Texas Hospital Turns Green

Children's Hospitals Today, Spring 2008
By Sonja Weisel

CHT Spring 2008 - Texas CH Photo 2Between cracks in the crumbling runway of the long defunct Robert Mueller Municipal Airport in Austin, TX, the idea for a “green” children’s hospital began to grow. In 2003, the city of Austin was redeveloping the airport into a sustainable, mixed use urban community, and the overcrowded Children’s Hospital of Austin was looking for a replacement facility site. The result was Dell Children’s Medical Center of Central Texas, a member of the Seton Family of Hospitals, a $200 million hospital designed to heal children without harming the environment. The facility, opened in July 2007, is striving to become the first inpatient hospital in the world to achieve Leadership in Energy and Environmental Design (LEED) Platinum Certification, the highest designation awarded by the U.S. Green Building Council.

Initially skeptical about committing to a green building initiative, Robert Bonar Jr., Dr.HA, president and CEO of Dell Children’s, was quickly convinced. “The business case is that our return on investment was six years,” Bonar explains. “But there is also a human aspect as well.” The hospital believed early that benefits to patients and families as well as the environment could be significant.

To avoid making arbitrary decisions about which sustainable components to incorporate, the hospital and its Ohio-based architectural firm, Karlsberger, established four guiding principles.

“The first principle is that we won’t do dumb things, meaning we won’t spend money if it doesn’t have a payback,” says Joe Kuspan, AIA, Karlsberger director of design and lead architectural designer for the project. “The second is that anything with less than a 12 percent return on investment is dumb. The third is that we must know we’re being dumb, which meant we had to do our research. Lastly, we identified LEED Platinum as our goal so we never settled for something less.”

Sustainable Features

CHT Spring 2008 - Texas CH PhotoAlthough plenty of green ideas, including roof mounted wind turbines and waterless urinals, didn’t make the cut, the 475,000-square-foot, 169-bed hospital embraced many others.

“The biggest hurdle was developing the mechanical, electrical and plumbing requirements to achieve the highest level of efficiency we could. Unlike an office building, a hospital runs seven days a week, 365 days a year,” says Kuspan.

To address energy needs, Dell Children’s partnered with Austin Energy to build a cogeneration plant to generate electricity and useful heat at the hospital site. Powered by clean-burning natural gas, the plant is 75 percent more efficient than coal-fired plants. Steam, a plant byproduct, is being used by the hospital as well as by neighboring buildings in absorption chillers to meet chilled water needs. Because it was less expensive for Austin Energy to build the localized plant than to upgrade existing infrastructure, the company covered the plant’s costs—saving the hospital $6 million.

Cost and impact on the environment was also reduced by recycling the airport runway for use in the building’s base, eliminating the need to haul millions of pounds of waste off site. In addition, 92 percent of construction waste was recycled.

Energy is saved through high-albedo (reflective) roofing and paving materials that help keep the building cool, high efficiency and cut-off light fixtures with occupancy sensors, low-flow plumbing fixtures, a heat recovery system, and an under floor air distribution (UFAD) system in a non-clinical area of the building.

“We did the calculations and determined the UFAD was a $250,000 premium to install,” says Kuspan. “But when you looked at the energy benefits, the payback was less than 18 months. That’s a good business decision.”

The hospital also boasts a three-acre healing garden and six interior courtyards that represent the six ecosystems found in the 46-county region that Dell Children’s serves. More important, “they are the lungs of the building,” says Kuspan. “We draw the air used to ventilate the building from the gardens rather than the rooftops. So you’re cooling 95 degree air down to 72 degrees rather than cooling 110 degree air.”

The Human Element

Green building is not only about increasing efficiency and saving money, but reducing negative impact on building occupants. That includes natural exterior lighting, which some studies show improves patient morale and decreases use of analgesics.

“With the exception of the surgery and imaging areas, you are never more than 32 feet from a window,” says Alan Bell, Dell Children’s director of design and construction, Seton Family of Hospitals. “You can always see outside, no matter what floor you’re on, if it’s raining or what time of day it is.”

The hospital reduced emission of toxic substances by using products, including carpets, paints and tiles that emit little or no volatile organic compounds, and it eliminated products that contain formaldehyde. As a result, occupant health is protected and there is no “new car” smell.

“When you walk into the building it smells like outside,” says Bell.

Broad Benefits

Community response to the hospital has been gratifying, says Bonar.

“We believe we’re going to be better off in terms of patient and family satisfaction and in patient recuperation times,” he adds. “We also believe the building is going to have a positive effect in reducing staff turnover. It has already had a positive influence on recruiting nurses and physicians.”

Other expected benefits include reduced operating and maintenance costs, improved productivity, reduced liability and an increase in philanthropic giving from donors.

The benefits are also trickling down to other communities. As a result of working on Dell Children’s, “Karlsberger established a corporate policy that all of its health care projects have to qualify for LEED certification,” says Kuspan.

It’s Not Easy Being Green

As of September 2007, Karlsberger estimated that Dell Children’s earned 52 LEED points—52 are necessary to achieve platinum status. Now the hospital is waiting to find out from the U.S Green Building Council if it reached its goal.

In the meantime, other children’s hospitals continue to plan new facilities, and Bonar predicts that some will consider striving for some level of LEED certification.

“Be careful about which green initiatives you implement,” he cautions. “Depending on your individual circumstance, some are expensive with minimal return. You want to work on initiatives that make sense and have the greatest impact and bang for the buck.”

Commitment to going green is also key.

“A hospital has to start with [sustainability] in mind on day one” says Kuspan. “It has to be integrated into the design, and you need 100 percent buy-in from owners, staff, construction managers, engineers and architects. Everyone has to understand what you’re trying to do. It’s the only way these projects can be successful.”

Sonja Weisel is a freelance writer based in Austin, TX, and a former member of the NACHRI communications staff.

Green is Good … Right?

CHT Spring 2008 - CH of Pittsburgh Photo“There are a lot of theories that green construction is a good thing, but not a lot of research,” says Roger Oxendale, president and CEO of Children’s Hospital of Pittsburgh of UPMC. Oxendale hopes to change that by partnering with the University of Pittsburgh School of Engineering to evaluate whether the hospital’s new 10-acre green campus in Pittsburgh will improve employee measures such as absenteeism and patient satisfaction and health.

Opening in May 2009, the campus will include a 296-bed, 900,000-square-foot sustainable hospital, designed by architecture firm Astorino, which will seek certified-level Leadership in Energy and Environmental Design (LEED) status. A pediatric research building will seek silver LEED status. A one-year baseline study of various measures will be taken at the hospital’s current facility and then measured again in the new, green facility.

Oxendale believes that “if the hospital can influence how patients and their families think about the environment in their homes as well as outdoors, there can be an overall improvement in health in the community.”

A $5 million pediatric environmental medical center, which will operate on the new campus, will test his theory by striving to connect the hospital’s research with the environment. For example, the center will study how the environment that kids live in influences asthma. Oxendale hopes that as the center moves forward, the research “will inform pediatric clinical treatment as well as environmental education.”