Project Summary

Client: Boulder Community Hospital

Architecture and Interior Design: Oz Architecture (core and shell); Boulder Associates, Inc. (interior)

Planning/Landscape Architect: Civitas

Energy/LEED Consultant: Architectural Energy Corp.

MEP Engineering: Shaffer-Baucom Engineering & Consulting

Electrical Engineer: BCER Engineering, Inc.

Structural Engineer: Monroe & Newell Engineers, Inc.

Civil Engineer: Drexel, Barrell & Co.

Photography: Sergio Ballivian Photography/DP

Completed: September 2003

Total Building Area (sq. ft.): 155,000 (hospital), 67,000 (outpatient services)

Total Cost (hospital, excluding land): $45,600,000

Cost/Sq. Ft.: $294

Although the concepts of “green building” and LEED™ certification for “sustainable design” are hardly new to the healthcare community, achievement of them is new. In fact, the first hospital to achieve Leadership in Energy and Environment Design (LEED) certification—the Boulder Community Foothills Hospital (BCFH) in Boulder, Colorado—did so only last year. It was the culmination of years of work by the hospital, two architectural firms, a leading technology vendor, and construction subcontractors. The process took them into healthcare project planning areas that had never before been explored so comprehensively or in such depth.

The process began nearly four years ago, when the hospital's board of directors committed to seeking LEED certification. “There was a lot of hesitancy in the design/planning/construction community about this at first,” says BCFH's environmental coordinator Kai Abelkis, “because it had never been done before. Now all the team members—and it really was a team effort—are touting their LEED experience. Everyone knows how to build a hospital, but adding LEED requirements shined a new light on the effort.”

To get the requisite number of points for LEED certification—in the BCFH case, enough to gain a silver award—the project had to meet criteria in five general areas: sustainable site development, water savings, energy efficiency, materials selection, and indoor environmental quality. Each of the team members took the lead at one time or another in each of these areas. For example:

Sustainable site development. “With only 17 acres buildable on a 49-acre site, we built to density within that footprint,” says Kristi Ennis, design director at Boulder Associates, the architectural firm primarily responsible for the inside clinical and office spaces. “The remaining 32 acres, which used to be a field where cows and horses grazed, has been kept open, with native grasses and even a prairie dog town. The people in the area remember and like it this way.”

Other decisions included design of the roof overhangs and control of the exterior lighting, notes David Schafer, project architect and principal with Oz Architecture, primarily responsible for designing the core and shell of the building. “To maximize the cost-effectiveness of the overhangs,” he says, “we installed them only on the south and west sides of the building. This provided the needed shade, was aesthetically satisfying, since these areas face the public access approaches, and avoided wasting money and space.”

Control of exterior lighting posed a different challenge: “With environmentally sensitive design, you shouldn't be wasting lighting energy by shining upward into space or out into your neighbor's space,” Schafer says. “This meant there could be no uplighting of trees or even of the flag pole. After considerable discussion—and the LEED process is good for inspiring this sort of thing—we came up with two decisions: First, our canopy over the main entrance would be made of steel with frosted glass insets, which we would uplight at night, but only after making sure that the glass we selected had sufficient opacity to contain the light. Second, instead of lighting the flag pole, the hospital decided to take the flag down every night—very much in keeping with flag etiquette.”

Also helping BCFH gain the LEED point for site development was the project's encouragement of alternative transportation to automobiles. Bike racks with nearby showers, liberal use of annual bus passes, and provision of choice parking spots for car pools led to the hospital's constructing 25% fewer parking spaces than the city of Boulder required. The hospital had to show it had room for the added 25% to get the city waiver but will not be required to build it unless that proves to be necessary.

Water savings. In Colorado, the issue of water conservation has special resonance. Because of the arid surroundings and the need to distribute the beneficence of the mighty Colorado River sufficiently to the burgeoning population of the Southwest, ownership rights are closely guarded. “We don't own the rain that falls on our property,” notes Ennis, “in that we can't collect it for future use, so there's a lot of emphasis on directing the water where it's most useful.” For BCFH, this has meant a venture into the emerging practice of “Xeriscaping”—cultivating native plants needing relatively little water. (The word “Xeriscape™,” Ennis notes, has been trademarked by the Denver Water Board.)

The hospital also has moved into the exotic technology of the waterless urinal. “This was one of my ideas,” notes Abelkis. “They're made of a sort of Teflon® material, draining into an absorbent gel. They actually work, and they can be maintained as easily as standard urinals. They're useful for public rest rooms in an institution our size—I wouldn't recommend them for a football stadium.” BCFH is a test site for these, and standard plumbing for more traditional facilities was installed in the walls, just in case. The public restrooms also use electric-eye controls for the sinks.

Energy efficiency. BCFH made a couple of crucial decisions regarding mechanical and electrical systems. One was to build a freestanding central utility building that would be sized and equipped to handle growth with relatively little modification. Space was provided so that extra boilers and chillers could literally be slid into place, as needed, and all piping was sized to accommodate the added capacity. “We figure that, at today's energy and construction costs, the $1.3 million spent on building now will pay for itself over 12 years,” says Ennis.

Meanwhile, the project's technology contractor, Johnson Controls, installed its Metasys® system, a uniquely flexible HVAC system that shuts down or activates the cooling/heating room by room, depending on whether the openable windows in the patient rooms are open or closed; shutting down a room's heating or cooling when its window is open is intended to significantly improve energy conservation. The system also manages indoor air quality (see “Indoor environmental quality,” below) and helped the hospital to gain LEED points, notes Johnson Controls project manager Curt Erickson.

Electrical and mechanical subcontractors did investigate such futuristic technologies as photovoltaics, geothermal cooling and solar hot water, Ennis notes, but found none that were sufficiently cost-efficient as yet.

Materials selection. A significant part of the team effort, involving all the subcontracting team members, says Ennis, was research on sustainable building materials. By LEED standards, materials should be locally manufactured/harvested, include recyclable/rapidly renewable ingredients, and emit low levels of volatile organic compounds (VOCs). In this case, Ennis notes, BCFH received extra credit from LEED for going beyond its standards.

Finding local products was the relatively easy part. Ennis notes, “Our façade is all local materials, including fly ash for the cement, brick from Colorado clay, and sandstone from a town ten miles up the road.” A particular challenge, however, came in finding low-emitting VOC paints, adhesives, coatings, carpets, and casework substrates that were market-ready. “We were fortunate in that our contractor on the site was able to offer us subcontractors to help us with the search,” Ennis explains. “At one point, we thought we would have to go ahead and open up three operating rooms using paint that wasn't low-VOC, until a subcontractor found a good paint of this type just one day before painting had to be completed. Today, low-VOC paint is much easier to get.”

The search for rapidly renewable material led to linoleum, using linseed oil derived from flax seed, which can be rapidly grown, harvested, and regrown. Interestingly, the design team found that there are no longer any American-based linoleum manufacturers but, Ennis says, with the growing interest in green-building issues, an American plant will be opened in 2008.

Indoor environmental quality. Air quality, according to Abelkis, was the issue that initially inspired the hospital's board to consider LEED certification. He says, “The resulting improvement in air quality was the most beneficial aspect of the LEED efforts. It's a quality-of-life issue for our patients and staff, and an obvious concern for a healthcare institution. I don't know if you can put a cost justification on a higher air-quality standard, but it goes without saying that it's the right thing to do.”

For this, the hospital uses the Johnson Controls Metasys system, which relies on carbon dioxide sensors to properly exhaust indoor air and bring in fresh air to maintain consistently healthy oxygen levels.


Although anticipating savings from the LEED certification process over the long run, Abelkis notes, “Costs should not always be the determining factor. The question is, will you achieve your mission and commitment to the community? The fact is, this probably would have been a beautiful hospital without the LEED process. That process, though, made us rethink a lot of things in detail. We learned that these important things can be done, and we hope that others will see this, too.” HD

For further information