Thoughts on Greenbuild 2013: Rethinking Healthcare Design


In recent months, two notable events on sustainable design and construction took place in Philadelphia.  You may have heard about one, even attended yourself.  Greenbuild® is the U.S. Green Building Council’s (USGBC®) annual convention which draws approximately 30,000 attendees yearly from around the world, and it was at our own Convention Center this year.  The other event, a summit on sustainable design in Higher Education and Healthcare was hosted by the USGBC’s local chapter at the end of October, a precursor to what we could expect at Greenbuild.

Several key staff members from CMA attended the events to build on their “green” knowledge and increase their exposure to new products and technologies.  Following is a brief commentary on issues specific to green healthcare design and construction addressed at these events.


Do Buildings Work Well for their Occupants?

At the October summit, Chris Pyke, Director of Research for the U.S. Green Building Council, delivered the keynote speech from which emerged the message that health, wellness, and experience are driving sustainable design practices.  He asked, “Do buildings work well for their occupants?”  Healthcare facilities have the unique quality of being places where ill and well people commingle for the purpose of improving health and, therefore, are ideal opportunities for implementing strategies to create buildings that are active in the service of increasing well-being.  Mr. Pyke challenged us to go beyond energy conservation; don’t stop at Net Zero buildings, he said.  Create buildings that engage occupants and foster positive experiences.  Intentionally design for wellness.

It was but one message, an old one, which also came out of Greenbuild; but it is a message that has constant relevance and modest virtue.  Health, wellness, and experience are themes that reverberated throughout educational sessions and presentations, many of which focused on the newly revised version of LEED, v4.  With the launch of LEED v4 comes the revised version of LEED® for Healthcare.  LEED® rating systems have always promoted health, wellness, and experience by virtue of their being designed to generate buildings that perform better, not only in their use of energy but also in the effects they have on their occupants.

Going Within and Out to Heal

Credits within the LEED for Healthcare rating system that specifically promote health, wellness, and experience, notable because they have these goals as their sole purpose, encourage us to create spaces that draw us out of the sterile confines of exam rooms and endless corridors and into natural environments outdoors and stimulating interior spaces.  “Places of Respite” and “Direct Exterior Access” are two credits designed for this purpose.  They speak to the complexity of healing, recognizing that for many conditions, the hospital bed isn’t enough.

Buildings with these features have intangible benefits that may go unnoticed due to the difficulty of tracking them but are nonetheless vital to the complete success of a high performance building and organization.  Some benefits that were noted by various presenters on sustainable design in healthcare are reduced absenteeism, improved staff recruitment and retention, a stronger public image for the Owner, and getting recognized as leaders in the community for exemplary, thoughtful building practices.

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Flexible Space

Another subject addressed at Greenbuild and mentioned during the October summit that has been trending in healthcare design discussions is the flexibility of interior space in existing facilities.

During the summit, a panelist stated that “contractors deal with 19th century materials in 21st century hospitals.”  It was meant to raise awareness of the difficulty in adapting existing hospital space to new needs and technologies due to common methods of construction.  He challenged designers to rethink the nature of interior design in healthcare environments; to learn how other industries achieve flexible design.  How can we design and build for the inevitable change of use in existing healthcare facilities, he asked.  Regrettably, the question was left on the table for the rest of us to ponder as the panel wrapped up soon after.

Yet his reference to 19th century materials suggests that our traditional means of building interior spaces with metal framing and gypsum board yields too permanent of a space for facilities that need to adapt to changing procedures, staffing, and advancements in technologies.  Use of demountable partitions, an alternative to our common means, may alleviate the permanence.  Although in a small renovation, it would have the unfavorable effect of driving up cost.  It’s a matter of scale.  LEED for Healthcare under the Design for Flexibility Credit calls for the use of demountable partitions for 50% of applicable areas.  This isn’t practical for renovations to small areas when such projects are sourced singly; it is applicable to large scale projects, mainly new facilities.  This latter point was raised often as a general observation of LEED for Healthcare by designers who have attempted to implement the rating system in renovation projects.  It’s a valid point; yet is it a fault with LEED for Healthcare, or a fault with how small projects are executed?  It raises a question about the role procurement plays in the realization of small projects in large facilities.

Another means by which LEED for Healthcare encourages flexibility of interior space is with the use of movable and modular casework.  If such features are used along with demountable partitions within and adjacent to soft spaces like administrative and storage areas, near clinical areas that anticipate growth, as LEED recommends, then renovations may be less disruptive, less destructive, and completed faster.

Occupants’ health, wellness, and experience, and the practice of designing for flexibility are only a few subjects of many that were addressed during Greenbuild and various events leading up to it.  They are critical issues that matter to the healthcare community and those of us responsible for helping it realize their formal expression and implementation.

For additional information on CMAgreen Sustainable Design and Consulting, please contact Matt Perna, AIA, LEED + AP at 215.925.6565 or email us at

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