Mission Bay facility’s quest to be greener

Here key project participants Alisdair McGregor and Afaan Naqvi, of the San Francisco offices of Arup, and Tyler Krehlik of Anshen+Allen, describe how a rigorous planning and design process should result in the new UCSF Mission Bay Hospital meeting tough environmental goals, while providing a highly therapeutic environment that stimulates and speeds patient recovery.

Sustainability in healthcare has unique opportunities and challenges. The emissions from energy use and construction materials have been shown to have negative impacts on the general population’s health. If we follow the principle of “first do no harm”, then we should endeavour to eliminate any negative impacts that our hospital designs have on health. We have opportunities to improve healthcare delivery through better design, for example through better access to daylight, reducing the risk of airborne infection transmission, and more therapeutic environments. We might define a sustainable healthcare facility as one that minimises the negative health impact on the surrounding environment while promoting healthy outcomes for patients and staff. This is a different approach to merely defining sustainability as a LEED rating. The Green Guide for Health Care has gone some way to incorporating the specifics of the healthcare environment into a LEED-like rating system, and this system can indeed give a more appropriate measure of healthcare sustainability than LEED. These different metrics for sustainable hospitals can be confusing, but, as detailed further in this article, we considered all of these measures in the early stages of planning of the UCSF Mission Bay Hospital in San Francisco, and incorporated them into a projectspecific sustainability plan. US hospitals have very high energy use. Data from the 2003 CBECS energy survey shows US inpatient hospitals averaging 250 kBtu/ft2/year. This compares with a rate for typical US commercial office buildings of 93 kBtu/ft2/year. Comparison against hospitals in Sweden, which have energy use of around 70 kBtu/ft2/year, shows that we have a long way to go on energy reduction for US healthcare facilities. Although the cost of energy is small compared with staff costs, energy costs are still significant in a low profit margin business. For a typical healthcare provider operating at a 5% profit margin, every dollar of wasted energy cost requires $20 of new revenue generation.

Dominated by space heating