Green Guide for Health Care

Creating High Performance Healing Health Care Facilities

A voluntary, self-certifying toolkit for harnessing best practices in the health care industry.

2008 GGHC

welcome

Healthcare Construction Boom

2008 GGHC

Source: 2007 McGraw-Hill Construction Healthcare Green Building SmartMarket Report

background

Healthcare Green Construction Boom?

Increase in Health Care Green Building Over Time

Projected Green Building Market Value

Source: McGraw-Hill Construction, 2007 Source: McGraw-Hill Construction Research & Analytics, 2007

2008 GGHC

Source: 2007 McGraw-Hill Construction Healthcare Green Building SmartMarket Report

background

Hippocratic Oath

From the modern version: I will prevent disease whenever I can, for prevention is preferable to cure.

2008 GGHC

1
2

Long ownership mean owners realize life cycle implications of their construction choices.
24/7 operations with patients in place require intensive coordination and redundancy of all services at all times. Health care facilities are often multiple building campuses of varying ages, conditions, systems The design and operation of health care buildings is highly regulated with intense economic and life safety oversight Operational issues, such as mercury elimination, have defined industrys environmental stewardship

3 4

2008 GGHC

design attributes overview

Construction frequently occurs within or adjacent to occupied buildings (where health is fragile, or steadiness of hand required)
Infection Control Risk Assessment (ICRA) protocols to minimize the impacts of construction on occupants demonstrate leadership to the wider sustainable building industry Healthcare construction managers can evolve a rigorous, sustainable set of practices for the healthcare industry that may inform wider construction practice

2008 GGHC

construction attributes overview

1998 American Hospital Association &

U.S. EPA Memorandum of Understanding 1 Virtual elimination of mercurycontaining waste from healthcare facilities waste streams by 2005;

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3

Reduce total waste volume by 33% by 2005, and by 50% by 2010; Identify hazardous substances for pollution prevention and waste reduction opportunities, including hazardous chemicals & persistent, bioaccumulative, and toxic pollutants.
2008 GGHC

Hospitals for a Healthy Environment (H2E)

(now forming part of Practice Greenhealth)

Founded in 1998, H2E is a voluntary program that educates health care professionals about pollution prevention opportunities in hospitals & healthcare systems, noting environmental & public health benefits in addition to reducing costs associated with waste disposal.

Successes to Date
97% of hospitals
have implemented mercury reduction/ elimination programs

72% of hospitals
have inventoried and replaced mercurycontaining devices

80% of hospitals
have implemented a waste reduction policy for all waste types

source: 2005 AHA/H2E Survey (Note: percentages refer to survey respondents)

2008 GGHC

2002 ASHE Green Healthcare Construction Guidance Statement

1 2
Protect the immediate health of building

occupants.
Protect the health of the surrounding local

community.

Protect the health of the

global community
and natural resources.

2008 GGHC

strategies overview

Chapter 1.2 Environment of Care

the built environment has a profound effect on health, productivity, and the natural environment Recognizes health cares primary mission to first, do no harm - and enhanced patient environment, employee effectiveness, and resource stewardship. Systems & Sustainable Design Referenced tools: GGHC, LEED Interdisciplinary design teams Site selection and development Natural light & views of nature Thermal & lighting control Acoustical control Waste minimization Water quality and conservation Energy conservation Indoor air quality 2008 GGHC

 Void in the marketplace of health care specific green building tool Core content transfer from existing tools (e.g., LEED) but need to tailor for healthcare Explicit health-based focus Sensitivity to an over-regulated sector voluntary best practices with no certification thresholds Reinforces integrated design as essential Bridges design & construction with operational considerations
2008 GGHC

Section / Category Name

Pre-Req. / Max. Total

LEED HC

1 2 3 4 5 6

Integrated Design Sustainable Sites Water Efficiency Energy & Atmosphere Materials & Resources Environmental Quality

7 Innovation & Design Process

2 1 1 3 2 3 0 12

0 21 6 21 21 24 4 97

6 16 5 19 14 17 NA 11 - 77

1 1 1 3 2 3

2008 GGHC

construction section

public comment draft

Section / Category Name

Pre-Req. / Total Points 1- 2 0- 9 0- 5 6 - 39 3- 5 3- 6 0- 8 0 - 14 2 - 19 0- 7 15 - 114

1 Integrated Operations & Education 2 Sustainable Sites Management 3 Transportation Operations 4 Facilities Management 5 Chemical Management 6 Waste Management 7 Environmental Services 8 Food Service 9 Environmentally Preferable Purchasing 10 Innovation in Operation

2008 GGHC

operations section

GGHC Credit Organization

Intent

Health Issues
Credit Goals Documentation Reference Standards Technologies & Strategies

2008 GGHC

GGHC Website Registration Green Guide for Health Care Website Registrants
top ten countries with international website registrants gghc website registrant growth
GGHC Website Registrant Growth
20000 18000 16000 14000 12000 10000 8000

geographic distribution

1. 2. 3. 4. 5.

Canada Australia United Kingdom India France

6. Malaysia 7. Argentina 8. Brazil 9. South Africa 10.Portugal

Release GGHC Version 2.2

18,000+ website registrants every state in the U.S. every Canadian Province 500 new registrants/month 100+ countries
Last updated April 2008

6000 4000 2000 0

Nov-03 Jan-04 Mar-04 May-04 Jul-04 Sep-04 Nov-04 Jan-05 Mar-05 May-05 Jul-05 Sep-05 Nov-05

Release GGHC Version 2.1 Pilot

Release GGHC Version 2.0 Pilot
Jan-06 Mar-06 May-06 Jul-06 Sep-06 Nov-06 Jan-07 Mar-07 May-07 Jul-07 Sep-07 Nov-07 Jan-08 Mar-08

2008 GGHC

registration overview

geographic distribution
Green Guide for Health Care Registered Projects

green guide project growth

148 registered projects 36,000,000 sf 34 states Current as of January 4 Canadian provinces 2007 7 countries Current as of April 2008

2008 GGHC

project overview

Leadership in Energy & Environmental Design

A voluntary, consensus-based standard for developing highperformance, sustainable buildings

Dollard Discovery Health Center LEED v2.0 Certified

LEED-New Construction LEED-Existing Buildings LEED-Commercial Interiors LEED-Core & Shell LEED-Homes LEED-Neighborhood Development (Pilot)

Schools Retail: New Construction (Pilot) Retail: Commercial Interiors (Pilot) Healthcare (Public comment) Campus (Under development) Labs (Under development)

www.usgbc.org
2008 GGHC

Sample LEED Certified Health Care Projects

Boulder Community Foothills Hospital (CO) LEED Silver

British Columbia Cancer Institute (BC) LEED-Canada Gold

Jewish Hospital Medical Center South (KY) LEED Silver OHSU Center for Health and Healing (OR) LEED Platinum Parrish Medical Center (FL) LEED Silver Providence Newberg Medical Center (OR) LEED Gold 2008 GGHC

340 LEED registered health care 3% of total registered projects 31 LEED certified health care 2% of total certified projects
As of April 2008

LEED for Healthcare Mission Statement

LEED for Healthcare supports sustainable planning, design, and construction of healthcare facilities by adapting the U.S. Green Building Councils LEED to respond to the unique set of opportunities and challenges presented by the healthcare sector.

By affirming healthcares fundamental mission of first, do no harm, LEED for Healthcare recognizes the profound impact of the built environment on the health of occupants, local communities, and global ecology and encourages design strategies that enhance the healing environment for patients, healthy and productive work environments for staff, and responsible ecological stewardship.
2008 GGHC

USGBC-GGHC Memorandum of Understanding

September 2007 Work together on tools, educational programs and other activities to support green health care building.
Jointly develop health care-related resource materials, education and training events Jointly identify a prioritized research agenda Continue to collaborate on developing future health care-related green building tools
2008 GGHC

Monthly Newsletter Calendar

Webinars through Practice Greenhealth on construction related sustainable design topics

2008 GGHC

registration overview

project participation and the Forum

What: Peer-to-peer forum to discuss issues and strategies Who: Health care project participants: - Health care facility project teams - Contracted design teams (architects, engineers, interior designers, etc) - Green Guide Steering Committee - Not vendor reps Where: online at www.GGHC.org

2008 GGHC

project overview

project registration is easy

Registration is all on line No cost No minimum point threshold No obligation No disclosure of project names or information without permission

2008 GGHC

project overview

www.gghc.org
a. Download a copy b. Register a project c. Sign on to the forum d. Donate to the Green Guide
2008 GGHC