Building Health and Wellness into Healthcare Buildings

Since the medical care system first embraced health and wellness as a core business paradigm, hospitals, healthcare workers and patients alike have reaped the benefits. Healthcare workers have fewer sick days, reduced medical expenses and greater workplace satisfaction, leading to increased employee retention. Patients are empowered to more effectively manage their own health, improving patient outcomes and the patient experience overall. From a pure business standpoint, such programs are recognized to contribute to the bottom line.

A final step toward integrating health and wellness into the very DNA of the medical care system relates to the facilities in which these services are rendered. Here’s where architects, designers, engineers and facility managers can make their mark—in the planning, construction, furnishing and operation of “healthy buildings.”

In short, healthy buildings are built with occupant health, comfort and wellness in mind. The green building movement that has driven so much new construction and renovation in the commercial and residential building sector for the past two decades is now transforming hospitals, outpatient centers and medical office complexes.

For instance, the U.S. Green Building Council’s Leadership in Energy and Environmental Design standard for the health care industry (LEEDv4 BC+D: Healthcare) provides a four-tiered recognition system (from basic “Certified” to “Silver,” “Gold” and “Platinum”) in which buildings are rated based on the number of credits they earn. As Hannah Chenoweth discussed in a recent story for Health Spaces, LEEDv4 BC+D: Healthcare was specifically developed for facilities like hospitals that must keep their doors open 24/7.

In addition to energy savings measures, these credits—which often require third-party certification—are aimed at improving indoor air quality, minimizing exposure to harmful ingredients and encouraging sustainable product manufacturing that can reduce health risks throughout the supply chain. A comprehensive list of applicable credits can be found on the USGBC website.

INDOOR AIR QUALITY

Some of the most important third-party certifications recognized by LEED, WELL Building Standard, Green Guide for Healthcare, and other rating programs such as the European-based BREEAM sustainability assessment system, are those focused on indoor air quality. Product certification programs, such as SCS Global Service’s Indoor Advantage standard, subject products and materials to laboratory testing to determine the level of volatile organic compound (VOC) off-gassing against strict standards, and limit the use of specific chemicals to ensure that there is a healthy indoor environment.

Look around. Just about everything you can see, and some things you can’t, are candidates for indoor air quality certification—flooring tile and carpeting, wall panels, ceiling materials, paints and coatings, workstations, building materials and insulation, doors and windows and a wide range of furnishings specifically geared toward the healthcare system.

Leading furniture companies like KI, Herman Miller, Keilhauer and Steelcase have certified exam room stools and tables, waiting room chairs and sofas, recliners, nurses’ stations, work desks, casework cabinets for exam room sinks and storage, procedure and supply carts and accessories. SCS’s Certified Green Products Guide lists nearly 5,000 products qualified under the Indoor Advantage program alone, and thousands more that comply with other standards that minimize VOC off-gassing, such as the Association for Contract Textile’s Facts® label (e.g., upholstery), GreenSquared® for the tile industry and FloorScore® for resilient flooring products.

Additionally, in June of this year the U.S. EPA officially began to require that composite wood products demonstrate compliance with its formaldehyde emissions regulations certification through third-party certification (under the Toxic Substances Control Act, Title 6). This requirement applies to all producers selling hardwood plywood (veneer or composite core), particleboard and medium density fiberboard (MDF) products in the United States.

HEALTH PRODUCT DECLARATIONS

Another significant development in the healthy building movement is the emergence of health product declarations. These declarations, developed by the Health Product Declaration (HPD) Collaborative, are intended to increase transparency around potentially dangerous ingredients used in the manufacture of a wide range of products, and to encourage manufacturers to find safer alternatives. HPDs have been issued from everything from structural steel and rebar to finishing tile and bathroom fixtures.

Greater transparency not only serves the interests of product purchasers but of manufacturers as well. The certification process provides manufacturers with greater insight into their supply chains and the associated health impacts of product ingredients, and points out opportunities to reduce or eliminate ingredients of concern.

Third-party verified HPDs make products eligible not only for LEED v4 MR, but also for the Healthy Building Network’s Portico healthy building product listing, and the Living Product Challenge for Net Positive Material Health Imperative. The International Living Future Institute’s (ILFI) Living Building Challenge includes the use of healthy materials among its key criteria for eligibility in the Declare and Redlist-Free labeling databases.

SUSTAINABLE PRODUCTION

The trend in product certification standards is toward the development of “multi-attribute” standards that address many facets of sustainability, including environmental and social ramifications. Such standards can substantially improve working conditions throughout the supply chain that have far reaching health consequences.

In the healthcare sector, sustainable production standards exist for a variety of basic building materials and finished products, ranging from wood obtained from Forest Stewardship Council certified forests to carpeting certified to the NSF/ANSI 140 standard. On the operations side, a growing number of hospital cafeterias and restaurant vendors to medical complexes may choose to offer USDA Organic or Sustainably Grown food items, while gift shops may offer Veriflora® sustainably produced flowers.

In a nutshell, the options to enhance health and wellness objectives through building construction, renovation and operations are quite substantial. It is now up to decision makers to recognize and make these options a priority.

Nicole Muñoz is Managing Director for Environmental Certification Services at SCS Global Services, based in Emeryville, Calif. [email protected]; www.scsglobalservices.com