assisted living: time for change · and climate, translating it into ... design — strategies that...
TRANSCRIPT
WINTER 2019PRSRT STD
US POSTAGEPAID
Bolingbrook ILPermit 422
THE MAGAZINE OFSUSTAINABLE FLOORINGAND DESIGN
RESILIENT SAFE AND SANITARY
design trendsFOR 2019
ASSISTED LIVINGTIME FOR
CHANGE
sustainabilityrsquosROLE IN HEALTHCAREDESIGN
projects products platforms policies practices people
24 i GO i winTer 2019 greenoperationsnet
As healthcare systems across the country plan for tomor-row mdash undertaking construction projects to replaceaging facilities or expanding and upgrading existing
structures mdash new concepts surrounding sustainability in thegreen built space are being considered
What was in the past a focused methodology on seeminglysimplistic environmental impacts has become a more holisticapproach mdash sustainable healthcare is becoming inextricablylinked to patient and staff well-being and quality of care andsocial sustainability is beginning to reign
As health and wellness concepts have over the last fewyears become more integral to the design process mdash in additionto product choice and transparency mdash an evolution within sus-tainable building continues to take shape Designers and ven-dors alike agreed this evolution will continue to push the bound-aries of healthcare design in an effort to promote better patientoutcomes environmental healing and even profit margins
NATURAL HEALINGWhen it comes to social sustainability one of the most signifi-
GOFEATURE
holisticSocial sustainability continues toevolve health and wellness design
HEALTHCAREBY lIz SWITzER
biophilic design is incorporated into perkins + willrsquos memorialSloan kettering monmouth project in middletown nJ hospitalpatients have been found to have substantial healing benefits whenexposed to environments that incorporate principles of biophilia
copyhal
kin
mas
on
greenoperationsnet winTer 2019 i GO i 25
oppoSiTe page Stantecrsquos mary bird perkins our Lady of theLake cancer center in baton rouge La represents a new vision forcancer treatment Limited in size and located between a tower busystreet and parking garage it lacked a sense of place and stature soStantec looked beyond the chassis of the building to enhancesurroundings with through-light and nature themes featuringLouisiana-based indigenous materials
aboVe hdrrsquos Sunshine coast university hospital in Queenslandaustralia is one of the countryrsquos largest construction projects to dateThe building captures the qualities of its localersquos vernacular characterand climate translating it into an environment that is ideal for healing
cant factors in healthcare design from the past decade has beenthe emergence of evidence that suggests access to nature canenhance both the healing and patient experience As this con-cept has gained more widespread acceptance healthcareorganizations and design firms have begun turning to biophilicdesign mdash strategies that mimic natural environments
New program space is being added to healthcare projectsthat offer patients and staff places of respite not just within heal-ing gardens on the ground level but at every floor to decreasetravel distances
Biophilic design principles are also changing the materialfinishes such as flooring in common areas and even patientrooms In addition leading healthcare organizations in the lastdecade have embraced integrated healthy lifestyle and livingcenters non-traditional health-related components and cultural-ly appropriate and place-specific design concepts according tohealthcare architect Alex Tsaparis and senior principal BrendaBush-Moline both of Stantec Inc an international design andconsulting services company
POPULATION HEALTHThe potential for an even broader holistic approach to health-care design lies in the concept of population health mdash a systemat-ic approach that aims to prevent and cure disease by keepingpeople healthy The concept is made up of a series of compo-nents including education employment lifestyle securitysafe-ty housing access to food transportation and environment alldesigned in a way that is sustainable
In this way accessible timely and curated resources that
respond to specific community health needs over time cantransform lifestyles for qualitative improvements in healthTsaparis said
Interestingly as the design industry looks ahead to improv-ing the patient experience of care the focus on improving pop-ulation health will likely tie more closely to reducing the percapita cost of healthcare
This approach to sustainability has become more main-stream over the past 10 years as healthcare reimbursementshave evolved and organizations recognize the impact they canhave And that is good news according to Bush-Moline ldquoWe seethe impact of the built environment and what we offer citizensshapes the ability to achieve these goals thereby creating amore sustainable and healthier living scenariordquo she said
Designers also noted however opportunities for smartinvestments must be measured in non-traditional ways and val-
Continued on page 26
copydan
Sch
wal
m
26 i GO i winTer 2019 greenoperationsnet
ued beyond the profitmarginsof individual organizationsldquoThis by its nature has beenand continues to be a disrup-tive concept as it challengesthe norms related to financialinvestments and returns theresponsibilities of stakeholdersand the roles of individuals inhealthrdquo Bush-Moline said
The construct overalldesigners noted requires adepth of partnerships byhealthcare providers retailersmerchants community servic-es leaders government cityand township officials regula-tory agencies and others withgoodwill citizen-level supportmeasured risk and an invest-ment in iterative processes toinvent improve and refine
However looking into thefuture if the major focus forhealthcare design is on humanhealth and wellbeing health-care will need to evolve toinclude improvements in the area of social equity serving theneeds of the underserved and uninsured while integrating moredeeply into everyday lives according to architect Colin Rohlfingdirector of sustainable development HDR a global engineeringarchitecture environmental and construction services firm
NET ZERO READYIn terms of healthcare design facility solutions Rohlfing said proj-ects that are pushing toward Net Zero Ready mdash a structure thatproduces as much energy as it consumes mdash have had the mostsignificant impact with displacement ventilation radiant panelsand even natural ventilation directly affecting infection controlprocedures and patient bed placement ldquoThese more efficientand healthy solutions can also result in reduced healing timesand better thermal comfort directly impacting facility opera-tions and revenue modelsrdquo he said
He added that there is also a renewed focus on ldquodo no harmrdquoand the realization that building materials may contain toxicchemicals has overhauled material specifications significantly inthe past 10 years ldquoElimination of Red List chemicals and arequirement for transparency in building material ingredientshave changed the materials that multiple healthcare organiza-
tions will allow in their spacesrdquohe said
Mary Dickinson co-direc-tor of Perkins+Willrsquos MaterialPerformance Lab echoedthose sentiments ldquoIn the lastten years the building designindustry has united in pursuitof a building materials marketwhere product content infor-mation is transparent andaccessible and where materi-als with toxicants have alterna-tivesrdquo she said
These known toxicants arefound in abundance in health-care and are used to combathospital-acquired infections
and meet high-performance demands Dickinson pointed outThey include stain repellents antimicrobials and phthalates toname a few In many cases she said these substances that serveas a ldquosafety netrdquo are not necessary
However times are changing and the concept of specifyingtruly toxic-free materials within the healthcare design industry isbeing championed by numerous environmental and healthorganizations For example in response to this growing issueHealth Care Without Harm mdash an international coalition of health-care organizations mdash pledged to reform the environmental prac-tices of the healthcare industry through specific initiativesincluding reduction in incineration through improved wastemanagement practices and alternative technologies the phase-out of mercury and PVC plastics in medical products and theeducation of the industry
In the coming decade mdash due in part to groups such asHealthcare Without Harm mdash healthcare institutions are poised tojoin the building design industry in its pursuit of alternate mate-rials designers noted
ldquoThe good news for manufacturers is that meeting this mar-ket demand opens opportunities to be publicly celebratedrdquoDickinson said
GOFEATURE
Continued from page 25designed by hdr northsidehospital cherokee in cantonga automatically adapts to theamount of light with glass thatdarkens in direct sunlight andincreases transparency asdaylight reduces
copydan
Sch
wal
m
24 i GO i winTer 2019 greenoperationsnet
As healthcare systems across the country plan for tomor-row mdash undertaking construction projects to replaceaging facilities or expanding and upgrading existing
structures mdash new concepts surrounding sustainability in thegreen built space are being considered
What was in the past a focused methodology on seeminglysimplistic environmental impacts has become a more holisticapproach mdash sustainable healthcare is becoming inextricablylinked to patient and staff well-being and quality of care andsocial sustainability is beginning to reign
As health and wellness concepts have over the last fewyears become more integral to the design process mdash in additionto product choice and transparency mdash an evolution within sus-tainable building continues to take shape Designers and ven-dors alike agreed this evolution will continue to push the bound-aries of healthcare design in an effort to promote better patientoutcomes environmental healing and even profit margins
NATURAL HEALINGWhen it comes to social sustainability one of the most signifi-
GOFEATURE
holisticSocial sustainability continues toevolve health and wellness design
HEALTHCAREBY lIz SWITzER
biophilic design is incorporated into perkins + willrsquos memorialSloan kettering monmouth project in middletown nJ hospitalpatients have been found to have substantial healing benefits whenexposed to environments that incorporate principles of biophilia
copyhal
kin
mas
on
greenoperationsnet winTer 2019 i GO i 25
oppoSiTe page Stantecrsquos mary bird perkins our Lady of theLake cancer center in baton rouge La represents a new vision forcancer treatment Limited in size and located between a tower busystreet and parking garage it lacked a sense of place and stature soStantec looked beyond the chassis of the building to enhancesurroundings with through-light and nature themes featuringLouisiana-based indigenous materials
aboVe hdrrsquos Sunshine coast university hospital in Queenslandaustralia is one of the countryrsquos largest construction projects to dateThe building captures the qualities of its localersquos vernacular characterand climate translating it into an environment that is ideal for healing
cant factors in healthcare design from the past decade has beenthe emergence of evidence that suggests access to nature canenhance both the healing and patient experience As this con-cept has gained more widespread acceptance healthcareorganizations and design firms have begun turning to biophilicdesign mdash strategies that mimic natural environments
New program space is being added to healthcare projectsthat offer patients and staff places of respite not just within heal-ing gardens on the ground level but at every floor to decreasetravel distances
Biophilic design principles are also changing the materialfinishes such as flooring in common areas and even patientrooms In addition leading healthcare organizations in the lastdecade have embraced integrated healthy lifestyle and livingcenters non-traditional health-related components and cultural-ly appropriate and place-specific design concepts according tohealthcare architect Alex Tsaparis and senior principal BrendaBush-Moline both of Stantec Inc an international design andconsulting services company
POPULATION HEALTHThe potential for an even broader holistic approach to health-care design lies in the concept of population health mdash a systemat-ic approach that aims to prevent and cure disease by keepingpeople healthy The concept is made up of a series of compo-nents including education employment lifestyle securitysafe-ty housing access to food transportation and environment alldesigned in a way that is sustainable
In this way accessible timely and curated resources that
respond to specific community health needs over time cantransform lifestyles for qualitative improvements in healthTsaparis said
Interestingly as the design industry looks ahead to improv-ing the patient experience of care the focus on improving pop-ulation health will likely tie more closely to reducing the percapita cost of healthcare
This approach to sustainability has become more main-stream over the past 10 years as healthcare reimbursementshave evolved and organizations recognize the impact they canhave And that is good news according to Bush-Moline ldquoWe seethe impact of the built environment and what we offer citizensshapes the ability to achieve these goals thereby creating amore sustainable and healthier living scenariordquo she said
Designers also noted however opportunities for smartinvestments must be measured in non-traditional ways and val-
Continued on page 26
copydan
Sch
wal
m
26 i GO i winTer 2019 greenoperationsnet
ued beyond the profitmarginsof individual organizationsldquoThis by its nature has beenand continues to be a disrup-tive concept as it challengesthe norms related to financialinvestments and returns theresponsibilities of stakeholdersand the roles of individuals inhealthrdquo Bush-Moline said
The construct overalldesigners noted requires adepth of partnerships byhealthcare providers retailersmerchants community servic-es leaders government cityand township officials regula-tory agencies and others withgoodwill citizen-level supportmeasured risk and an invest-ment in iterative processes toinvent improve and refine
However looking into thefuture if the major focus forhealthcare design is on humanhealth and wellbeing health-care will need to evolve toinclude improvements in the area of social equity serving theneeds of the underserved and uninsured while integrating moredeeply into everyday lives according to architect Colin Rohlfingdirector of sustainable development HDR a global engineeringarchitecture environmental and construction services firm
NET ZERO READYIn terms of healthcare design facility solutions Rohlfing said proj-ects that are pushing toward Net Zero Ready mdash a structure thatproduces as much energy as it consumes mdash have had the mostsignificant impact with displacement ventilation radiant panelsand even natural ventilation directly affecting infection controlprocedures and patient bed placement ldquoThese more efficientand healthy solutions can also result in reduced healing timesand better thermal comfort directly impacting facility opera-tions and revenue modelsrdquo he said
He added that there is also a renewed focus on ldquodo no harmrdquoand the realization that building materials may contain toxicchemicals has overhauled material specifications significantly inthe past 10 years ldquoElimination of Red List chemicals and arequirement for transparency in building material ingredientshave changed the materials that multiple healthcare organiza-
tions will allow in their spacesrdquohe said
Mary Dickinson co-direc-tor of Perkins+Willrsquos MaterialPerformance Lab echoedthose sentiments ldquoIn the lastten years the building designindustry has united in pursuitof a building materials marketwhere product content infor-mation is transparent andaccessible and where materi-als with toxicants have alterna-tivesrdquo she said
These known toxicants arefound in abundance in health-care and are used to combathospital-acquired infections
and meet high-performance demands Dickinson pointed outThey include stain repellents antimicrobials and phthalates toname a few In many cases she said these substances that serveas a ldquosafety netrdquo are not necessary
However times are changing and the concept of specifyingtruly toxic-free materials within the healthcare design industry isbeing championed by numerous environmental and healthorganizations For example in response to this growing issueHealth Care Without Harm mdash an international coalition of health-care organizations mdash pledged to reform the environmental prac-tices of the healthcare industry through specific initiativesincluding reduction in incineration through improved wastemanagement practices and alternative technologies the phase-out of mercury and PVC plastics in medical products and theeducation of the industry
In the coming decade mdash due in part to groups such asHealthcare Without Harm mdash healthcare institutions are poised tojoin the building design industry in its pursuit of alternate mate-rials designers noted
ldquoThe good news for manufacturers is that meeting this mar-ket demand opens opportunities to be publicly celebratedrdquoDickinson said
GOFEATURE
Continued from page 25designed by hdr northsidehospital cherokee in cantonga automatically adapts to theamount of light with glass thatdarkens in direct sunlight andincreases transparency asdaylight reduces
copydan
Sch
wal
m
greenoperationsnet winTer 2019 i GO i 25
oppoSiTe page Stantecrsquos mary bird perkins our Lady of theLake cancer center in baton rouge La represents a new vision forcancer treatment Limited in size and located between a tower busystreet and parking garage it lacked a sense of place and stature soStantec looked beyond the chassis of the building to enhancesurroundings with through-light and nature themes featuringLouisiana-based indigenous materials
aboVe hdrrsquos Sunshine coast university hospital in Queenslandaustralia is one of the countryrsquos largest construction projects to dateThe building captures the qualities of its localersquos vernacular characterand climate translating it into an environment that is ideal for healing
cant factors in healthcare design from the past decade has beenthe emergence of evidence that suggests access to nature canenhance both the healing and patient experience As this con-cept has gained more widespread acceptance healthcareorganizations and design firms have begun turning to biophilicdesign mdash strategies that mimic natural environments
New program space is being added to healthcare projectsthat offer patients and staff places of respite not just within heal-ing gardens on the ground level but at every floor to decreasetravel distances
Biophilic design principles are also changing the materialfinishes such as flooring in common areas and even patientrooms In addition leading healthcare organizations in the lastdecade have embraced integrated healthy lifestyle and livingcenters non-traditional health-related components and cultural-ly appropriate and place-specific design concepts according tohealthcare architect Alex Tsaparis and senior principal BrendaBush-Moline both of Stantec Inc an international design andconsulting services company
POPULATION HEALTHThe potential for an even broader holistic approach to health-care design lies in the concept of population health mdash a systemat-ic approach that aims to prevent and cure disease by keepingpeople healthy The concept is made up of a series of compo-nents including education employment lifestyle securitysafe-ty housing access to food transportation and environment alldesigned in a way that is sustainable
In this way accessible timely and curated resources that
respond to specific community health needs over time cantransform lifestyles for qualitative improvements in healthTsaparis said
Interestingly as the design industry looks ahead to improv-ing the patient experience of care the focus on improving pop-ulation health will likely tie more closely to reducing the percapita cost of healthcare
This approach to sustainability has become more main-stream over the past 10 years as healthcare reimbursementshave evolved and organizations recognize the impact they canhave And that is good news according to Bush-Moline ldquoWe seethe impact of the built environment and what we offer citizensshapes the ability to achieve these goals thereby creating amore sustainable and healthier living scenariordquo she said
Designers also noted however opportunities for smartinvestments must be measured in non-traditional ways and val-
Continued on page 26
copydan
Sch
wal
m
26 i GO i winTer 2019 greenoperationsnet
ued beyond the profitmarginsof individual organizationsldquoThis by its nature has beenand continues to be a disrup-tive concept as it challengesthe norms related to financialinvestments and returns theresponsibilities of stakeholdersand the roles of individuals inhealthrdquo Bush-Moline said
The construct overalldesigners noted requires adepth of partnerships byhealthcare providers retailersmerchants community servic-es leaders government cityand township officials regula-tory agencies and others withgoodwill citizen-level supportmeasured risk and an invest-ment in iterative processes toinvent improve and refine
However looking into thefuture if the major focus forhealthcare design is on humanhealth and wellbeing health-care will need to evolve toinclude improvements in the area of social equity serving theneeds of the underserved and uninsured while integrating moredeeply into everyday lives according to architect Colin Rohlfingdirector of sustainable development HDR a global engineeringarchitecture environmental and construction services firm
NET ZERO READYIn terms of healthcare design facility solutions Rohlfing said proj-ects that are pushing toward Net Zero Ready mdash a structure thatproduces as much energy as it consumes mdash have had the mostsignificant impact with displacement ventilation radiant panelsand even natural ventilation directly affecting infection controlprocedures and patient bed placement ldquoThese more efficientand healthy solutions can also result in reduced healing timesand better thermal comfort directly impacting facility opera-tions and revenue modelsrdquo he said
He added that there is also a renewed focus on ldquodo no harmrdquoand the realization that building materials may contain toxicchemicals has overhauled material specifications significantly inthe past 10 years ldquoElimination of Red List chemicals and arequirement for transparency in building material ingredientshave changed the materials that multiple healthcare organiza-
tions will allow in their spacesrdquohe said
Mary Dickinson co-direc-tor of Perkins+Willrsquos MaterialPerformance Lab echoedthose sentiments ldquoIn the lastten years the building designindustry has united in pursuitof a building materials marketwhere product content infor-mation is transparent andaccessible and where materi-als with toxicants have alterna-tivesrdquo she said
These known toxicants arefound in abundance in health-care and are used to combathospital-acquired infections
and meet high-performance demands Dickinson pointed outThey include stain repellents antimicrobials and phthalates toname a few In many cases she said these substances that serveas a ldquosafety netrdquo are not necessary
However times are changing and the concept of specifyingtruly toxic-free materials within the healthcare design industry isbeing championed by numerous environmental and healthorganizations For example in response to this growing issueHealth Care Without Harm mdash an international coalition of health-care organizations mdash pledged to reform the environmental prac-tices of the healthcare industry through specific initiativesincluding reduction in incineration through improved wastemanagement practices and alternative technologies the phase-out of mercury and PVC plastics in medical products and theeducation of the industry
In the coming decade mdash due in part to groups such asHealthcare Without Harm mdash healthcare institutions are poised tojoin the building design industry in its pursuit of alternate mate-rials designers noted
ldquoThe good news for manufacturers is that meeting this mar-ket demand opens opportunities to be publicly celebratedrdquoDickinson said
GOFEATURE
Continued from page 25designed by hdr northsidehospital cherokee in cantonga automatically adapts to theamount of light with glass thatdarkens in direct sunlight andincreases transparency asdaylight reduces
copydan
Sch
wal
m
26 i GO i winTer 2019 greenoperationsnet
ued beyond the profitmarginsof individual organizationsldquoThis by its nature has beenand continues to be a disrup-tive concept as it challengesthe norms related to financialinvestments and returns theresponsibilities of stakeholdersand the roles of individuals inhealthrdquo Bush-Moline said
The construct overalldesigners noted requires adepth of partnerships byhealthcare providers retailersmerchants community servic-es leaders government cityand township officials regula-tory agencies and others withgoodwill citizen-level supportmeasured risk and an invest-ment in iterative processes toinvent improve and refine
However looking into thefuture if the major focus forhealthcare design is on humanhealth and wellbeing health-care will need to evolve toinclude improvements in the area of social equity serving theneeds of the underserved and uninsured while integrating moredeeply into everyday lives according to architect Colin Rohlfingdirector of sustainable development HDR a global engineeringarchitecture environmental and construction services firm
NET ZERO READYIn terms of healthcare design facility solutions Rohlfing said proj-ects that are pushing toward Net Zero Ready mdash a structure thatproduces as much energy as it consumes mdash have had the mostsignificant impact with displacement ventilation radiant panelsand even natural ventilation directly affecting infection controlprocedures and patient bed placement ldquoThese more efficientand healthy solutions can also result in reduced healing timesand better thermal comfort directly impacting facility opera-tions and revenue modelsrdquo he said
He added that there is also a renewed focus on ldquodo no harmrdquoand the realization that building materials may contain toxicchemicals has overhauled material specifications significantly inthe past 10 years ldquoElimination of Red List chemicals and arequirement for transparency in building material ingredientshave changed the materials that multiple healthcare organiza-
tions will allow in their spacesrdquohe said
Mary Dickinson co-direc-tor of Perkins+Willrsquos MaterialPerformance Lab echoedthose sentiments ldquoIn the lastten years the building designindustry has united in pursuitof a building materials marketwhere product content infor-mation is transparent andaccessible and where materi-als with toxicants have alterna-tivesrdquo she said
These known toxicants arefound in abundance in health-care and are used to combathospital-acquired infections
and meet high-performance demands Dickinson pointed outThey include stain repellents antimicrobials and phthalates toname a few In many cases she said these substances that serveas a ldquosafety netrdquo are not necessary
However times are changing and the concept of specifyingtruly toxic-free materials within the healthcare design industry isbeing championed by numerous environmental and healthorganizations For example in response to this growing issueHealth Care Without Harm mdash an international coalition of health-care organizations mdash pledged to reform the environmental prac-tices of the healthcare industry through specific initiativesincluding reduction in incineration through improved wastemanagement practices and alternative technologies the phase-out of mercury and PVC plastics in medical products and theeducation of the industry
In the coming decade mdash due in part to groups such asHealthcare Without Harm mdash healthcare institutions are poised tojoin the building design industry in its pursuit of alternate mate-rials designers noted
ldquoThe good news for manufacturers is that meeting this mar-ket demand opens opportunities to be publicly celebratedrdquoDickinson said
GOFEATURE
Continued from page 25designed by hdr northsidehospital cherokee in cantonga automatically adapts to theamount of light with glass thatdarkens in direct sunlight andincreases transparency asdaylight reduces
copydan
Sch
wal
m