Stand-alone health care buildings: Sustainability

Stand-alone medical buildings and specialized treatment facilities are engineering challenges, and more are being designed and built due to changes in health care requirements. Sustainable design often is top-of-mind for engineers, owners, and clients.


Neal Boothe, PE, Principal, exp, Maitland, Fla. Courtesy: expDouglas T. Calhoun, PE, Senior Vice President, WSP | Parsons Brinckerhoff (formerly ccrd), Dallas. Courtesy: WSP | Parsons BrinckerhoffCaleb Haynes, PE, Principal/Director, TME LLC, Birmingham, Ala. Courtesy: TME LLC

Brian Kolm, PE, Team Leader, Mechanical, HDR Inc., Omaha, Neb. Courtesy: HDR Inc.Craig Kos, PE, LEED AP, Vice President, Environmental Systems Design Inc., Chicago. Courtesy: Environmental Systems Design Inc.Bryan Laginess, PE, LEED AP, Vice President, Peter Basso Associates, Troy, Mich. Courtesy: Peter Basso Associates


Neal Boothe, PE, Principal, exp, Maitland, Fla.

Douglas T. Calhoun, PE, Senior Vice President, WSP | Parsons Brinckerhoff (formerly ccrd), Dallas

Caleb Haynes, PE, Principal/Director, TME LLC, Birmingham, Ala.

Brian Kolm, PE, Team Leader, Mechanical, HDR Inc., Omaha, Neb.

Craig Kos, PE, LEED AP, Vice President, Environmental Systems Design Inc., Chicago

Bryan Laginess, PE, LEED AP, Vice President, Peter Basso Associates, Troy, Mich.


Figure 2: When working on stand-alone medical structures, converting an existing space can be a challenge—especially if the previous space was a nonmedical structure. Courtesy: Camille Sylvain Thompson, Peter Basso AssociatesCSE: Energy efficiency and sustainability are often a request from building owners and CIOs. What net zero energy and/or high-performance systems have you recently specified on stand-alone medical buildings and specialized treatment facilities (either an existing building or new construction)?

Kolm: Mechanically, some energy efficiency strategies used more in today's designs are condensing boilers, heat-recovery chillers, and desiccant systems for outdoor-air preconditioning.

Calhoun: We, as engineers, strive to focus on sustainability as a part of our practice. It is a mindset and a process. For example, VRF systems are much more efficient than packaged DX systems. These types of facilities represent a high revenue stream for the system or owners. Return on investment does not typically drive the decisions. The design has to meet the operational needs, the speed to market, and the construction budget while still keeping the overall sustainability and lifecycle cost in mind.

CSE: Many aspects of sustainability (power, HVAC, etc.) require the building facility team to follow certain practices to be effective. What, if anything, can an engineer do to help increase chances of success in this area?

Kolm: To make some of the sustainability strategies more effective, I have found that engineers should communicate to the owner exactly what will be designed and discuss the comfort level with them on operating the building long-term with the strategies implemented. Designing a highly efficient building on paper and Day 1 of operation is great. However, if the owner is not sophisticated enough to operate it at its full potential, then the initial investment is lost and may actually be costing the owner more over time versus a building that they would be more comfortable to operate.

Haynes: In all design, we have to remember to be aware of the operability and maintainability of the systems. We can design the most efficient and complicated system known to man, but if the facility staff cannot operate it effectively, then it will likely be more inefficient than a simpler design. It's our job to make sure the system is designed to be as efficient as possible while also specifying an effective amount of training to make sure the operators are equipped with the proper tools.

Laginess: I think having the facility team involved during design helps greatly. They will have some stake in the design of the systems they will be maintaining and will have a better understanding of how the system works before it's even implemented.

Calhoun: Education of the owner is the key. We can design energy-efficient systems, such as condensing boilers with a low-temperature hydronic heating system. But if the operator is accustomed to seeing 180°F hot water and changes the setpoints, the efficiency benefits of the system design are lost.


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