The United States Green Building Council (USGBC) develops and administers the Leadership in Energy and Environmental Design (LEED) rating system. LEED is a voluntary point based system that covers five main areas of sustainable design including site, water, energy, materials, and indoor environmental quality. Based on the total number of points achieved, various levels of certification are awarded and these levels are: Certified, Silver, Gold and Platinum. For each credit category, specific minimum criteria are established and the project team determines which measure applies to a project. Additionally, the rating system has several “prerequisites” that are mandatory requirements and not electives. To achieve LEED certification, a hospital project requires a dedicated project team that is fully committed to integrated project delivery and a creative design approach.
As of early 2012, all new construction and major renovation projects for hospitals, medical office buildings, clinics and other health related buildings that are seeking LEED certification must be registered and follow the LEED for Healthcare Rating System (LEED-HC). This rating system contains most of the criteria under the more common LEED for New Construction (LEED-NC) rating system but has a few additional elements that are specific to sustainable hospital design.
These include (prerequisites are mandatory, others are voluntary):
1. (prerequisite) Environmental Site Assessment
2. (prerequisite) Minimal potable water use for medical equipment
3. (prerequisite) Source reduction strategies for Mercury reduction
4. (prerequisite) Integrated planning and design
5. Connection to the natural world (places of respite)
6. Connection to the natural world – direct access for patients
7. Water use reduction
- Measurement and verification plan
- Building equipment
- Cooling towers
- Food waste systems
8. Contaminant prevention – airborne releases
9. Contaminant reduction strategies
- Mercury in lamps
- Lead, Cadmium and Copper
10. Furnishing and medical furnishing (material based)
11. Flexible design (future adaptation)
12. Acoustic performance (background noise)
13. Low emitting materials (enhanced requirements over LEED-NC)
Advancements in Healthcare operations, high performance green building technologies, and the tools used to optimize performance have increased sharply, especially over the last decade. At a basic level, the LEED-HC rating system is a platform from which these elements can be addressed, undergo feasibility study, and be included into the owner’s project requirements. All of the LEED credits, typically listed in a checklist, are based on current applications and technologies and typically have underlying benefit to the owner, the users, the community and the environment. Many credits are not suitable for a specific project and it is the charge of the project team to determine what applies, and just as importantly, what does not apply.
It can be difficult to take in the entire LEED rating system in one sitting. As it is a process, the introduction of LEED related credits (or sustainability) into design development involve an element of analysis and discovery. Therefore, it is a prudent approach, before quickly deciding whether or not to pursue LEED certification, to allow that discovery process to mature over the course of the design and starting as soon as possible. Since the LEED checklist can introduce certain sustainability ideas (which are often just plain good ideas) the project team has a resource for determining what measure, or approach, applies to a particular project. This is also the time to introduce modern design concepts and tools such as integrated project delivery, energy simulation, daylight analysis, building science principles, and facility management implications to the design process.
The result of steering the design process towards an exceptional level of energy, environmental and indoor quality performance is a building with reduced energy costs, noticeably better indoor environmental quality, and with optimum facility management capability and achieved within a budget that is acceptable to the owner. This result is the essential intent of the LEED rating system. Once the owner’s project goals are determined and the project team has a defined path forward, then a decision to pursue LEED certification can be made and from that point, the exercise becomes mostly an administrative exercise for preparing the necessary submittal documentation.
