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A hospital is a building where people go to get well. But how healthy is the hospital building?
Some Pittsburgh architecture firms have produced environmentally friendly, sustainable health care facilities in recent years that may serve as blueprints for the industry.
The new $625 million Children's Hospital in Lawrenceville, designed by Astorino, features water-efficient landscaping, an advanced air filtration system and conservative-minded water fixtures while maximizing use of natural sunlight. Much of the building material came from within the region, reducing hauling costs.
Designstream Architectural Studios was behind the design of one of the region's first sustainable medical office, Children's Community Pediatrics in East Liberty, with low gasemitting paints and carpets, an advanced ventilation system and insulated windows.
PDFThe hospital of the future, however, may resemble the Perkins Eastman-designed Children's Home of Pittsburgh and Lemieux Family Center on Penn Avenue and South Aiken in Friendship. Feeling more like a home than a hospital, the Children's Home offers adoption services and temporary care for medically fragile children in an energy-saving, material-sustaining space.
Touring the facility, Perkins Eastman architect and principal Alan Schlossberg says the attention paid to paints, fabrics and double-insulated windows only begins to tell the story. The real goal, he says, is "sustainability that can stand the test of time."
To achieve that goal, Mr. Schlossberg started with a tree.
In the back of the 2,700-square-foot yellow brick building and adjoining parking lot is an 80-year-old sycamore he wanted to preserve, along every other old growth tree he could save. That tree, as well as the refurbished brick wall along the property's back perimeter, connects the facility to the surrounding neighborhood while also serving as a visual anchor for the lot.
As for the building itself, brick and concrete from the demolished convent and nursing home that had stood there before was pulverized and used as fill to support the foundation, saving hundreds of thousands of dollars to truck it out.
But, Mr. Schlossberg notes, the building is made for people, some of them very ill, so he's incorporated many other "green" features not immediately apparent to non-architects.
The three-story structure is stretched narrowly east to west, parallel to Penn Avenue, with window-lined corridors facing outside. This accomplishes two things, bringing light to high-traffic walkways while insulating patient rooms -- which face south and get even more sunlight -- from traffic noise.
For the Child's Way daycare area downstairs, Mr. Schlossberg had in-floor radiant heating installed. "The children spend a lot of time on the floor. We wanted to make sure it wasn't cold for them."
Two floors up is a licensed hospital area with all the equipment and technology to maintain youngsters with organ transplants, or who are being treated for cystic fibrosis or who are recovering from a bout of meningitis.
The result is a setting much more home-like and welcoming than clinical, designed to make its residents comfortable while also helping them heal.
Behind it is a philosophy "that the environment can have an impact on the patient's outcome," said Martin L. Siefering, also a principal at Perkins Eastman. "Absence of stress can have a remarkable impact on healing."
One might wonder why this didn't happen decades ago.
"Health care has been slow to the [sustainability] process, primarily because the [hospital] environment is complex operationally," said Thomas J. Briney, a senior associate at Perkins Eastman.
Also, said Mr. Siefering, "It's an industry that's so intensely regulated." For example, operating rooms require specific minimum air exchange rates, which affects airflow throughout a facility and complicating energy conservation efforts.
The Pittsburgh region is not a great candidate for LEED-quality, sustainable hospitals simply because so many local hospitals are so old. For long-established facilities, though, there are still options.
They can be as simple as Excela Health Frick Hospital's decision to replace paper milk containers with bottled milk, then sprinkle recycling bins throughout its cafeterias. The hospital gets a 2-cent rebate for every recycled bottle, with that money earmarked for the Frick Hospital Foundation.
Or an option can be as systematic as hiring a full-time sustainability coordinator, something the University of Pittsburgh Medical Center has done with a $250,000 grant from the Heinz Endowments, and the establishment of a $5 million green action fund.
Allison Robinson has been UPMC's coordinator for environmental initiatives for nearly three years. The organization's ongoing programs include installing energy-efficient heating, cooling and electrical equipment, a work still in progress. Lights have been upgraded, and the staff has tried to use sustainable material for flooring and wallboards.
When Ms. Robinson's office was remodeled, workers installed carpet squares instead of wall-to-wall carpeting. "If one part is damaged, then you only have that one square that you have to replace," she said.
They also are installing new water-conserving valves and fixtures in public bathrooms. Many of these sustainability features were built into the new Children's Hospital in Lawrenceville, though Ms. Robinson said it could be another year before they've collected and analyzed data to measure what kind of savings -- both material and monetary -- have been realized.
And there are definite limitations, even in the greenest of hospitals.
Less toxic "green" cleaners are not strong enough to kill the germs and bacteria found in some areas of the hospital. Most so-called "red bag" materials -- those coming in contact with bodily fluids -- must be incinerated, although the staff at Magee Women's Hospital has been able to reduce the amount that must be destroyed.
The biggest area of waste, Ms. Robinson said, is simple packaging for all the goods a hospital needs. UPMC is addressing that. Instead of ordering 500 tongue depressors at a time, the staff will order 5,000, then repackage them in smaller, reusable containers.
Changes in clinical areas are not as easy to implement, Ms. Robinson said, but she's seen an encouraging interest and commitment to sustainability among the nursing and physician staffs. The hope is that all workers will become more aware, then incorporate a sustainability mindset in their private lives as well as their work lives.
"Sustainability was not a hot issue 10 years ago," said Mr. Sierfering. But awareness is growing. He compared it with improvements in accessibility brought about by the Americans with Disabilities Act. Now, "That's such an integral part of what we do that we no longer think about it.
"That's where we have to get with sustainability."
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