GREEN HOSPITALBy Dr.Mahboob ali khan Phd

GREEN HOSPITALRefers to a structure and using process that is

environmentally responsible and resource efficient throughout a Hospital’s life cycle : from sitting to design, construction, operation, maintenance, renovation, and demolition.

Green Hospital – also known as sustainable or high performance Hospital increases the efficiency with which Hospitals and their sites use and harvest energy, water, and materials.

GREEN HOSPITAL CONCEPTThe ‘GREEN HOSPITAL’ concept is gaining

importance in various countries, including India. These are Hospitals that ensure waste is minimized at every stage during the construction and operation of the Hospital, resulting in low costs, according to experts in technology.

A Green Hospital is a structure that is environmentally responsible and resource efficient throughout it’s life cycle.

OBJECTIVE Green Hospital are designed to reduce the

overall impact of the built environment on human health and the natural environment by :

Efficiently using energy, water and other resources.

Protecting occupant health and improving employee productivity.

Reducing waste, pollution and environment degradation.

Goals of green HospitalGreen Hospital brings together a vast array of practices and techniques to reduce and ultimately eliminate the impacts of Hospitals on the environment and human health. It often emphasizes taking advantage of renewable resources, e.g., using sunlight through passive solar, active solar, and photovoltaic techniques and using plants and trees through green roofs, rain gardens, and for reduction of rainwater run-off. Many other techniques, such as using packed gravel or permeable concrete instead of conventional concrete or asphalt to enhance replenishment of ground water, are used as well.

Fundamental principles :   Structure Design Efficiency, Energy Efficiency, Water Efficiency, Materials Efficiency, Indoor Environmental Quality Enhancement , Operations and Maintenance Optimization , and Waste and Toxics Reduction

Structure design efficiencyThe foundation of any construction project is rooted in the

concept and design stages. The concept stage, in fact, is one of the major steps in a project life cycle, as it has the largest impact on cost and performance. In designing environmentally optimal Hospitals, the objective is to minimize the total environmental impact associated with all life-cycle stages of the Hospital project. However, Hospital as a process is not as streamlined as an industrial process, and varies from one Hospital to the other, never repeating itself identically. In addition, Hospitals are much more complex products, composed of a multitude of materials and components each constituting various design variables to be decided at the design stage. A variation of every design variable may affect the environment during all the Hospital's relevant life-cycle stages.

Energy efficiencyTo reduce operating energy use, high-efficiency windows and

insulation in walls, ceilings, and floors increase the efficiency of the Hospital envelope, (the barrier between conditioned and unconditioned space). Another strategy, passive solar Hospital design, is often implemented in low-energy homes. Designers orient windows and walls and place awnings, porches, and trees to shade windows and roofs during the summer while maximizing solar gain in the winter. In addition, effective window placement (day lighting) can provide more natural light and lessen the need for electric lighting during the day. Solar water heating further reduces energy costs.

Onsite generation of renewable energy through solar power, wind power, hydro power, or biomass can significantly reduce the environmental impact of the Hospital. Power generation is generally the most expensive feature to add to a Hospital.

Water efficiencyReducing water consumption and protecting water quality are key

objectives in sustainable Hospital. One critical issue of water consumption is that in many areas, the demands on the supplying aquifer exceed its ability to replenish itself. To the maximum extent feasible, facilities should increase their dependence on water that is collected, used, purified, and reused on-site. The protection and conservation of water throughout the life of a Hospital may be accomplished by designing for dual plumbing that recycles water in toilet flushing. Waste-water may be minimized by utilizing water conserving fixtures such as ultra-low flush toilets and low-flow shower heads. Bidets help eliminate the use of toilet paper, reducing sewer traffic and increasing possibilities of re-using water on-site. Point of use water treatment and heating improves both water quality and energy efficiency while reducing the amount of water in circulation. The use of non-sewage and greywater for on-site use such as site-irrigation will minimize demands on the local aquifer.

Materials efficiencyGreen Hospital materials are composed of renewable,

rather than nonrenewable resources. Green materials are environmentally responsible because impacts are considered over the life of the product. Depending upon project-specific goals, an assessment of green materials may involve an evaluation of one or more of the criteria listed below.

Green Hospital material/product selection criteria : Resource efficiency  Indoor air quality   Energy efficiency  Water conservation   Affordability

Resource EfficiencyRecycled Content: Products with identifiable recycled

content, including postindustrial content with a preference for post consumer content.

Resource efficient manufacturing process: Products manufactured with resource-efficient processes including reducing energy consumption, minimizing waste (recycled, recyclable and or source reduced product packaging), and reducing greenhouse gases.

Locally available: Hospital materials, components, and systems found locally or regionally saving energy and resources in transportation to the project site.

Durable: Materials that are longer lasting or are comparable to conventional products with long life expectancies.

Indoor environmental quality enhancement Indoor Air Quality seeks to reduce volatile organic compounds,

or VOCs, and other air impurities such as microbial contaminants. Hospitals rely on a properly designed ventilation system (passively/naturally- or mechanically-powered) to provide adequate ventilation of cleaner air from outdoors or recirculated, filtered air as well as isolated operations (kitchens, dry cleaners, etc.) from other occupancies.

Low or non-toxic: Materials that emit few or no carcinogens, reproductive toxicants, or irritants as demonstrated by the manufacturer through appropriate testing.

Moisture resistant: Products and systems that resist moisture or inhibit the growth of biological contaminants in Hospitals.

Systems or equipment: Products that promote healthy IAQ by identifying indoor air pollutants or enhancing the air quality.

Operations and maintenance optimization

No matter how sustainable a Hospital may have been in its design and construction, it can only remain so if it is operated responsibly and maintained properly.. Every aspect of green Hospital is integrated into the O&M phase of a Ensuring operations and maintenance(O&M) personnel are part of the project's planning and development process will help retain the green criteria designed at the onset of the project Hospital's life. The addition of new green technologies also falls on the O&M staff. Although the goal of waste reduction may be applied during the design, construction and demolition phases of a Hospital's life-cycle, it is in the O&M phase that green practices such as recycling and air quality enhancement take place

Waste reduction Green architecture also seeks to reduce waste of energy, water and

materials used during construction. For example, in California nearly 60% of the state's waste comes from commercial Hospitals .During the construction phase, one goal should be to reduce the amount of material going to landfills. Well-designed Hospitals also help reduce the amount of waste generated by the occupants as well, by providing on-site solutions such as compost bins to reduce matter going to landfills.

To reduce the impact on wells or water treatment plants, several options exist. "Greywater", wastewater from sources such as dishwashing or washing machines, can be used for subsurface irrigation, or if treated, for non-potable purposes, e.g., to flush toilets and wash cars. Rainwater collectors are used for similar purposes.

Centralized wastewater treatment systems can be costly and use a lot of energy. An alternative to this process is converting waste and wastewater into fertilizer, which avoids these costs and shows other benefits.

HOW TO MAKE GREEN HOSPITALS

Cost and payoffThe most criticized issue about constructing environmentally friendly

Hospitals is the price. Photo-voltaics, new appliances, and modern technologies tend to cost more money. Most green Hospitals cost a premium of <2%, but yield 10 times as much over the entire life of the Hospital. The stigma is between the knowledge of up-front cost vs. life-cycle cost. The savings in money come from more efficient use of utilities which result in decreased energy bills. It is projected that different sectors could save $130 Billion on energy bills. Also, higher worker or student productivity can be factored into savings and cost deductions.

Studies have shown over a 20 year life period, some green Hospitals have yielded $53 to $71 per square foot back on investment. Confirming the rentability of green Hospital investments, further studies of the commercial real estate market have found that LEED and Energy Star certified Hospitals achieve significantly higher rents, sale prices and occupancy rates as well as lower capitalization rates potentially reflecting lower investment risk.

Regulation and operationThe Indian Hospital industry is highly de-centralized

with people and/ or groups engaged in design, construction, equipment provision, installation, and renovation working together. Each group may be organized to some extent, but there is limited interaction among the groups, thus disabling the integrated green design and application process.

Hence, it is very important to define and quantify sustainable Hospital practices and their benefits. It is also important to separate the role of different participants in ensuring that the Hospital consumes minimal resources over its entire life cycle and leaves behind a minimal environmental footprint.

Indian Green Hospital Council The Indian Green Building Council (IGBC), was formed in the year

2001 by Confederation of Indian Industry (CII). The vision of the council is to usher in a green Hospital movement in India and facilitate India to become one of the global leaders in green Hospitals by 2015.

With a modest beginning of 20,000 sq ft (1,900 m2). green built-up area in the country in the year 2003, today more than 1053 green Hospitals ( as on April 2011) with a built-up area of over 648,000,000 sq ft (60,200,000 m2). are being constructed all over India, of which 147 green Hospitals are certified and fully functional

LEED India for New Construction LEED India for Core and Shell IGBC Green Homes IGBC Green Factory Hospital IGBC Green SEZ IGBC Green Townships

Green Rating for Integrated Habitat AssessmentGRIHA has been developed after a thorough study and

understanding of the current internationally accepted green Hospital rating systems and the prevailing Hospital practices in India. The team has researched on several international rating systems. A few team members were also sponsored under a study tour by USAEP (United States Asia Environmental Partnership) to understand the eco-rating systems prevalent in the US. The team has vast experience in providing design assistance to green Hospitals in the country and long and varied experience in carrying out energy conservation studies in existing hotels, offices, and other commercial Hospital. The team has effectively utilized the several multi-disciplinary strengths and experiences of the colleagues at TERI to arrive at the tools that addresses cross-cutting issues in the design, development, and operation of a green Hospital.

Suzlon Energy Limited - Pune

Several accolades continue to shower upon Suzlon’s global headquarter in Pune - “One Earth” - ever since the facility has been LEED ‘Platinum’ rated and certified as an eco-friendly Hospital by the Green Hospital Council. Built to perfection on an area of 41,000 square meters (10.13 acres), One Earth can be counted as among the largest green Hospital projects in India and is living proof that our world can be replenished with a little green effort, everyday.

Biodiversity Conservation India Ltd (BCIL) - BangaloreAs a green builder who strives for the conservation of diversity in vegetation, forests, culture and urban lifestyles, BCIL has created some of the most energy-efficient residential homes India has ever set eyes upon. The company’s TZed homes in Whitefield, Bangalore has been certified as the first residential apartment in the world to be rated ‘Platinum’ under LEED. TZed, which means “Towards Zero Energy Development” is a 2,49,000 sq.ft. green project spread across 5.5 acres and is designed to reduce lighting and energy by nearly 70 per cent.

No home at BCIL TZed Homes uses incandescent lamps, halogens and fluorescent tubelights

ITC Green Centre - GurgaonRenowned as one of the early adopters of the green Hospital movement in India, the ITC Green Centre is still considered a benchmark for green Hospitals. It was the first 'Platinum' rated Hospital in India and has endeavored to adopt green practices that go beyond recycled waste and day-lit offices. Within a built-in area of 180,000 sq.ft., the Hospital features alternative transportation facilities, storm water management system, solar thermal technology, reflective high-albedo roof paint, minimal exterior lighting, separate smoking rooms with exhaust system and zero-water discharge

More than 10% of the Hospital materials are refurbished from other sites and 40% are from within 500 miles of the project site

The Druk White Lotus School - LadakhIn this desert landscape of severe climatic conditions, 3,500 meters above sea level, was born a modest school that is adjudged as an outstanding example of sustainable, green, cost effective Hospital development. This multi-award winning structure is the recipient of the Best Asian Hospital, Best Education Hospital and Best Green Hospital awards. It combines the best of traditional Ladakhi architecture with 21st century engineering excellence and is built with traditional materials such as locally excavated stone, mud bricks, timber and grass.

Traditional mud brick masonry is used internally to provide increased thermal performance and durability

Who is GreenOne of the most innovative green Hospitals in the country is the CIMS care institute of medical science at Ahmedabad that best demonstrates the use of solar energy to produce steam. Right from the bricks, air conditioning, lighting & heating systems to harvesting rain water, the hospital has spent around Rs 50 crore extra on the Rs 150-crore project. "We not only save money in the long run but also make our contribution to save the planet," said Dr Milan Chag, managing director, CIMS.

This Hospital puts to use appropriate technologoes and passive solar concepts to achieve energy-efficiency

Doon School - DehradunAuthorities can rightfully claim that this establishment is one of India's first green school campuses that opted for recycling measures and successfully achieved cent per cent self-sufficiency in energy, water and organic fertilizer. Several old Hospital blocks that were part of the 69 acre school were redesigned and solar thermal systems, waste management processes as well as biomass gasification systems were introduced as part of its green initiatives.

Doon school drastically reduced the need for artificial heating/cooling air conditioning through solar thermal systems and cross-ventilation

Raintree Hotels - ChennaiHere is an eco-sensitive hotel for the eco-savvy traveler. The entire chain of Raintree business hotels across Chennai city are the first eco-sensitive hotels in South India. Everything about this hospitality range is green: right from the rubber wood, bamboo and medium-density fiber used for construction down to the Portland Pozzalana cement containing 15 to 20 per cent fly ash. The George Fisher concealed cistern installed at the hotel controls the water used in toilet flushes and the sewage treatment plant recycles water for use in air conditioners.

Setting new standards of environmental responsibility without compromising on guest experience

Rajiv Gandhi International Airport - Hyderabad India’s first Greenfield airport is undeniably among the top 10 green Hospitals in India and the first airport in Asia to be awarded the LEED ‘Silver’ rating certification by US Green Hospital Council. Featuring 100,005 sq. m. of glass encased terminal, this green Hospital ensures optimal use of natural light and minimal wastage of electricity or energy consumption. Yet another of its green features includes the recycling of treated wastewater for landscaping, air conditioning and flushing requirements.

This greenfield airport has been built at a cost of Rs 2,478 crore

Patni Knowledge Centre* Climate responsive architecture* Over 50% green area* 75% of the area receives natural daylight* 95% of the occupants get access to outside views* Zero discharge Hospital; 100% recycling of sewage* Drip water irrigation and solar water heating* Interior materials with low volatile organic compound (VOC) emissions* Healthy air quality with CO2 sensors for adding fresh air on demand* Maximum use of eco-friendly recyclable material.

 Set up with an investment of Rs.. 175 crores, this Green IT-BPO centre is spread over 5 acres of land and seats over 3,500 people.

Nokia - GurgaonAmong India’s most sustainable Hospitals is the corporate office of Nokia in Gurgaon which has been granted accreditation as one of the world’s leading green Hospitals by the U.S. Green Hospital Council (USGBC). This is the first time that a commercial interior fit-out project in India is being awarded the Green Hospital Award and prestigious LEED ‘Gold’ rating. What makes this green office stand out from the rest is its smart lighting and ventilation systems, high-efficiency chillers, high-performance double glazing, heat recovery wheel, green guard certified furniture and online CO2 monitoring system.

START THINKING GREEN

THANK YOU !