BUILDING TECHNOLOGIES PROGRAM

Integrated Building Design Critical to High-Performance Hospitals

New construction and major renovations offer hospitals their best prospects for achieving optimal energy efficiency. Integrated building design (IBD) is a nontraditional approach that has been particularly effective in creating high- performing, environmentally friendly buildings. Such facilities often cost less to operate and sometimes cost less to build. A facility built through the ongoing collaboration of all stakeholders is more likely to achieve optimal energy efficiency than one based on a succession of hand-offs. Integrated building design increases opportunities to create hospitals that have a favorable effect on patient healing, employee health, and environmental sustainability. Integrated Building Design Team This fact sheet has been developed by the U.S. Department of Energy’s Hospital Energy • Architects and designers Alliance to help owners and operators employ the IBD process to lower energy consumption and resultant costs while maximizing patient comfort and environmental sustainability. • Construction managers Although some of the strategies considered can be undertaken using a traditional approach, • Contractors IBD often produces results that otherwise would not have been attainable.

• Energy modelers, cost estimators While traditional design and construction involves a series of hand-offs from one expert to • Engineers the next, IBD is a collaborative approach that draws upon the needs, expertise, and insights of a multidisciplinary team (see box at left) throughout a project. • Facilities managers and operators • Integrated design facilitator/ Kicking off a Project consultant The team can save time and money by identifying incompatible design elements and • Medical staff representatives solving problems before actual design and construction begin. Typically, the team kicks off a project by holding a “charrette,” an intensive workshop in which the key stakeholders • Owners and senior management generate and discuss ideas for combining low-energy-use and other greening strategies. A • Specialty consultants charrette helps cut across boundaries of a large collaborative project, allowing the team to address organizational differences, reduce difficulties, verify decisions, and expedite the design process. 2 INTEGRATED BUILDING DESIGN FACT SHEET

Whole-Building The Path to High • Assess and confirm project feasibility Approach is Key Performance and construction requirements. IBD’s “whole-building” approach views There are many steps the IBD team takes • Formulate high-performance project goals, including measurable a facility as an interdependent system in the creation and successful operation energy performance goals, such as rather than as separate components. This of a high-performance facility. Key phases the following: viewpoint helps to ensure that systems are indicated below, with important work harmoniously rather than against considerations highlighted within each. ––Use less than a certain number of one another. Whole-building design takes Btu/square foot/year. into consideration such elements as site, Pre-Design ––Achieve 30 percent energy savings energy, materials, indoor air quality, During this phase, hospital management over code. acoustics, operations, economics, and organizes its IBD team and makes broad natural resources. Employing the whole- • Determine financial evaluation criteria. decisions that determine the direction of building approach during the initial • Commit as an organization to the the entire project. Among them: design phase is the most important step in IBD process for the project. Discuss achieving high-performance buildings. • Establish key needs and project priorities. questions and concerns. t Case Study

Dell Children’s Medical Center of Central Texas Austin, Texas • Opened in July 2007

Financial Investments and Benefits • Fly ash substituted for Portland cement. • Capital budget was $200 million. • Water-efficient autoclaves and low-flow • Construction cost was $130 million. and dual-flush plumbing fixtures save an estimated 4.1 million gallons of water per • Gross capital savings were $6.8 million year. (eliminated the need to build a central plant when the local utility and the • Onsite 4.3 MW natural gas-fired CHP hospital’s parent company collaborated plant that supplies 100 percent of the to build an onsite district energy plant). hospital’s electricity, heating, and cooling and is 75 percent more efficient than • Invested $5.8 million of these savings into coal-fired plants. energy conservation measures. Notable Features • “Right-sized” distributed air handling units with dedicated outdoor air units with heat recovery. • Under-floor air distribution in

Photography/Karlsberger © John Durant Photos: administration area. • High-efficiency lighting fixtures with The 509,000-square-foot Dell Children’s daylight-harvesting system and Medical Center of Central Texas is the occupancy sensors. world’s first inpatient hospital to achieve Leadership in Energy and Environmental • Exterior stairwells that don’t require Design, or LEED®, certification at the climate control. platinum level—the highest offered through • Daylighting that reaches 90 percent of the U.S. Green Building Council. The the perimeter rooms and 35 percent of 176-bed hospital, built on 32 acres of the treatment and diagnostic areas. “brownfield” site of a former municipal • 47,000 tons of airport runway material airport, serves 46 counties. This high- reused on the site. performance facility is the result of a collaborative effort among a broad group • 92 percent of construction waste recycled, of internal and external stakeholders. diverting 32,000 tons from landfills. INTEGRATED BUILDING DESIGN FACT SHEET 3

• Assemble IBD team. Among the Case Study important considerations: ––Select an IBD “champion” to drive the process. ––Identify roles and responsibilities for members. ––Hire design professionals experienced with IBD. ––Hold a design charrette with the IBD team. Design The IBD process puts all design options on the table rather than prescribe the use of specific strategies. Many design possibilities—each with its unique set of technologies based on the team’s chosen criteria—are evaluated. Whole-building energy simulations are a part of this process. For information on energy- Providence Newberg Medical Center modeling software, see http://www1.eere. Newberg, Oregon • Opened in 2006 energy.gov/buildings/commercial_ initiative/modeling_software.html. The Providence Newberg Medical Center’s Notable Features team selects the best design approach 180,000-square-foot hospital, medical • Condensing boilers operating at 95 percent only after multiple potential designs— office, and administrative facility used efficiency, 15 percentage points over code. an integrated design process, energy including new iterations based on • High-efficiency lighting system that uses information or ideas that have come to modeling, and life-cycle cost analysis of design alternatives to become the first T5 lamps and emphasizes daylighting. light through this process—have been Programmable lighting system monitors thoroughly investigated and compared. hospital to achieve a LEED® Gold rating. Energy-efficient technology and practices daylighting and dims or turns off lights The most effective, least expensive helped Providence achieve a 26 percent when not needed. method of reducing a new facility’s energy savings annually. • HVAC system providing 100 percent energy consumption is to properly plan outside air. its orientation and building envelope. Financial Investments and Benefits It’s easy to see why in this example: • Construction budget was $63.5 million. • Variable primary flow chiller system. • Siting a building to maximize • Incremental project cost was $357,000, • Emergency generators are leased to utility daylighting reduces the need for financed partly through incentives from for maximum of 400 hours per year for electric lighting. local utilities and Energy Trust of Oregon. 10 years, in exchange for $56,000 in incentives. • Reducing electric lighting reduces • Annual energy cost savings are $178,000, the cooling load. or about 975,000 kWh of electricity. • A reduced cooling load requires a smaller cooling system. Further, designing the most appropriate The following concerns and activities ––Maximize shade provided by exterior building envelope for a particular project are important to achieving an optimal landscaping to minimize heat gain in often can reduce both heating and cooling building design: warm climates. requirements. Decisions of this nature, • Employ natural light advantageously. ––Perform preliminary modeling of made early in the design process, are building performance to determine likely to have a dramatic effect on a ––Choose window layouts and designs that use natural light as much as how various natural lighting strategies building’s lifetime energy consumption. would affect the HVAC load. Additionally, any upfront savings possible, particularly in patient resulting from well-thought-out design rooms and corridors. • Design an energy-efficient building strategies can be invested in higher- ––Combine natural light exposure with envelope. quality windows or controls, which will lighting control technologies ––Consider using green roofs to result in even more energy savings. (dimming or stepping). provide insulation and lower intake 4 INTEGRATED BUILDING DESIGN FACT SHEET

temperatures. These add value by improving patient views as well. “Many high-performance ‘green’ buildings cost no more, ––Contemplate installing revolving and even less, than their ‘brown’ equivalents—the key doors in high-traffic locations to is integrated design.” minimize loss of conditioned air. —Robin Guenther, Perkins+Will ––Work as a team to treat the building envelope as a complete system so that all aspects perform optimally its design, and contract documents. and medical personnel. The team has together. Commissioning is critical for ensuring primary responsibility for the long-term • Investigate on-site renewable energy that the design developed through the success of all energy-efficiency planning options, facilitating available whole-building design process is and operations. successfully constructed and operated. opportunities through careful site Members develop and implement each selection. Work as a team to consider • Systematically evaluate all equipment element of the hospital’s ongoing energy renewable generation impacts when to verify it is working according to management plan. Programs such as making decisions in other disciplines, specifications. Measure temperatures EPA’s ENERGY STAR® for Healthcare such as architectural decisions. and flow rates from all HVAC devices are helpful in creating energy • Compare multidisciplinary implications and calibrate all sensors to a standard. management guidelines and of centralized vs. decentralized plant • Review the sequence of operations to benchmarking tools. The following are options. verify that controls are providing the important aspects of an energy • Right-size the boilers and chillers correct interaction between equipment. management plan: based on reduced loads from other Because members of the IBD team have • Monitor performance, verify that goals improvements. firsthand knowledge of the building from are being met, and identify Construction and Commissioning pre-design through installation, they opportunities for improvements. should be involved throughout the During construction, it is important for • Oversee energy-efficiency operations commissioning process—as well as contractors and subcontractors to stay and maintenance training and periodic during subsequent recommissioning. involved in the IBD process. Responsible recommissioning. parties must review all substitution Operations • Assess occupant satisfaction and requests carefully to determine their Once construction is completed and fine-tune the integration of every aspect impact on the energy efficiency of other occupancy of the new building begins, of energy efficiency. building systems and the ability of the responsibility will shift from the IBD • Identify challenges and solutions. facility to meet energy-performance team to the energy management program Target opportunities for additional goals. team. This group is composed of energy savings and energy cost savings. Prior to use, the new facility should be representatives from across the hospital commissioned by an independent spectrum—finance, maintenance and For more detailed information on IBD, provider to verify that it performs facilities, purchasing, quality assurance, visit http://www1.eere.energy.gov/femp/ according to the building owner’s needs, government relations, clinical operations, pdfs/29267-4.1.pdf.

Hospital Energy Alliance A Strong Energy Portfolio for a Strong America HEA is a forum in which healthcare Energy efficiency and clean, renewable energy will mean a stronger leaders work together with DOE, its economy, a cleaner environment, and greater energy independence for national laboratories, and national building America. Working with a wide array of state, community, industry, and organizations to accelerate market university partners, the U.S. Department of Energy’s Office of Energy adoption of advanced energy strategies Efficiency and Renewable Energy invests in a diverse portfolio of and technologies. energy technologies.

EERE Information Center For more information, contact: 1-877-EERE-INFO (1-877-337-3463) Kristen Taddonio www.eere.energy.gov/informationcenter Building Technologies Program Energy Efficiency and Renewable Energy U.S. Department of Energy [email protected] July 2011 commercialbuildings.energy.gov/hospital