© 2008 GGHC welcome A voluntary, self-certifying toolkit for harnessing best practices in the health care industry. Creating High Performance Healing Health Care Facilities Green Guide for Health Care

© 2008 GGHC Healthcare Construction Boom background Source: 2007 McGraw-Hill Construction Healthcare Green Building SmartMarket Report

© 2008 GGHC Healthcare Green Construction Boom? background Increase in Health Care Green Building Over Time Source: McGraw-Hill Construction Research & Analytics, 2007 Projected Green Building Market Value Source: McGraw-Hill Construction, 2007 Source: 2007 McGraw-Hill Construction Healthcare Green Building SmartMarket Report

© 2008 GGHC From the modern version: I will prevent disease whenever I can, for prevention is preferable to cure. Hippocratic Oath

© 2008 GGHC The design and operation of health care buildings is highly regulated with intense economic and life safety oversight Health care facilities are often multiple building campuses of varying ages, conditions, systems 24/7 operations with patients in place require intensive coordination and redundancy of all services at all times. Long ownership mean owners realize life cycle implications of their construction choices overview design attributes Operational issues, such as mercury elimination, have defined industrys environmental stewardship 5

© 2008 GGHC Construction frequently occurs within or adjacent to occupied buildings (where health is fragile, or steadiness of hand required) overview construction attributes Infection Control Risk Assessment (ICRA) protocols to minimize the impacts of construction on occupants demonstrate leadership to the wider sustainable building industry Healthcare construction managers can evolve a rigorous, sustainable set of practices for the healthcare industry that may inform wider construction practice

© 2008 GGHC 1998 American Hospital Association & U.S. EPA Memorandum of Understanding 1 Virtual elimination of mercury- containing waste from healthcare facilities waste streams by 2005; 2 Reduce total waste volume by 33% by 2005, and by 50% by 2010; 3 Identify hazardous substances for pollution prevention and waste reduction opportunities, including hazardous chemicals & persistent, bioaccumulative, and toxic pollutants.

© 2008 GGHC Hospitals for a Healthy Environment (H2E) (now forming part of Practice Greenhealth) Founded in 1998, H2E is a voluntary program that educates health care professionals about pollution prevention opportunities in hospitals & healthcare systems, noting environmental & public health benefits in addition to reducing costs associated with waste disposal. Successes to Date 97% of hospitals have implemented mercury reduction/ elimination programs 72% of hospitals have inventoried and replaced mercury- containing devices 80% of hospitals have implemented a waste reduction policy for all waste types source: 2005 AHA/H2E Survey (Note: percentages refer to survey respondents)

© 2008 GGHC Protect the immediate health of building occupants. Protect the health of the surrounding local community. Protect the health of the global community and natural resources overview strategies 2002 ASHE Green Healthcare Construction Guidance Statement

© 2008 GGHC Chapter 1.2 Environment of Care …the built environment has a profound effect on health, productivity, and the natural environment… Recognizes health cares primary mission to first, do no harm - and enhanced patient environment, employee effectiveness, and resource stewardship. Systems & Sustainable Design Referenced tools: GGHC, LEED® Interdisciplinary design teams Site selection and development Natural light & views of nature Thermal & lighting control Acoustical control Waste minimization Water quality and conservation Energy conservation Indoor air quality

© 2008 GGHC Void in the marketplace of health care specific green building tool Core content transfer from existing tools (e.g., LEED®) but need to tailor for healthcare Explicit health-based focus Sensitivity to an over-regulated sector voluntary best practices with no certification thresholds Reinforces integrated design as essential Bridges design & construction with operational considerations

© 2008 GGHC construction section 1 – Integrated Design 2 – Sustainable Sites 3 – Water Efficiency 4 – Energy & Atmosphere 5 – Materials & Resources 6 – Environmental Quality 7 – Innovation & Design Process Section / Category Name Pre-Req. / Max. Total LEED HC NA public comment draft

© 2008 GGHC operations section 1 – Integrated Operations & Education 2 – Sustainable Sites Management 3 – Transportation Operations 4 – Facilities Management 5 – Chemical Management 6 – Waste Management 7 – Environmental Services 8 – Food Service 9 – Environmentally Preferable Purchasing 10 – Innovation in Operation Section / Category Name Pre-Req. / Total Points

© 2008 GGHC Intent Documentation Health Issues Reference Standards Credit Goals Technologies & Strategies GGHC Credit Organization

© 2008 GGHC 18,000+ website registrants every state in the U.S. every Canadian Province 500 new registrants/month 100+ countries GGHC Website Registration Last updated April 2008 Release GGHC Version 2.0 Pilot Release GGHC Version 2.1 Pilot Release GGHC Version 2.2 gghc website registrant growth geographic distribution Green Guide for Health Care Website Registrants overview registration 1.Canada 2.Australia 3.United Kingdom 4.India 5.France 6.Malaysia 7.Argentina 8.Brazil 9.South Africa 10.Portugal top ten countries with international website registrants

© 2008 GGHC Current as of January 2007 geographic distribution Green Guide for Health Care Registered Projects overview project 148 registered projects 36,000,000 sf 34 states 4 Canadian provinces 7 countries green guide project growth Current as of April 2008

© 2008 GGHC Leadership in Energy & Environmental Design A voluntary, consensus-based standard for developing high- performance, sustainable buildings Dollard Discovery Health Center LEED® v2.0 Certified LEED-New Construction LEED-Existing Buildings LEED-Commercial Interiors LEED-Core & Shell LEED-Homes LEED-Neighborhood Development (Pilot) Schools Retail: New Construction (Pilot) Retail: Commercial Interiors (Pilot) Healthcare (Public comment) Campus (Under development) Labs (Under development)

© 2008 GGHC Sample LEED® Certified Health Care Projects Boulder Community Foothills Hospital (CO) LEED Silver British Columbia Cancer Institute (BC) LEED-Canada Gold Jewish Hospital Medical Center South (KY) LEED Silver OHSU Center for Health and Healing (OR) LEED Platinum Parrish Medical Center (FL) LEED Silver Providence Newberg Medical Center (OR) LEED Gold 340 LEED registered health care 3% of total registered projects 31 LEED certified health care 2% of total certified projects As of April 2008

© 2008 GGHC LEED for Healthcare Mission Statement LEED for Healthcare supports sustainable planning, design, and construction of healthcare facilities by adapting the U.S. Green Building Councils LEED® to respond to the unique set of opportunities and challenges presented by the healthcare sector. By affirming healthcares fundamental mission of …first, do no harm, LEED for Healthcare recognizes the profound impact of the built environment on the health of occupants, local communities, and global ecology and encourages design strategies that enhance the healing environment for patients, healthy and productive work environments for staff, and responsible ecological stewardship.

© 2008 GGHC USGBC-GGHC Memorandum of Understanding September 2007 Work together on tools, educational programs and other activities to support green health care building. Jointly develop health care-related resource materials, education and training events Jointly identify a prioritized research agenda Continue to collaborate on developing future health care-related green building tools

© 2008 GGHC overview registration Monthly Newsletter Calendar Webinars through Practice Greenhealth on construction related sustainable design topics

© 2008 GGHC What: Peer-to-peer forum to discuss issues and strategies Who: Health care project participants: - Health care facility project teams - Contracted design teams (architects, engineers, interior designers, etc) - Green Guide Steering Committee - Not vendor reps Where: online at overview project project participation and the Forum

© 2008 GGHC Registration is all on line No cost No minimum point threshold No obligation No disclosure of project names or information without permission project registration is easy overview project

© 2008 GGHC a. Download a copy b. Register a project c. Sign on to the forum d. Donate to the Green Guide