Rumi Engineer – Sr. General Manager and Business Head – Green Building Consultancy Services, Godrej & Boyce Ltd.
Health care is a seller’s market and we’re all buyers–buyers with little knowledge and no ability to negotiate. Focus on quality of life helps healthcare facilities see the big picture for healthier, happier patients. All pillar efforts around existing system realignment, are underpinned by both technology and changing mindset. The drift towards effective environmental solution is catching up fast and how. GREEN – the novel idea, is Transforming Health Care. It is ‘THE ANSWER’ for world class and responsible infrastructure.
Currently, hospitals and healthcare buildings are one of the highest energy-intensive buildings, consuming energy almost twice as much as any commercial office buildings. These high energy intensive buildings operate 24/7 around the year with 100 percent systems backup. Today’s prevailing fierce energy concerns are further aggravated with the advent of electricity dependant modern medical equipment and technology. Critical areas like operation theatres, intensive care units, diagnostics department are huge energy guzzlers. Therefore there is a need to transform healthcare infrastructure from existing standards to energy efficient, toxic free, zero waste, water balanced solutions. There has to be increased focus on natural lighting, reducing energy demands. The biggest challenge nowadays is to control the impact of spiralling energy costs from directly affecting the cost of “care”.
Growing environmental awareness and concern, demands concentrated efforts in contributing to environment preservation. With the introduction of the green guidelines, there is a focused approach to sustainable designing in the healthcare sector. “Indian Green Building Council” (IGBC) and “GRIHA” (Green Rating for Integrated Habitat Assessment) are the green building rating systems in India, which help to review the requirements and aid in setting goals for green projects by targeting elements of sustainability. These rating systems lay down criteria which are to be achieved to be on the sustainability path. These tools, by qualitative and quantitative assessment criteria, can be used to rate a building on the degree of its sustainability.
For a Hospital which aligns its Design and Operations to a green rating system there exists tremendous potential for significant reduction in water, optimization of energy efficiency, conserves natural resources, Best Management practices for handling waste. It therefore provides healthier spaces for occupants, as compared to a conventional building. It is essential to set specific ‘measurable’ goals for energy efficiency, water conservation, rain water harvesting, material and resource management as well as construction waste management. It is observed that for a hospitals power costs constitute 40% of the operating cost thereby making power a significant expense head. Most of the green certified hospitals & health care projects have reported energy demand reductions from 15 to 30 percent. Sustainable building practices contribute to “triple bottom line” benefits; in other words, greener buildings result in improved performance in three areas: Environmental, Economic and Community Health.
The CII committee has surveyed 25 top-notch hospitals in Mumbai, Pune and Delhi found that healthcare institutions need improvements in their power infrastructure as they work non-stop round the year.
A survey conducted by Hosmac healthcare consultancy across metros on the electricity expenditure for a hospital revealed that,
ïHigh-end hospitals with 300 beds and above spend around 60% of their power expenditure on services directly related to patient care (comprising OPD, IPD, ICU, radiology, diagnostic services etc)
ïHospitals with higher level of technology spend four times more than hospitals with basic technology infrastructure.
ïHospitals with high dependence on artificial lighting spend three times more, when compared with hospitals depending on natural lighting systems.
The survey therefore recommended green hospitals to reduce electricity consumption and slash operational costs considerably.
The next most important and absolutely indispensible aspect in any healthcare facility is Indoor Environmental Quality (IEQ). It is a Pre-requisite in the Hospitals & Healthcare Units.
Indoor Air Quality (IAQ) is defined as air quality within the buildings and structures that would impact the health and comfort of its occupants. Factors that can affect indoor air quality include:
ïVOCs (volatile organic compounds)
ïParticulates (dust from construction activities, poor housekeeping etc)
IEQ comprises of many facets like Material, Paints, Cleanliness, Storage, HVAC system and so on. Exposure to poor indoor air quality can cause health effects to occupants such as dizziness, nausea, headaches, upper respiratory irritation, dryness and irritation of skin. Some of the common IAQ issues in hospital can be prevented through proper housekeeping practices, preventive maintenance of the HVAC (heating, ventilation and air conditioning system), and dust control during construction.
Any compromise in maintaining IEQ will be detrimental to operations of the Healthcare unit. Good ambience like Natural Lighting, Views outside to Landscape, and Treated Fresh Air acts as catalyst for fast recovery of Patient.
ESTABLISHED HOSPITALS COULD TREAD THE “GREEN PATH”
A decade ago, for an existing hospital to adopt the green practises would have been a challenge. However, today there are numerous options available along with technology to tackle the grey areas of concern. A healthcare organization may choose to prioritize energy reduction, water conservation, waste minimization, or any number of individual initiatives, the practice of sustainable building is really about an integrated approach to planning, design, construction, operations, and maintenance. It is an overarching philosophy or commitment that influences decision-making.
By embracing the green concepts existing hospital, mainly benefit in terms of energy saving leading to monetary savings. As per estimates, 15 to 30 per cent of energy and around 30 per cent of water could be saved if a hospital is shifted to the green concepts. For existing building retrofits, the investment for achieving energy efficiency pay back is within 4 to 5 years max.
Under general lighting, if tubelights are upgraded to CFLs (compact fluorescent lamps), the energy savings is 30 per cent, and with LED lamps it is as high as 45-50 per cent. This is dependent on the scale of the project, age, technology and operation schedule of the building. We are well aware that even if the systems are designed and commissioned efficiently but not operated and maintained, there is an impact on the energy efficiency ultimately increasing the cost. It is important for the facility to continuously measure, monitor and analyse systems so that they operate at optimum efficiency. With goal of ‘Measure to Save’ over 5% energy cost saving is often pegged to granular metering.
Moreover, selection of materials for the interiors would provide a healthy environment for the patients. For example, under the green building method, there is a prescribed permissible limit for usage of volatile organic compounds as these are harmful. 100 per cent water recycling takes place in green hospitals. Water wastage is further minimized by use of low water flow fixtures. Use of certified housekeeping chemical is encouraged.
Sustainable building goes beyond simple return-on-investment (ROI) analysis of the first costs of specific improvements; rather, it evaluates an improvement over its entire life cycle, including first costs and subsequent operations, maintenance, and disposal costs.
Efficient Building= Excellent Design + O&M* best management practice
*(Operation & Maintenance)
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