity system, it houses six physicians, 15 exam rooms, a procedure room and lab, and radiology and EKG services. “What we've tried to do is to reduce or eliminate the impact of this building on the environment,” says Gary Kusnierz, director of system facilities for Affinity Health System.

Affinity Health System partnered with The Boldt Company, an Appleton, Wisconsin, construction and construction management firm specializing in sustainable construction. Boldt has participated in LEED-certified and -registered projects throughout the nation.

“We made the decision to build a sustainable project, so we looked for a company skilled in project management with experience in LEED certification,” Kusnierz says. Boldt's LEED experts recommended including green elements that were central to patient service rather than selecting features simply to increase LEED points awarded. “A lot of the sustainable elements we incorporated were selected for patient care improvement,” Kusnierz notes. “We paid more attention to the patient early in the design phase and are attempting to change the patient experience.”

Many buildings incorporate green elements into the design and construction, but Affinity sees gaining LEED certification as the most widely recognized and prestigious standard of sustainability. The rigorous rating system examines everything from site issues to water management, recycled content of materials used in construction, energy efficiency, and even indoor air quality.

The Boldt project team acknowledged that they are setting a standard for sustainable design and construction in the Greenville Clinic. “The old clinics were one story, closed in, artificially lit, and very sterile smelling,” says Theresa Lehman, Boldt field engineer and sustainable consultant for the project. “This clinic is so airy and bright that you feel more relaxed and comfortable, and your level of anxiety and stress is reduced—it's not like sitting in a traditional patient waiting room.”

But it's what's beneath the surface that really gives the project its LEED credentials. The clinic qualifies for 33 LEED credits and will be submitted as a “certified” project, making it the first certified clinic in the state and one of only a few such healthcare projects in the United States.

In all LEED-certified projects, sustainable issues are unique to the site. In this case, the clinic is situated in a rapidly growing, suburban setting, the goal of Affinity being to locate clinics near residential populations so that people are close to personalized medical care. The downside of that, though, is the potential for urban sprawl and light pollution. “The clinic is on a main highway in a businesslike setting, but family homes are literally in its backyard,” says Lehman. To accommodate this, site lighting is focused downward and signs on the building are backlit rather than illuminated from the front.

Storm water management was a critical element of design for a facility in this rapidly growing community. The suburban infrastructure was not set up to manage large volumes of runoff, so the clinic's design and construction team implemented measures to manage its storm water with a retention pond, with water filtered through riprap before returning to the water table or storm sewer.

Maintaining indoor air quality was also a goal for the project. The air quality management plan started at the beginning of construction. “The ductwork was covered with plastic and filters to keep it clean, and special Minimum Efficiency Reporting Value (MERV)-rated filters were installed on air-handling units to catch airborne particles. Both steps caught contaminants and reduced their recirculation,” says Lehman.

Mold and mildew also contribute to indoor air quality problems, therefore the plan called for limiting moisture absorption in construction materials. Drywall was stored in a clean, dry place rather than the usual practice of storing it directly on the newly cured concrete floor and covering it with plastic to keep moisture, dirt, and debris from contaminating it. Other absorptive materials, such as insulation, ceiling tiles, and carpet, were also protected and stored in a dry place.

One of the biggest challenges during construction was educating construction crews and subcontractors about LEED requirements. “We had to communicate to Boldt's site superintendent, the field foreman, the material suppliers, and our waste hauler what our specific LEED goals were and explain how their work would affect the project's certification,” Lehman says.

The completed project includes several sustainable design details. Its interior design reflects sustainability values such as an entryway/atrium with natural lighting, wood ceilings, and recyclable materials (figures 1 and 2). The lobby also houses a waterfall and frequently used grand piano, while just outside the lobby is a Rain Garden of evergreens and flowering plants serving as a natural filter for storm water runoff. Family- and staff-friendly features, respectively, include a children's play area (figure 3) near the atrium and a pleasant staff kitchen (figure 4).

All parties agree there is a cost associated with sustainable construction. “That's why we counsel our partners to select sustainable elements that are central to the customer experience,” Lehman says. “In the course of every project, budget decisions will come into play, so it is really important that the ‘green’ decisions you make reflect your business's goals and image.” And savings will come: “When you look at the life-cycle cost of the building over a 30-year period, that's where you will find the savings for this type of design,” Kusnierz says.

Meanwhile, though, the decision to build sustainable elements into the project were driven more by the healing mission of the Affinity organization and its long-term focus on stewardship for patients and their environment—goals they're already achieving and that LEED has certified.

Mary Schmidt is an independent writer and communications consultant based in the Midwest.

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