As the global population continually increases its reliance on and rapid depletion of the world’s natural resources, like water and fossil fuels, legislators and professional organizations are urged to establish energy strategies that set and meet goals for better energy performance.
For example, the U.S. Green Building Council supported by the U.S. Department of Energy and other organizations have focused in on creating Net Zero Energy Buildings aiming for carbon-neutral facilities by 2030.
At the state level, the California Energy Commission sets energy policies and planning regulations for residential and commercial buildings. Its most recent set of codes establishes specific directives that healthcare facilities throughout California must comply with as of January 1, 2023. These codes include encouraging efficient electric heat pumps, expanding solar photovoltaic and battery storage standards, and strengthening ventilation standards, among others.
The key to success here is incorporating energy-efficient strategies into the design, construction, and operation of new buildings and retrofitting existing structures. When it comes to healthcare facilities, however, considerations must be made for their unique design challenges, including 24/7 operation, infection control, high ventilation rates, and stringent temperature and humidity requirements for critical areas, among others.
What Does “Net-Zero” Mean?
Net zero refers to the goal of minimizing greenhouse gas emissions caused by an organization’s activities – those that humans influence – to practically zero. Simply put, this means netting out the positives and negatives in emissions to produce no impact.
Net zero differs from carbon neutrality, though mathematically they’re the same. With net zero, the intention is to maximize the reduction of emissions before aiming to offset the impact. Whereas carbon neutrality focuses more on theoretically limitless emissions as long as there are counterbalances to equalize the results.
Carbon-Intensive Aspects of Today’s Healthcare Sector
Virtually all healthcare activities contribute to the industry’s carbon footprint, including the energy consumed in the buildings, the vehicles used to transport patients, and the products and services required to facilitate operations.
Like any other kind of building, hospitals and healthcare facilities cause emissions through their energy consumption, but most of the industry’s carbon-intensive actions occur throughout the supply chain, not at the hospitals themselves.
These aspects are categorized in three scopes:
- Scope 1: Direct emissions from a healthcare facility
- Scope 2: Emissions from purchased utility services
- Scope 3: Goods and services necessary for operations
Source: Yale Sustainability
While the sector does have a level of control for emissions in scopes 1 and 2, those in scope 3 can only be somewhat influenced by the healthcare industry.
Globally, direct and indirect emissions from healthcare total 2.0 gigatonnes of carbon dioxide equivalent. Approximately 30% of emissions are generated from burning fossil fuels or the purchase of electricity, heat, or steam. Most emissions, however, lie within scope 3.
Because the healthcare industry has limited influence and control over scope 3 emissions, there are many challenges in managing and offsetting the resulting carbon output.
Additionally, the very nature of healthcare building operations poses challenges to limiting emissions, including:
- 24/7 operation
- Infection control
- Indoor air quality
- High outside air ventilation rate
- Stringent temperature and humidity requirement for critical areas
- Room pressurization
- Room supply air changes per hour
- System reliability and redundancy
When carefully considering all these aspects of healthcare facilities, one thing remains steadfast in the pursuit of achieving net-zero emissions: it can’t come at the cost of staff and patient care and safety.
Seven Key Principles for Implementing Net Zero
The Seven Key Principles for Implementing Net Zero were presented by the International Energy Agency at the IEA-COP26 Net Zero Summit on March 31, 2021, and adopted by IEA Member Countries, including the US.
The principles state that:
- Sustainable recoveries can provide a once-in-a-generation down payment toward net zero. As countries stimulate economies and build back after the COVID-19 pandemic, they, and the companies within them, have an opportunity to jumpstart progress toward achieving net zero emissions. Now is the time to start.
- Clear, ambitious, and implementable net-zero-aligned roadmaps to 2030 and beyond are critical. National and local governments can increase confidence in the transition by establishing action roadmaps, which must consider the diverse circumstances in each region and options for implementation. Make a plan and communicate it.
- Transitions will go faster when learning is shared. A range of real-world implementation challenges are holding back transitions, including meeting the energy needs of underserved populations and improving safe and sustainable energy access for vulnerable populations. By creating ways to share best practices, collaborate on technology, and provide targeted advice across borders, leaders in the field can help drive the pace of transition across the global energy system. We’re all in this together.
- Net zero sectors and innovations are essential to achieve global net zero. Early-stage technologies will need to provide almost half of the emissions reductions required to set the world on an ambitious path to net zero. The development and deployment at scale of a range of climate-neutral energy technologies – along with energy efficiency – can foster rapid, sustainable transitions across major energy sectors. Follow the leaders.
- Mobilizing, tracking, and benchmarking public and private investments will be instrumental in achieving net zero. The climate emergency requires an urgent shift to climate-neutral energy investment to achieve net zero by 2030. Major international efforts are necessary to increase capital flow, and both public and private sectors need to create the environments for sustainable and socially acceptable energy investment. Bank on a better future.
- People-centered transitions are morally required and politically necessary. As countries seek to advance their shifts to clean energy technologies, the success of these efforts relies on enabling citizens to benefit from transition opportunities and navigate disruptions. It will also be necessary to provide training and skills development to equip citizens to participate in the net zero economy. Rally the troops.
- Net zero energy systems need to be sustainable, secure, affordable, and resilient. It’s critical for governments, companies, and other key contributors to maintain security for energy systems through the transitions to net zero. Managing existing and anticipating new energy security challenges, including the flow of energy, requires:
- A diverse, sustainable, and socially acceptable clean energy and technology mix
- Optimizing existing infrastructure
- Addressing emerging challenges like climate resilience
- Cyber risks and the availability and security of critical minerals
Bringing Building Goals Together
For healthcare facilities to withstand both manmade and natural disasters, designing for resiliency is key. Fortunately, the tools to accomplish net-zero buildings are also keys to occupancy during a disruption to a facility’s energy supply.
These tools include:
- Reducing heat loss and gain by improving the building envelope
- Using high-efficiency electric heat pumps for space and water heating
- Storing energy by pre-heating or pre-cooling water and the buildings themselves
- Enabling demand flexibility for appliances, which may be internet-automated to reduce energy use when the grid is dirty
- Considering peak conditions rather than normal operating conditions to ensure reliability and carbon-offsetting
- Adding solar photovoltaic (PV) systems for decarbonization and habitability
- Purchasing green power or connecting to local microgrids or solar
- Commissioning energy and water systems and building envelopes to verify operation is aligned with design goals
Other intersections between building goals include:
Climate Risk Assessment
Determining potential risk from climate change, which may include the temperature rise and an increase in natural disasters like wildfires, storms, hurricanes, or drought, and designing emergency solutions to address them.
Consideration of the physical location of healthcare facilities is critical. Along with choosing a setting that maximizes access for local communities and reduces transportation times when every moment matters, facilities should be located away from flood zones and oriented to benefit from natural daylighting and energy efficiency opportunities.
Healthcare facilities can be designed to conserve water through the use of low-flow plumbing fixtures, greywater systems, and rainwater harvesting to maximize naturally occurring conditions and reduce water consumption.
Sourcing sustainable, low-maintenance, and local materials can reduce environmental impact. Recycled and recyclable materials can help the drive toward net zero. Indoor air quality is also a concern for healthcare facilities but selecting materials with low volatile organic compounds (VOCs) improves the air quality of the indoor environment and reduces health-related issues.
Achieving Net-Zero Healthcare Design
Net-zero structure requires a comprehensive and tailored approach that considers the individual building’s unique needs, but the general steps include:
Passive Design Optimization
Façade design to utilize daylight and ensure the optimal natural light for occupants while limiting the use of artificial lighting, reducing glare, and optimizing heating and cooling is an important factor in net-zero emissions. Doing so allows natural ventilation for some of the year, supplemented by mechanical systems to heat in winter and cool in summer as needed.
Reduced Operational Energy Demand
Heating, cooling, and lighting can be optimized by widening temperature set bands and allowing occupants to control their own comfort, aided by fans and natural airflow. Each building has its own drivers of energy consumption, which should be considered to determine alternatives.
Reduced Fossil Fuel Usage
Fifth-generation heat networks and electric heat pump technologies can replace fossil fuel technologies to facilitate low carbon energy use. Combined with zero-emission vehicles, these measures can improve air quality and promote more efficient buildings.
Onsite Renewable Energy and Storage
Any necessary energy sources after optimization can come from onsite technologies or off-site renewable certified energy sources to reduce overall consumption.
Limited Upfront Embodied Carbon
All upfront carbon for the initial build and the carbon intensity need to be limited, including construction materials and emissions associated with the construction work. Using modular construction approaches and circular economy principles will limit upfront embodied carbon.
Whole Life Carbon vs. Whole Life Costing
All upfront and operational carbon emissions, including those for fit outs, maintenance, refurbishment, deconstruction, and reuse should be measured and evaluated over the life of the design to ensure a durable and robust building.
Healthcare facilities should publicly disclose all operational, embodied, and whole-life carbon annually using an embodied carbon database like the ICE database.
These general steps are crucial to not only new construction but refurbishment of existing structures to address net-zero challenges. A phased approach minimizes costs, optimizes resources, and works toward “quick wins” in high-impact areas to move closer to net zero.
Resilient, Net-Zero Healthcare Design with Given Design Group
Reaching net-zero goals in healthcare facilities is challenging, but there are a variety of methods and approaches that can balance the unique needs of each building. It goes without saying that hospitals and campus-wide medical centers are enormous consumers of energy. For example, to minimize exposure of airborne pathogens to vulnerable immune compromised patients, healthcare facilities tend to use outside air versus recycled air. Using 100% outside air, which can be 105 degrees or more, requires a lot of energy to cool to 68 degrees for use inside.
Conversely, to reduce the energy demand on rooftop air handlers, much less effort is needed to maintain the desired temperature of recycled air routed back via return air ducts. For this scenario, Given Design Group has been working with engineers to use more UV lights within the ventilation systems to kill airborne bacteria and allow conditioned air to be reused.
Additionally, Given Design Group has been working with healthcare facility clients to identify places for solar panel installation over parking areas and providing feasibility reports to address reducing energy demands by switching all the campus-wide light fixtures to LED.
At Given Design Group, we’re focused on creative, user-first design solutions and innovations in the way healthcare facilities are designed and built to better serve the needs of patients, staff, and the environment. Contact us today to discuss your project.