Published on : August 19, 2010

Sustainable Design for Healthcare Interiors

Sustainable Design for Healthcare Interiors

Sustainability may be the holy grail of healthcare design, but many interiors fall well short of green objectives when built conventionally. There is an alternative approach that meets the loftiest goals and provides a sound economic investment.
If you walked into a sustainably designed healthcare facility, how would it be different than a conventional one? Could you see it, feel it, smell it? The answer is yes to all three. Buildings designed from a sustainable perspective start with a big picture understanding that drills right down to the finest of details, the kind that any patient or employee can appreciate. The best examples transcend mere cookbook approaches to sustainability with enduring, functional and beautiful design.

Healthcare design is necessarily complex, with sustainable design often being perceived as adding just another layer to that complexity. In fact, the principles of sustainability can be applied to create facilities that realize business objectives:

Improving patient outcomes, reducing employee absenteeism, lowering costs and easily accommodating technological change. Sustainable design of hospitals and related facilities can achieve all of these without further depleting scarce financial resources.

Architects typically are responsible for the design of the building envelope and coordinate design of the mechanical plant with engineers. Ensuring wise use of materials and reducing energy usage are prime considerations in a sustainable facility. In consultation with stakeholders from the client group, the architect may decide to design a narrow floor plate, in order to improve occupants’ access to natural light and the provision of fresh air. Reducing travel distances for nursing staff, so that nurses are not forced to walk miles each day in search of supplies, is an architectural decision in support of employee wellbeing and the efficient use of manpower.

Nowhere is the outcome of sustainable design practice more evident to the average visitor than in the interior design of a healthcare facility.

  • You can see it ~ Beautiful environments instead of utilitarian ones, personalized patient spaces instead of clinical ones.
  • You can feel it ~ Space for family members to congregate and visit without feeling they are in the way; a more pleasant work environment for staff thanks to thoughtful decisions about workstation design, material choices and provision of technical aids.
  • You can smell it ~ Specification of materials and products with low volatile organic compounds (VOCs) makes the smell of the interior sweeter than was the case in the past when toxic materials (adhesives, fibers, paints) were extensively used.

Interior designers have a primary role to play in achieving sustainable goals. Beyond the obvious strategies and results listed above, designers can be instrumental in supporting objectives that reduce the incidence of infection, accommodate technological change and minimize the negative environmental impact associated with interior construction.

The Interior is the Villain

In the debate about what sector or activity is most harmful to the environment, buildings are often overlooked. In fact, they contribute almost half of carbon dioxide emissions in North America. The real villain is the interior, contributing to unhealthy conditions for occupants and impacting negatively on the wider environment. Conventional interiors use too much space; they encourage electricity and HVAC gluttony; they are built with materials that cannot be reused and they fail miserably to accommodate new technology. The use of toxic materials for flooring, walls and ceilings adds to the corpse.

Even when conceived under the aegis of a green certification system like LEED, there is no guarantee interiors will achieve sustainable outcomes. Finishes that reduce VOCs make a difference but are only a partial solution, especially in hospitals where controlling and minimizing mold growth and the spread of infectious diseases is a more critical priority than low VOCs.  The culprit undermining sustainability is conventional stud and drywall construction of interiors, a solution that may be time-honored but creates a host of environmental issues.

A shortlist of problems associated with conventional building of interiors includes:

  • Construction with drywall creates waste: For every square foot of drywall built brand new, one pound is disposed. In landfills, drywall releases deadly hydrogen sulphide gas. It is estimated between 10-15 percent of landfill construction waste is new drywall.
  • Drywall construction is dusty and hazardous in healthcare settings, especially when renovations are being undertaken. Filtering out drywall dust particles with HEPA filters is a costly and not always effective strategy.
  • The US Environmental Protection Agency has estimated that when conventional interior construction is gutted because of changes in use, 155 lbs of material waste is created per square foot.
  • The actual construction of gypsum and stud walls is time consuming, with all construction occurring on site; during the long timeframe for construction, materials stored on site may develop mold before being erected.
  • Transportation pollution is another, albeit hidden factor in conventional construction: crews must arrive daily at the building site, which entails individual vehicular trips that contribute to the building’s greenhouse gas footprint.
  • When changes are made to the interior, medgas outlets and associated pipeline products, together with wiring and cabling for power and data installed in conventional walls, are stripped and discarded; ditto for all of the drywall. Yet change is the one constant in hospital and other healthcare interiors.

Green building systems do not penalize or discourage the use of conventional interior construction; they focus on material choices rather than on changing how the interior is built. Healthcare administrators and planners intent on realizing sustainable environments are advised to do some homework to find better ways to build.

Versatile Wall Solutions for Healthcare Interiors

The advent of sustainable design, with its focus on improving interior air quality has heightened the search for alternatives to conventional construction. Interiors solutions that use pre-engineered modular walls are rapidly gaining acceptance among designers, facility managers and nursing staff in healthcare facilities.

A major factor is the versatility of these wall systems. Renovations to interior spaces can be made in days rather than weeks because these walls are pre-manufactured. They arrive on site ready for erection, contribute negligible if no VOCs and do not create construction debris and dust. When combined with preinstalled med gases and either conventional or plug and play electrical and cable solutions, the walls are installed―med gases, power and data included―in a fraction of the time of conventional walls and without disturbing regular operations. No cutting into drywall is required.

Agile architectural solutions such as modular walls are flexible in another regard: They can uniquely adapt to technological change. From embedded LED TV screens and walls with dry erase surfaces to the installation of medical gas lines, a well-conceived and constructed modular interior is adaptable given different uses in a healthcare setting. The best modular solutions are designed so that a wall cavity that accommodated a particular technology this week can be changed over to another next month merely by popping off a face tile and making the technological change.

Tiles in some wall manufacturers’ products can be easily removed and cleaned, and the interior of the wall checked periodically for signs of mold. In contrast, drywall construction does not show evidence of mold until it becomes apparent on the exterior of the wall, by which time the wall is riddled with mold; this necessitates removal of affected materials and results in lost beds during reconstruction and clean up.

Some modular solutions are product neutral which means they can be used with pre-existing furniture and fixtures, extending the life of these elements. In yet another example of flexibility, one manufacturer’s walls have horizontal extrusions that can be used to hang cabinets, keeping furniture off the floor and making for more efficient and effective cleaning.

Sustainable Design Isn’t Just Green

A healthcare setting is meant to be a healing environment. There is a trend to designing less clinical-looking spaces, introducing opportunities for creating a more personal or homey feeling in individual patient rooms and admitting areas. Some modular walls can be customized without undermining hygienic requirements. Thoughtfully-designed and aesthetically-pleasing interiors are not only good for patients and their families; they improve the well-being of nursing staff as well.

There are two major budgets in every healthcare facility: capital and operating. Investing in an agile architectural solution with the capital budget brings financial benefits when operational changes require reconfiguration of the floor space or changes in how the walls are used. Unlike conventional drywall construction, modular walls with tile skins can be reused, repositioned and redeployed with the latest in technology.

Healthcare settings represent a long-term financial investment. High performance assemblies are preferred, together with material and construction choices that are smart investments. Pre-manufactured modular walls avoid the waste associated with conventional drywall construction and are reusable.

Reduce-reuse strategies are the ultimate in sustainability. The new LEED for Healthcare guidelines recognize modular walls as a credit in situations where at least 50 percent of interior walls are modular.

About the Author

Andrée Iffrig, LEED AP, is a graduate architect and writer at DIRTT Environmental Solutions. DIRTT―Doing It Right This Time―refers to creating sustainable interiors with agile architectural solutions. DIRTT manufactures pre-engineered modular walls used in building interiors as an alternative to conventional stud and drywall construction. DIRTT’s wall systems behave like built-in-situ walls. They are sturdy and carry plumbing, power and medical gas lines. Actual production of DIRTT walls results in less than five percent waste. Every effort is made to recycle waste materials. Wall assemblies are manufactured off-site and installations are speedy, with no negative impact on air quality; material usage is kept to a bare minimum. DIRTT has two manufacturing plants, in Calgary, Alberta and Savannah, Georgia.  Andrée Iffrig, LEED AP – Tel. 403-450-7617 – Email: aiffrig@dirtt.net / www.dirtt.net