Sustainable Healthcare Architecture

Robin Guenther, Gail Vittori

• Publisher: Wiley
• Year: 2013
• ISBN:
  9781118416112
• Edition: 2
• Topic: Arquitectura
• Subtopic: Sostenibilidad en la arquitectura

"With this book, Robin Guenther and Gail Vittori show us how critical our green building mission is to the future of human health and secures a lasting legacy that will continue to challenge and focus the green building movement, the healthcare industry, and the world for years to come."
—From the Foreword by Rick Fedrizzi, President, CEO and Founding Chair, U.S. Green Building Council

INDISPENSABLE REFERENCE FOR THE FUTURE OF SUSTAINABLE HEALTHCARE DESIGN

Written by a leading healthcare architect named one of Fast Company 's 100 most creative people in business and a sustainability expert recognized by Time magazine as a Green Innovator, Sustainable Healthcare Architecture, Second Edition is fully updated to incorporate the latest sustainable design approaches and information as applied to hospitals and other healthcare facilities. It is the essential guide for architects, interior designers, engineers, healthcare professionals, and administrators who want to create healthy environments for healing.

Special features of this edition include:

• 55 new project case studies, including comparisons of key sustainability indicators for general and specialty hospitals, sub-acute and ambulatory care facilities, and mixed-use buildings
• New and updated guest contributor essays spanning a range of health-focused sustainable design topics
• Evolving research on the value proposition for sustainable healthcare buildings
• Profiles of five leading healthcare systems and their unique sustainability journeys, including the UK National Health Service, Kaiser Permanente, Partners HealthCare, Providence Health & Services, and Gundersen Health System
• Focus on the intersection of healthcare, resilience, and a health promotion imperative in the face of extreme weather events
• Comparison of healthcare facility-focused green building rating systems from around the world

Sustainable Healthcare Architecture, Second Edition is an indispensable resource for anyone interested in the design, construction, and operation of state-of-the-art sustainable healthcare facilities.

PART 1
CONTEXT

Chapter 1
DESIGN AND STEWARDSHIP

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The standard for ecological design is neither efficiency nor productivity but health, beginning with that of the soil and extending upward through plants, animals, and people. It is impossible to impair health at any level without affecting it at other levels. The etymology of the word “health” reveals its connection to other words such as healing, wholeness, and holy. Ecological design is an art by which we aim to restore and maintain the wholeness of the entire fabric of life increasingly fragmented by specialization, scientific reductionism, and bureaucratic division.
DAVID ORR

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INTRODUCTION

What does stewardship mean, and what is the role of the design disciplines in furthering and developing this idea? The stewardship model of responsibility has its foundation in theological writings on the relationship between humans and the natural world—hence its prominent position in many of the mission statements of faith-based healthcare organizations. At many such organizations, stewardship of God-given natural resources has been reinterpreted in the modern era to include promotion of human health. Such an expanded view leaves the design industries a correspondingly broad role in terms of stewardship.

The concept of resource stewardship is pivotal in sustainable, or “green,” design as it is currently defined and practiced throughout the design disciplines. The design of hospital buildings (as cultural artifacts) can be viewed as an important component of the larger practice of the design of habitats for humans—in this case, healing habitats. For the last half-century, however, the design of hospital buildings has been remarkably independent of the broader trends in architectural design. As a particular typology, healthcare architecture has evolved in a world apart, responding, for the most part, to industry trends in technology and ever-more complex life-safety regulations. Until recently, healthcare owners, architects, and engineers have been unaware of the impact that sustainable design concerns have had on the larger design industry.

Environmental stewardship is a defining principle of sustainable architecture, as the essayist and commentators in this chapter eloquently state. Architect Bill Valentine, FAIA, postulates below that “less is better” and challenges design professionals to reconsider scale and deliver better, healthier buildings using less. Designer and educator Pliny Fisk III presents an expanded definition of lifecycle design, one that postulates a “new ecology of mind,” which joins together architecture and neuroscience. In his essay, designer Jason F. McLennan challenges design to redefine itself as no less than “living” for our buildings, our health, and the planet. The scientific community is in general agreement that Finally, architect Bob Berkebile, FAIA, challenges us to human activity now exceeds the global carrying capacimagine a “restorative” and “regenerative” future, a concept further explored in the final chapter.

The sustainable design movement, through such leaders as Paul Hawken, Amory Lovins, and L. Hunter Lovins, has given us new lenses for viewing the economy: Natural Capitalism: Creating the Next Industrial Revolution (2000) and The Ecology of Commerce (1993). The parallel ideologies of “clean production” and William McDonough and Michael Braungart's “cradle to cradle” are having significant impacts on building materials science, from revolutions in the petrochemical components of our material economy to end-of-life ideas such as “waste equals food.” Science writer Janine Benyus, in Biomimicry: Innovation Inspired by Nature (1997), points to a future when science will look to nature for inspiration and technology—and an impressive roster of corporations and designers who have adopted biomimicry principles in their research and applied them to products is testament to that future becoming reality (Biomimicry 3.8, 2012). Just outside the silo that defines the current practice of healthcare architecture, notions of planetary stewardship linked to health are fundamentally redefining the design and production of the built environment.

THE CASE FOR STEWARDSHIP

The scientific community is in general agreement that human activity now exceeds the global carrying capacity of the Earth's ecosystems, and that those ecosystems are rapidly degrading. The United Nations' Millennium Ecosystem Assessment, released in 2005, chronicles the continued degradation of the natural environment, amplifying the growing awareness that healthy people cannot live on a sick planet. The Ecological Footprint Atlas (Ewing et al. 2010) and the World Wildlife Fund's Living Planet Report (2010) estimate the world's economies are overshooting their capacity for natural resource regeneration by 50 percent (see Figure 1.1). While much of the discussion on finite global resources has focused on the depletion of nonrenewable resources, such as petroleum, it is increasingly evident that renewable resources, and the ecosystem services they provide, are also at great or even greater risk (Ewing et al. 2010).

Figure 1.1 In 2007, humanity's total ecological footprint worldwide was 18.0 billion global hectares (gha); with world population at 6.7 billion people, the average person's footprint was 2.7 gha. But there were only 11.9 billion gha of biocapacity available that year, or 1.8 gha per person. This overshoot of approximately 50 percent means that in 2007 humanity used the equivalent of 1.5 Earths to support its consumption.

Source: Global Footprint Network and UNDP, 2010

Environmentalist and writer Bill McKibben (1989) contends that there are no longer any ecosystems on Earth uninfluenced by humans. “Anthropocene,” a term introduced in 2000 by Nobel Prize laureate Paul Crutzen and ecologist Eugene Stoermer, describes our current geological epoch as fundamentally defined by the influence of human activities (Crutzen and Stoermer 2000). The Living Planet Report (2010) reports general decline in global biodiversity from 1970 to 2007 as follows:

• 37 percent decline in temperate and topical freshwater ecosystems
• 24 percent decline of marine life
• percent decline in terrestrial plant and animal species

From 10 to 15 percent of the Earth's land surface is dominated by agriculture and urban development. Close to 50 percent of the Earth's land mass has been transformed by humans. Humans consume more than 40 to 50 percent of all available freshwater (in the Middle East, consumption is estimated to be 120 percent); 25 percent of the Earth's land surface is cultivated. Furthermore, the globalization of nature—that is, the introduction of nonnative species in unfamiliar ecoregions—has disastrously weakened functioning ecosystems (Millenium Ecosystem Assessmen...