Healthcare Design - May 2021 - 36

In Focus

certification that quantifies a range of health and well-being impacts on
building occupants.
Workshop participants and survey respondents identified several
perceived barriers to the wider adoption of these rating systems by the
healthcare market, with the cost of the certification process one of the
most commonly cited. This includes not only the certification fees paid to
the rating system, which range from 5 to 6 cents per square foot, but also
the soft costs incurred by the design and construction teams for energy
modeling, commissioning, and certification services (often provided by
a third-party consultant). These services have been estimated to add $1
to $5 per square foot (with large projects at the low end and small and/or
complex phased projects at the higher).
The price for certification is often viewed as the cost above and beyond
that of a building not seeking certification. However, it's common to optimize performance of new buildings with energy modeling and commissioning, for example. In other words, the reality of the premium associated with
certification is often just the cost of a third-party certification consultant
and the fees paid to the rating system.
Lack of perceived value of certification is another obstacle, responses
showed. Owners, in particular, believe that their project teams are following many of the best practices that are defined within the rating systems and
incorporating those ideas, such as local material sourcing and construction
waste recycling, into their projects, eliminating the need to incur the cost of
certification. However, one of the key attributes of a rating system is to encourage market transformation-changing the way buildings are designed

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and constructed. In addition, third-party certification explicitly demands rigor: Incorrect products must be sent back to distributors, demolition
waste must have a legitimate recycling destination, filters must be changed in the field, monitoring must be documented. These processes
require management and time.
A N I D E A L R AT I N G S Y S T E M

Participants in the session and survey also were
asked to name the important characteristics
of an ideal third-party rating and certification
system. Participants agreed that rating system
developers will need to focus on these ideas to
grow use by the healthcare sector, particularly in
acute care hospital projects.
Be healthcare specific. The unique requirements, both regulatory and clinical, of
healthcare facilities make it challenging to
incorporate generic commercial building rating system strategies. In addition, a healthcare
tool should prioritize strategies that make the
most difference to the performance of healthcare buildings. For example, site and location issues (like access to public transit and

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Healthcare Design - May 2021

Table of Contents for the Digital Edition of Healthcare Design - May 2021