green
sustainable
be weighed against a hospital's individual needs and local
energy market. However, the willingness to think outside of
the grid and creatively work around cost constraints should
be a universal mentality, not just for the sake of clients, but for
the sake of the patients and the environment.
Redefine ROI to reflect true sustainability
Embracing renewable energy and renewable energy partnerships requires a more holistic definition of ROI encompassing environmental and social effects and the long-term costs
of those ramifications. This definition of ROI should echo
the World Commission on Environment and Development's
definition of sustainability — "meeting the needs of the present
without compromising the ability of future generations to meet
their own needs." Many hospitals do not need solar power to
meet the needs of the present generation — electrical power is
available, and it is cost-competitive. However, in the long term,
relying solely on electrical power could impair a hospital's
ability to meet future financial needs as utility costs rise, and to
fulfill future environmental needs of the population at large, as
hospitals continue to produce greenhouse gases with alarming
rapidity.
GS&P;'s entry in Kaiser Permanente's "Small Hospital, Big Idea"
design competition proposed a utility partnership to reduce the
first costs of solar installations.
To avoid future deficit, look at both soft and hard costs
when calculating ROI throughout a facility's lifecycle. Typical
lifecycle cost analysis includes acquisition, operations and
maintenance and disposal costs, all hard costs with tangible
price tags. Soft costs would include factors like staff productivity, absenteeism, patient recovery times and medical errors.
For example, adding daylight wells can cost more upfront.
However, according to many Evidence-Based Design studies, increased daylight can improve recovery times, patient
satisfaction scores, staff stress levels and absenteeism
and turnover rates. Long term, these benefits can certainly
outstrip initial costs, especially considering that construction
costs represent about 15 percent of a building's lifetime cost,
while staff represents the largest portion.
Beyond the numbers, there is a social and moral duty to
consider how decisions impact the overall health of the community and environment. That responsibility encompasses the
pursuit of renewable energy sources to decrease CO2 emissions and attendant health complications. While working to
lower CO2 emissions, however, there is a second responsibility
— keeping costs down and making healthcare more affordable. Decisions based on ROI affects the financial bottom line,
the patient healing environment, hospital staff environment and
the environment, healthcare or otherwise, that future generations must live with. It's time to think more creatively.
Michael Compton, LEED AP BD+C, is a designer in Gresham, Smith
and Partners' healthcare market. He is a strong proponent of sustainable design practices and teachings and has taught university-level
classes on sustainable architecture and design.
(1) Jacobson, Mark Z. "On the causal link between carbon dioxide and air
pollution mortality." Geophysical Research Letters 35.3 (2008).
(2) "Kaiser Permanente Thrives on PG&E; Partnership." Pacific Gas & Electric
Company. September 2009. www.pge.com/includes/docs/pdfs/mybusiness/
energysavingsrebates/incentivesbyindustry/healthcarebio/C-5113.pdf
(3) Parkinson, Giles. "UBS: Boom in unsubsidised solar PV flags energy
revolution." Renew Economy. 23 January 2013. http://reneweconomy.com.
au/2013/ubs-boom-in-unsubsidised-solar-pv-flags-energy-revolution-60218
(4) Brazilian, Morgan, et. al. "Reconsidering the Economics of Photovoltaic
Power." Bloomberg New Energy Finance. London, UK, 2012.
40 Medical Construction & Design | November/December 2013
www.mcdmag.com