Healthcare Design - October 2019 - 26

KIM SHINN

Title: Principal, Sustainability Wizard
Firm: TLC Engineering Solutions
Location: Nashville

S U S TA I N A B L E D E S I G N C H A L L E N G E : P R O V I N G
T H E VA L U E O F L E E D

Some healthcare system owners ask for projects to be designed
and constructed to LEED standards, but not to go through with
certification. Owners follow this "LEED-lite" path because
they, mistakenly, believe that the modest cost of certification
is not worth the return on investment (ROI). However, it's important to note that the current cost of LEED registration and
certification reviews is less than 75 cents per square foot of
conditioned area. That's less than three-tenths of one percent
of an even modestly priced MOB project-it's a rounding error.
WHY IT'S AN ISSUE

Without the rigor of third-party review and certification, projects inevitably will fall short of the LEED criteria in the various fields of construction waste management, material transparency, indoor environmental quality, habitat restoration and preservation, and water and
energy performance. Additionally, independent third-party reviewers
are not susceptible to the pressures of schedule and budget, as are the
team members. It's simply too easy, convenient, and, frankly, human to
take a path of lesser resistance when faced with an obstacle. For example, let's say specifications call for a finish system to disclose its material
ingredients and a system with this documentation has a delivery time of
six weeks but the project schedule is only five weeks from completion.
It's all too easy to substitute another option with a four-week delivery but
that doesn't have the material disclosure documentation.
Projects that fail to meet the LEED criteria simply will not perform
as well as a LEED-certified project. And falling short means that these
uncertified (and uncertifiable) projects have the greater potential to degrade the environment, adversely affect their occupants and users, and
consume more non-renewable resources, such as energy and water, than
their LEED counterparts.
THE SOLUTION

Invest in third-party certification. Invest is the operative word because
projects do get a return on that investment. Some returns, particularly in
water and energy, are more tangible than others because they impact the
bottom line. But projects also will get returns in healthier environments
for staff, patients, and visitors through better access to daylight and views
to nature; fewer toxic chemicals in finishes and furnishings; and quieter,
acoustically calmer rooms and corridors.
Another rumor often heard in arguments against the value of certification is that LEED requires project teams to expend more work on docu-

26

OCTOBER 2019

HCDMAGAZINE.COM

mentation. This is simply not true if the project
team is performing the scope of work required
by contract. LEED requires essentially no more
submittal documentation than is required for
a licensing or code review, or in shop drawing
review, and in many cases less than is required
in some more rigorous jurisdictions, such as
California's Office of Statewide Health Planning and Development or Florida's Agency for
Health Care Administration.
Another typical bogeyman is the expense of
an energy model to assess energy performance
or commissioning to confirm proper building
operations before occupancy. With the rise of
rigor of the energy code, particularly since the
adoption of 2012 IECC and ASHRAE 90.1-2010,
teams that don't follow the performance path
(where an energy model is used to demonstrate
that the designed building uses less energy than
a standard reference building) will invariably
spend more of the owner's money if they follow
the prescriptive path. Why? For inpatient occupancies in some climate zones, the code usually
mandates higher-than-optimal envelope insulation values. These prescriptive insulation
levels will trap heat inside the building during
mild outdoor conditions, raising the air-conditioning energy. Instead, we find that energy
modeling, particularly when used by the project team during early design, saves both capital
and operating cost through reduction of envelope and system sizes, as compared to following
design practices and rules-of-thumb that predate energy codes of the last decade.
Commissioning, including that of the envelope, is another place where the ROI has been
well documented to have simple paybacks that
are often less than a single year. In particular,
the monitoring-based commissioning now in
LEED v4 is a great tool for operations personnel to identify energy performance hiccups before they turn into unexpectedly high energy or
water bills.
We practice in an industry that places a lot of
stock in certifications. When you sit in your doctor's office and look at the certificates on his or
her walls, doesn't it improve your confidence in
the person's abilities? How would it make you
feel to find out your surgeon trained in a program that was modeled on an accredited program but decided to save money by not bothering with the accreditation? We should hold the
same standards to building certification.


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Healthcare Design - October 2019

Table of Contents for the Digital Edition of Healthcare Design - October 2019

Healthcare Design - September 2019
Contents
EDITORIAL
SHOW TALK
DRAWING A CONNECTION
TAKE FIVE
DESIGN ACCELERATOR
FIRST LOOK
RISING UP
2019 HCD EXPO PREVIEW
STAFF SATISFACTION
PRODUCT SPOTLIGHT
THE CENTER
FACE TIME
Healthcare Design - October 2019 - Intro
Healthcare Design - October 2019 - Healthcare Design - September 2019
Healthcare Design - October 2019 - Cover2
Healthcare Design - October 2019 - 1
Healthcare Design - October 2019 - 2
Healthcare Design - October 2019 - Contents
Healthcare Design - October 2019 - 4
Healthcare Design - October 2019 - 5
Healthcare Design - October 2019 - 6
Healthcare Design - October 2019 - 7
Healthcare Design - October 2019 - 8
Healthcare Design - October 2019 - EDITORIAL
Healthcare Design - October 2019 - SHOW TALK
Healthcare Design - October 2019 - 11
Healthcare Design - October 2019 - 12
Healthcare Design - October 2019 - DRAWING A CONNECTION
Healthcare Design - October 2019 - 14
Healthcare Design - October 2019 - TAKE FIVE
Healthcare Design - October 2019 - DESIGN ACCELERATOR
Healthcare Design - October 2019 - 17
Healthcare Design - October 2019 - FIRST LOOK
Healthcare Design - October 2019 - 19
Healthcare Design - October 2019 - RISING UP
Healthcare Design - October 2019 - 21
Healthcare Design - October 2019 - 22
Healthcare Design - October 2019 - 23
Healthcare Design - October 2019 - 24
Healthcare Design - October 2019 - 25
Healthcare Design - October 2019 - 26
Healthcare Design - October 2019 - 27
Healthcare Design - October 2019 - 28
Healthcare Design - October 2019 - 29
Healthcare Design - October 2019 - 2019 HCD EXPO PREVIEW
Healthcare Design - October 2019 - 31
Healthcare Design - October 2019 - 32
Healthcare Design - October 2019 - 33
Healthcare Design - October 2019 - 34
Healthcare Design - October 2019 - 35
Healthcare Design - October 2019 - 36
Healthcare Design - October 2019 - STAFF SATISFACTION
Healthcare Design - October 2019 - 38
Healthcare Design - October 2019 - 39
Healthcare Design - October 2019 - PRODUCT SPOTLIGHT
Healthcare Design - October 2019 - 41
Healthcare Design - October 2019 - 42
Healthcare Design - October 2019 - 43
Healthcare Design - October 2019 - 44
Healthcare Design - October 2019 - 45
Healthcare Design - October 2019 - 46
Healthcare Design - October 2019 - 47
Healthcare Design - October 2019 - THE CENTER
Healthcare Design - October 2019 - 49
Healthcare Design - October 2019 - 50
Healthcare Design - October 2019 - 51
Healthcare Design - October 2019 - 52
Healthcare Design - October 2019 - 53
Healthcare Design - October 2019 - 54
Healthcare Design - October 2019 - 55
Healthcare Design - October 2019 - FACE TIME
Healthcare Design - October 2019 - Cover3
Healthcare Design - October 2019 - Cover4
Healthcare Design - October 2019 - HDC1
Healthcare Design - October 2019 - HDC2
Healthcare Design - October 2019 - HDC3
Healthcare Design - October 2019 - HDC4
Healthcare Design - October 2019 - HDC5
Healthcare Design - October 2019 - HDC6
Healthcare Design - October 2019 - HDC7
Healthcare Design - October 2019 - HDC8
Healthcare Design - October 2019 - HDC9
Healthcare Design - October 2019 - HDC10
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