Cost, Energy-and Sometimes Green

While there are many motivations for hospitals and other healthcare facilities to undertake upgrades, energy efficiency is a growing concern. Recent surveys show that cost savings-not sustainability − has been the main impetus for healthcare providers to choose green building options. In fact, cost was the No. 1 factor in another survey of 960 ASHE and ASHES members by Health Facilities Management survey (see Charts 3 and 4).

"This is an important trend in healthcare architecture," says SAFTI FIRST's Griffiths. "The emphasis on energy performance and conservation has encouraged more use of daylight in many facilities." Energy codes are another motivation, adds ELP's Hedberg, with the energy standard ASHRAE 90.1 and the International Energy Conservation Code (IECC) being mandated in many jurisdictions. "But in too many cases, energy issues are overpowering the quality of design, which should be the designer's primary motivation," he says, pointing out that indirect lighting fixtures, as seen at the Nashville hospital, are less efficient than unshielded troffers but more conducive to patient comfort and recovery.

The answer is to balance performance and cost-to meet energy codes, but without losing sight of EBD and environment of care. "The federal stimulus funding of the last two years helped encourage public healthcare facilities to become high-performance green buildings, meaning that they are not just built green, but they're also built to live green," says Excel's Gagnon. As an example, he points to the Executive Order 13514, a new federal guidance that will requires all federal facilities to focus on sustainability with several specific goals such as reducing carbon emissions, energy usage and diverting at least 50 percent of non-hazardous solid waste by 2015.

Code-driven and federal initiatives like these will be buttressed by growing market need, adds TIMELY's Bevens. "We have seen an increase in elderly care facilities including assisted living and nursing homes. As to how quickly this will change, we don't know until we see how the federal government is going to help take care of the elderly," she wonders. The sentiment is echoed by Bluworld's Morton: "If you consider assisted living facilities and other senior care options, that healthcare segment is growing very rapidly, especially on the public side."

"Healthcare has sustained a lot of architects and others in the building and construction industry over the past few years," Morton adds. "There are no signs of healthcare overall slowing down."

C.C. Sullivan is a marketing consultant specializing in the architecture, design, and construction segments. He is former editor-in-chief of the magazines Architecture and Building Design + Construction.