Healthcare Design - August 2013 - 11

STUDY

CHILDREN'S HOSPITALS AND CLINICS OF MINNESOTA (STORYLAND GARDEN); AMERICAN AERIAL PHOTOS (HILLSBOROUGH)

Green healthcare design
doesn't have to cost more
Five years ago, the study "Demystifying First Cost Green
Building Premiums in Healthcare" was released, showing that the capital cost premium for green healthcare
design was 2.4 percent. "At the time, there were a lot
of questions about [green and costs]," says Gail Vittori,
co-director, Center for Maximum Potential Building
Systems. "We thought the findings would help to be a
myth-buster."
Yet, despite the data and an increasing number of
completed projects that have earned LEED certification,
concern over cost premiums continued to persist. So
Vittori decided to revisit the topic, partnering with Robin
Guenther, principal, Perkins+Will (who was involved in
the 2008 study), and Breeze Glazer, associate, research
knowledge manager, Perkins+Will.
The updated study used a new set of hospital projects, all of which were completed between 2010 and
2012, and were LEED certified for New Construction by
the U.S. Green Building Council. The 15 certified projects represented a range of sizes and geographic locations, as well as new construction and major additions.
The team, which will present its findings during the
Healthcare Design Conference (Nov. 16-19, Orlando)
in the session "LEED Certified Hospitals: Perspectives
on Capital Cost Premiums and Operational Benefits,"
conducted interviews with project design teams and
gathered additional input from three national construction firms. So what did they find? "The averages were
similar, with some slight variation, but it basically ranged
from 0 to 5 percent," Vittori says.
In fact, the report states that for the 13 sample
hospitals greater than 100,000 square feet, the average
capital cost green premium was less than 1 percent,
while the smaller hospitals reported an average capital
cost green premium of 2.1 percent.
So why does the cost concern persist? "For healthcare, green is still relatively new," Vittori says. "Even with
the evidence-based data we're providing, people hold
onto this concern. It's kind of the risk-averse nature of
healthcare, perhaps."
While the study looked at one aspect of the building
value proposition, the authors say there's a lack of
operational benefit data from completed facilities. In
the report, only 29 percent of the 15 sample hospitals
reported to have completed a post-occupancy evaluation. "We need to get better at teasing out the results,"
Glazer says. "To a certain degree, owners are going
on faith or anecdotal evidence of the benefits of these
buildings, but we need to provide the data to help that
increase go further."
For more information on the
session, visit www.healthcare
designmagazine.com/conference.
-AD

BIM digs deep to provide savings

An aerial view of
the University of
North Carolina
Hospital's
Hillsborough
Campus project.

Most project teams rely on building information modeling (BIM)
to assist in planning, designing, and troubleshooting a project's
above-ground systems. But for the University of North Carolina
Hospital's Hillsborough Campus project, Skanska (Parsippany,
N.J.) focused the technology underground, where it was used
to provide rock evaluation for site preparation and coordinating
underground utilities.
This four-phase, $156 million project on a greenfield site includes
a three-story MOB, 14,000-square-foot central energy plant, and a
241,574-square-foot patient tower and treatment building.
To establish the existing below-ground conditions, the project team
worked with a site surveyor on the building footprint and the location
of the underground utilities, and hired a boring contractor to perform
exploratory drilling in the proposed path of the water and sanitary
piping, storm utility, gas lines, and duct banks. The data was added to
the CAD drawings to show the team the rock elevations, and then was
used to develop a 3-D model. Findings showed that some of the original proposed routes for utilities would clash with rock. "We were 30
to 40 feet below grade with trench rock, which was very expensive [to
excavate]," says Al Painter, project executive at Skanska. "So we talked
to the owner and the design team about relocating the lines from the
rear of the project to the front of the building to incur less rock."
This adjustment saved the project more than $300,000 and eliminated more than 100 clashes between multiple site utilities, site utilities
and rock, and site utilities and unforeseen conditions.
The team also used the BIM model to determine that raising the
basement layer on the buildings up from 20 feet to 18 feet in floor-tofloor height would bring even further savings. "You still have to mass
excavate, but by reducing the basement height, you're actually raising
the level of the basement so you're excavating less rock," Painter says.
With three of the four phases completed, the design team is now
working on the hospital, which is expected to be operational in July
2015. The readjusted basement height, however, means there's less
available square footage between floors than the original proposal.
"We're now faced with the challenge that we have less space and we're
trying to coordinate above-ceiling utilities," Painter says. "That's where
the modeling really helps out."-AD

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Healthcare Design - August 2013

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