Sustainability Checklist: 8 Key Areas of Focus for Healthcare Construction

By John Timmerman

Sustainable facilities practices and green initiatives are becoming more common across the healthcare industry. But sustainability can be hard to define as a concept – covering everything from energy efficiency to corporate responsibility. Therefore, it can be difficult for organizations, particularly those just beginning their sustainable journeys, to pin down which efforts will best establish their culture of sustainability. This checklist provides eight viable and valuable areas of focus for organizations looking to begin or deepen their sustainable business practices during construction or renovation, including:

  • Practical areas for any organization to focus sustainability efforts.
  • Explanations on why those areas are valuable.
  • Recommendations for each focus area.
  1. Establish a direct connection between project design decisions and positive impacts on human health.

While potential business savings are strong motivation for green initiatives, the end goal of all healthcare industry sustainability efforts is always the improvement of human health. To build a lasting culture of sustainability, connect sustainable efforts to your mission of providing quality care to your patients. Then use this connection as the fundamental evaluation criteria for building design, construction and operation strategies, prioritizing those that best reflect your organizational ethos.

  1. Choose project locations that bring employment opportunities and services to communities without imposing transportation burdens on them.

The transportation emissions surrounding healthcare facilities is high, including ambulance fleets, hospital transport vehicles, and staff and patient travel. There are both social and environmental reasons to critically consider site location and the potential impact on required transportation. Environmentally, reducing the travel distance to and parking distance of care sites minimizes emissions of greenhouse gases, which is key considering that transportation emissions surrounding healthcare facilities tend to be high due to staff and patient travel, ambulance fleets and overall building emissions. Socially, it is vital for healthcare systems to ensure equal access to employment and patient care by choosing a site that is conveniently located to the community being served.

  1. Ensure your project will impact its surrounding environment minimally both now and into the future.

Look for rainwater collection and reuse opportunities, like green roofs and bioswales to capture building and parking lot runoff. With so much exposed roofing and parking at major healthcare facilities, look for ways to increase shading and reduce solar exposure with photovoltaics or reflective roof surfacing.  Once you have evaluated the site, there are many low-impact design (LID) and green infrastructure (GI) practices that can be applied, such as planting rain gardens with native plant material, installing a partially vegetated roof, using permeable paving or installing permanent features that can handle runoff.

  1. Create interior and exterior designs that minimize water consumption.

While there are many outdoor opportunities to reduce water consumption at any facility, the primary water consumers in healthcare lay inside the facility. Indoors, easy wins come with high efficiency appliances and fixtures. Where safely possible, regulating water pressure below baseline specifications can further reduce water consumption through flow fixtures and fittings.

  1. Leverage technology and designs that reduce reliance on non-renewable energy sources.

Start by establishing a baseline level of energy efficiency for your building and all its systems. From this baseline, determine excess energy that can be saved by achieving minimum levels of energy efficiency through elemental devices like lighting occupancy sensors, daylighting controls or automated receptacle controls. Additionally, energy costs and greenhouse gas emissions can potentially be offset by using on-site renewable energy systems such as photovoltaics systems, wind generators or thermal or electric generation from qualifying biofuels.

  1. Whether construction or operation, look for ways to recycle and reuse materials to minimize waste.

Consider both prevention and diversion strategies to reduce construction waste. If this is a renovation project, determine if any existing building resources can be adaptively reused, reducing the need for new materials. Every reused material represents waste reduced. Once you’ve maximized the reuse of available materials, select new materials that have been sourced in a responsible manner. Where appropriate, look to include bio-based materials like bamboo or recycled plastics, steel, or aluminum.

  1. Design your building to keep patients comfortable.

Sustainable design promotes healthcare provider productivity, patient comfort and overall well-being by providing good air quality, temperature control and noise management. The well-being of patients and hospital staff can also be affected by the type and amount of lighting in the facility. Glare control, color rendering and surface reflectivity should all be accounted for in healthcare facility designs. Effective use of skylights, blinds and building orientation can maximize the availability of natural lighting for your project. Another way to provide a connection to the natural environment is through quality views. If you can’t see outside from a particular space, even a picture of nature is better than nothing.

  1. If you can’t reduce your energy needs, consider shifting them to non-peak windows.

Simply changing the timing of heavy energy consumption can reap huge dividends. Energy utilities often refer to this as “flattening the curve.” Flattening that spike not only reduces the cost of energy, but also reduces the burden on the existing distribution system, helping make energy generation and distribution systems more efficient and reliable. Where possible, coordinate review of building load shape and peak load with a review of the regional grid profile to identify the best value load management strategies that the building can provide.

Any design decision that can be viewed through the lens of Corporate Social Responsibility as having a positive environmental, economic or social impact can be deemed a sustainable design, making the journey to sustainability an ongoing endeavor. It’s relatively easy to design projects that use sustainable construction methods to build with responsibly sourced materials. It’s much harder to create a culture of sustainability that guides and directs decisions across the organization. Looking at all projects through the lens of human health impact makes it easier to instill this ethos and measure progress on the road to sustainability.

John Timmerman serves as product marketing manager at Gordian. He has more than 30 years of experience in the “smart city” space and now helps develop solutions for “smart buildings” — including planning, design, construction and facilities management. Gordian ( is a leader in facility and construction cost data, software and services for all phases of the building lifecycle.