In its core values statement on “stewardship,” Seattle-based, Catholic health system Providence Health & Services quotes Psalm 24 and expands upon the chapter’s connection between heaven and earth by stressing the need to care for God’s creations. The health system recently demonstrated this commitment with the opening of Providence Newberg Medical Center, the first hospital in the country to earn a Gold Leadership in Energy and Environmental Design (LEED) rating from the U.S. Green Building Council (USGBC, www.usgbc.org).

The medical center, which opened last June in Newberg, Ore., was designed by Mahlum Architects of Portland, Ore., and Seattle, and built by general contractor Skanska USA Building Inc., headquartered in Parsippany, N.J. Mechanical, electrical and plumbing engineering services were provided by Glumac, with structural engineering by Degenkold Engineers; both engineering firms have offices based in Portland. Green Building Services Inc., also of Portland, oversaw the project’s LEED certification process. The facility includes a hospital and an adjoined medical office building.

The USGBC is a nonprofit organization based in Washington, D.C. The council’s LEED rating system is a recognized standard for sustainable building design, construction and operation. Facilities earn credits, or points, for meeting specific prerequisites or benchmarks in several areas. Based on the total number of points a project receives, it may be awarded a Certified, Silver, Gold or Platinum LEED designation.

Core values

Green building fits well with Providence’s core values of respect, compassion, justice, excellence and stewardship, says Richard Beam, the health system’s director of energy management services. “Energy management and sustainability are very visible ways of demonstrating those core values,” he says. 

The health system has a history of energy conservation. Twelve years ago, Providence leadership hired Beam as a full-time energy manager; 10 years ago the system became an Energy Star Partner of the federal Environmental Protection Agency. The Energy Star-certified buildings program was used as a template for managing energy conservation for all of the system’s facilities, which now number more than 200 buildings in five Western states, from Anchorage, Alaska, to Los Angeles.

So it was only natural that in 2000, when the system was preparing to build a replacement hospital in Newberg, the project planners considered LEED certification. 

Their first appraisal of the program was not promising. “Our initial assessment was that to build a hospital under a LEED program would be prohibitively expensive,” says Beam. Planners estimated that pursuing LEED certification would raise the project cost by $500,000—a significant amount considering the initial $41 million construction budget was already somewhat less than the team had wanted. “We were looking to cut the budget down, not add to it,” says Beam. 

This conclusion was disappointing to many at the health system, including Karen Weylandt, the system’s regional director for design and construction, and her staff, who had been attending seminars and conferences on sustainable construction practices and were eager to implement these concepts.

Meeting the challenge

To learn more about the possibilities for ecologically sound design and construction, Providence scheduled a charrette, or architectural brainstorming session, focused on this subject. The Northwest Energy Efficiency Alliance (www.nwalliance.org), a nonprofit energy conservation organization based in Portland, Ore., agreed to sponsor the eco-charrette, which was facilitated by Green Building Services. The entire project team attended the event—architects, engineers, builders, Providence executives and staff and Newberg community members. Energy efficiency experts from across the country were also in attendance. The eco-charrette revealed the extent of the community’s excitement about the project and the potential for a green hospital building.

The project team decided to try for a Silver LEED accreditation. “Karen went forth like a Star Trekker, going beyond the horizon,” says Beam. “She put together an architectural and engineering team that responded to this challenge.” 

For his part, Beam located several outside funds, including grants and a state energy tax credit, totaling about $356,000. Terry Smith, the system’s chief financial officer in Oregon, agreed to invest $178,000 more in the project after a life-cycle cost analysis for premium efficiency equipment showed the hospital could earn the money back in 14 months through lower operating costs. “He added that to our budget so we could go forward,” says Beam.

When the hospital was within six months of completion, the building’s LEED project manager, architect Katrina Shum Miller of Green Building Services, saw the facility was only two points short of earning a Gold certification. “There was the potential to be the first LEED Gold hospital ever built. How could you say no to that?” asks Beam.

The team earned one point by developing a more technical and comprehensive measurement and verification plan for energy consumption.

They could earn another by purchasing 50 percent green power for two years, a strategy they had earlier rejected due to cost considerations. However, the health system had received a windfall in energy grant money that exceeded expectations for a project in Portland. Beam asked Russ Danielson, vice-president and chief executive for Providence in Oregon, to reallocate the excess funds toward buying not just 50 percent, but 100 percent green power for the Newberg project for two years. “I felt that if we were going to build the world’s first Gold LEED hospital that we shouldn’t just sneak over the bar, but we ought to leap over that hurdle in a big, splashy way,” says Beam. Contracts for purchasing wind, geothermal and low-impact hydroelectric power were signed within an hour of Danielson’s acceptance of the proposal.

Environment, energy

More than 25 percent of the materials used in the facility contain recycled content. Over 30 percent were manufactured locally and more than half were extracted locally. “All the carpet we used, all the fabrics and woods, were from within a 500 mile radius,” says architect Michael Smith of Mahlum. The project team also chose items like formaldehyde-free furniture and paints, coatings, adhesives, sealants and carpets that contain low levels of volatile organic compounds (VOCs) to prevent off-gassing.

Both Weylandt and Smith note that these products are becoming standard in construction and design. “These are things we typically use in our projects,” says Smith. For example, Weylandt adds, “It’s pretty common today in the industry that when you put in carpet you put in green label” carpet that has been certified low-VOC by the Carpet and Rug Institute (www.carpet-rug.com) of Dalton, Ga.

Many of the sustainable design strategies used in the building are simply good design, says Smith. “Most of it is just good design practice. It’s my hope that in 10 years people won’t be talking about [sustainable design] anymore. It will just be a standard of care, the way all architects approach their projects,” he says.

Efficient systems also play a significant role in the building’s success. For example, the facility uses condensing boilers that operate at 95 percent efficiency, versus a code standard of 80 percent efficiency. The hospital’s high hot water usage made a premium efficiency hot water boiler plant a priority that is expected to yield financial returns for years to come, says Beam.

For air conditioning, premium efficiency chillers were installed. A primary variable-flow chilled water pumping strategy enables hospital staff to match closely the demand, production and distribution of hot and chilled water, avoiding the overproduction of either one. The cooling water loop system and low-flow plumbing fixtures used at the hospital are projected to reduce water usage by more than 20 percent. The use of native and drought-resistant plants in the facility’s landscaping should cut the amount of potable water needed for irrigation by more than half. Landscaping bioswales in the parking lot manage and filter impurities from storm water.

Lighting fixtures in the parking lot and other exterior areas face downward, with cutoff lenses to reduce light pollution. Campus roofs are covered with white thermoplastic membranes that lessen the buildings’ heat island effect.

Severe acute respiratory syndrome (SARS), avian flu and other airborne infectious diseases were prominent news items at the time the hospital was designed. To help contain potential airborne contamination, an air distribution system using 100 percent outside air was installed in the building; no air is recirculated. A heat recovery unit recaptures heat from the air before it is exhausted from the facility. “We exhaust the air but we retain the valuable heat,” Beam explains.

The Betterbricks Energy Studies in Buildings Lab, an initiative of the Northwest Energy Efficiency Alliance that is operated by the University of Oregon in Portland, helped the architects and engineers develop a high-efficiency lighting system for the facility. Daylighting is an important part of the hospital’s design, both for energy savings and to improve the environment for patients, staff and visitors. Daylighting has many benefits when executed properly, but it can have adverse effects, such as glare, unwanted heat and increased ultraviolet radiation exposure, and it can wash out light from the rest of the building’s lighting system. The building was oriented to take advantage of sunlight, but the south-facing glass has a different energy coefficient than the north-facing glass, says Smith. Also, a programmable lighting system monitors the amount of daylight in various parts of the building, automatically dimming or turning off lights when they are not needed. The system also turns off lights in unoccupied areas.

The facility is not only saving energy, it may even make energy for its community. The hospital participates in the Portland General Electric (PGE) dispatchable generation program. In exchange for $56,000 in incentives, the hospital is leasing the use of its emergency generators to the utility for a maximum of 400 hours per year for the next 10 years. The power company can use these generators to produce electricity during peak operation, which can be cheaper than buying kilowatt hours on the open market. PGE pays for the fuel and must notify hospital administrators, who retain a right of refusal, when the generators will be turned on. The Newberg hospital is one of three Providence facilities in the program.

Triple bottom line

The Providence planning team sees green building as having a “triple bottom line”: economic, social and environmental. The economic benefits at Providence Newberg include a projected 26 percent savings in energy costs. The state-of-the-art, environmentally friendly facility has also helped with physician recruitment, says Larry Bowe, the medical center’s chief executive. The medical office building is full; Weylandt says planning will begin early next year for the next medical office building on campus.

More patient beds may be added relatively soon, too, says Smith. To add rooms, the second floor nursing unit corridor can be extended on top of the first floor. “The first floor was designed to allow that to happen without too much disruption,” Smith says.  The master plan for the facility also includes the addition of a full wing onto the back of the hospital. With only 19 of the 57 acres on campus developed, “they have room to grow for years and years to come,” says Weylandt.

She adds that while following the LEED program was rewarding, it was challenging because the rating system was not developed for hospitals. For example, LEED requires daylighting in offices; this requires creative design in hospitals, which must also provide daylight in patient rooms. For future health care projects, Providence plans to follow the Green Guide for Health Care (www.gghc .org), which was developed for the health care sector by a number of design, health care and conservation groups. The USGBC itself is working on a LEED program for health care, considering the special needs of health facilities.

Bowe says it has been a great thrill for the hospital to be the first to receive a Gold LEED rating and to demonstrate that hospitals can be leaders in sustainable design. He says, “Sustainability is important to Providence not only because it is the right thing to do for the environment, but it’s also our calling as a health ministry to be good stewards with all of our resources, environmental and financial alike.”