Healthcare Design - May 2023 - 34

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it is a fundamental shift in the way project teams
approach the planning and design of healthcare
facilities of all scales.
Here are examples of how any organization
can consider these categories and KPIs when approaching
healthcare projects.
TOWARD A REGENERATIVE FUTURE
Because large hospitals are now expected to
last half a century or longer and many are not
going to open until up to a decade after conception,
they must be prepared for the unforeseeable.
This means that these facilities should be
designed to flex and adapt not only for advances
in care delivery and technology, but also for the
needs of our communities and the environment.
Like nature, our hospitals need to be able
to evolve over their lifecycle to help us realize a
regenerative future.
So how do we do this? There are strategies
that project teams and healthcare organizations
can consider now to work toward a regenerative
future, starting with establishing
carbon neutrality targets. If we have any hope
of meeting the Intergovernmental Panel on
Climate Change's target of limiting planetary
warming to 1.5 °C above pre-industrial levels,
then we must immediately shift away from fossil
fuels. Many health systems are leading in
this by establishing targets to achieve carbon
neutrality by 2025 through efficiency, electrification,
carbon offsets, and other non-fossil
fuel-based energy sources such as fuel cells and
biogas (renewable energy produced from the
breakdown of organic matter).
Project teams can help clients toward these
targets using carbon-balancing, a strategy that
aims to cut carbon through building techniques
and approaches that negate carbon emissions,
and by designing projects that result in zero
carbon emissions for both building operations
and the embodied carbon emissions associated
with construction. The first big step in this process
is removing operational carbon through
building and campus electrification. HDR is currently
designing several all-electric hospitals at
every scale-from large, urban medical centers
to small, rural community hospitals. Though
some organizations may not be ready to go all
electric now, the industry can prepare these facilities
to change in the near future by planning
and utilizing systems that are more easily convertible
to electricity. For example, some preparatory
measures can include structural and
electrical infrastructure for future rooftop solar
34
MAY 2023
photovoltaic systems and mechanical space for electric heat recovery chillers
to offset forms of mechanical heating.
Outside the building structure, project teams can prepare for future electrification.
This involves planning space for on-site green hydrogen storage
to replace diesel backup power, air-cooled electric heat pumps to replace
combustion-based indoor boilers, and geo-exchange systems that retrieve
and store heat from the earth. Additionally, assessments and studies on future
energy storage potential and electrical load demands are vital to understand
what's needed to make electrification possible.
The next step toward zero operational emissions is improving efficiency
and driving down energy use as much as possible. Strategies to achieve
this include detailed façade analyses to minimize solar loads and glare,
using more efficient systems like chilled beams and displacement ventilation
that better support human comfort, installing lighting systems with
controls and circadian rhythm measures, and designing for flexibility to
adapt to newer and more efficient technologies in the future. These systems
should also help mitigate the challenges presented by climate change,
which may include increased heat events, increased unhealthy air quality
days, and risks to water supplies.
With the goal being to eliminate the harmful emissions that drive climate
change and influence many community health impacts, the industry
needs to carefully look at hospital infrastructure and how the entire
campus system can unify to work toward regeneration. This requires addressing
embodied carbon emissions by reusing existing buildings whenever
possible. Where new construction is necessary, buildings should be
designed to use less materials. Projects can target those materials that have
the highest impacts-notably concrete and steel-by considering alternatives
like mass-timber or by maximizing material carbon sequestration
opportunities like carbon dioxide mineralization in concrete. Additionally,
the industry needs to ask manufacturers to limit the carbon associated
with their materials and reward those that do by using their products.
BENEFITTING THE ECOSYSTEM AND COMMUNITY
Supporting the human-nature relationship means integrating with and
improving the ecosystem that surrounds the built environment. In planning
and designing new projects, it's important to retain or develop biodiverse
environments, which can be achieved through a variety of measures
such as the re-naturalization of a landscape with native plantings or creating
fauna-friendly and bird-safe designs.
Typically, hospital towers are surrounded by parking. Project teams can
SUPPORTING THE HUMANNATURE
RELATIONSHIP MEANS
INTEGRATING WITH AND
IMPROVING THE ECOSYSTEM
THAT SURROUNDS THE BUILT
ENVIRONMENT.
HCDMAGAZINE.COM
employ the help of an arborist or an ornithologist to better understand
how landscape design can positively impact the future of each unique site
and reduce or eliminate the negative impact on wildlife that live there. In
many cases, certain native plantings should be retained; however, on other
occasions, non-native invasive species must be removed and replaced to
restore the natural environment. Green
space is critical, but the correct species for
the location and fauna are even more critical
for biodiversity. At the Orleans Health
Hub in Ontario, the decision was made to
reintroduce long grass meadows and native
plants to re-naturalize the landscape and
surrounding area.
By integrating green facades and green
roofs into our buildings, we not only provide
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