Article by Moritz Hirschmann
Responsible for an average 5% of global greenhouse gas (GHG) emissions, the healthcare sector is in dire need of a new sustainable direction. Indirect emissions through electricity consumption and the heating and cooling of buildings account for 12% of emissions in the German healthcare sector. Because of the specific role healthcare facilities play in providing care, a step towards sustainability for healthcare buildings means more than a step towards global reductions in carbon emissions; it also means a step towards the well-being of healthcare stakeholders.
Challenges in the sector
Healthcare buildings face multiple environmental, social and economic challenges to becoming sustainable. As an example, hospitals are challenged by:
Energy consumption: Hospital buildings are among the highest consumers of energy. In comparison, on average, hospitals consume more energy than hotel businesses. This is not only due to high energy demands for electricity and heating that come with the large space these buildings occupy, but also due to the specific equipment used in healthcare buildings. This equipment accounts for over half of the energy consumed in the healthcare sector.
Water consumption: While the average person in Germany uses over 100 liters of water per day, hospitals use between 300 and 1000 liters of water per patient per day. Water in hospitals is needed both for hygienic purposes, such as showering and cleaning laundry, and for other uses, such as for drinking and landscaping.
Building design: Hospitals need to be designed to be accessible to all. Additionally, as places for healing, hospitals need to maximize the physical and mental well-being of patients, staff and visitors. This means they need to be designed to be both efficient and comfortable at the same time. This can be challenging, due to the unique needs of hospitals. Apart from sustainable design, hospitals need to be designed to maximize patient well-being, as well as efficiency and minimize response time in the case of emergencies. Additionally, hospitals need to be able to keep up with potential changes in patient demands.
Urban heating: Each of the points raised here contributes to urban heating and vice versa. Urban heating occurs in high density housing and other built areas and is caused by heat that becomes trapped in the building structures and surrounding areas. This trapped heat increases temperatures, which in turn can increase energy costs, for example for air conditioning and water consumption, as well as increase the risk of heat-related illnesses, thereby countering the goals of healthcare buildings.
Addressing these challenges requires varied solutions to transform toward sustainable healthcare buildings. The solutions outlined below indicate just a few ways this transformation is possible. Furthermore, as the example of urban heating indicates, implementing one of these solutions can promote co-benefits by working to address multiple problems simultaneously. In essence, sustainability is not just about addressing one challenge, such as pollution, but rather it is an all-encompassing concept that aims to maximize benefits while doing no harm.
Some key measures for more sustainable building design in the health sector include, but are not limited to:
Photovoltaic panels (PV or solar panels) are sources of renewable energy and can be installed on many roof types and for most buildings, including healthcare buildings. These panels work in spaces that usually are not being used for other purposes. While the specific energy production of PV panels is dependent on a multitude of factors, solar panels in Europe take approximately a year to payback their initial energy investment, after which they will generate an energy surplus. Energy-saving light bulbs also can reduce electricity and resource use by lowering energy consumption and lasting longer than traditional incandescent bulbs.
Movement Sensors for certain parts of the buildings can ensure the lights are only on when needed. Another way to consume fewer resources is to install energy efficient appliances.
Natural ventilation can lower temperatures and reduce the energy use of air conditioning. Cool roof coating and reflective paint on roofs and other external surfaces also can work against the urban heating effect and reduce the need for air conditioning, not only reducing energy costs, but also working towards patient comfort in the hospital environment. A plant-rich environment, such as roof gardens and trees, can further reduce the urban heating effect, leading to lower energy requirements and improved patient well-being.
Water saving measures such as rainwater capture, low-flow shower heads and other water efficient appliances can further reduce water consumption, while solar-powered hot water collectors can reduce energy needs for warming water.
The potential for the return of investment over time, however, does not mean that indiscriminately implementing technical solutions is enough. Other impacts on the environment must be taken into account, such as production factors or impacts on the directly adjacent environment. All of these factors should be included in the building designs from the beginning or incorporated when renovating existing structures.
Financing Opportunities for a Sustainable Transformation
Often local and national governments and other entities offer subsidies and other incentives for including sustainable building practices. Some examples on different levels include:
On a national level, private subsidies offer low interest rate credits for buildings that adhere to certain sustainability practices. For example, KfW (a German promotional bank) has standards for a resource efficient house called the “Effizienzhaus”.
Federal funding on a national level comes from offices, such as the Federal Office for Economic Affairs and Export Controls (BAFA) which offers umbrella support for sustainable and energy efficient renovation and Federal Funding for Efficient Buildings („Bundesförderung für Effiziente Gebäude“).
On a regional level, state government entities provide support schemes. For example, Baden-Württemberg's Ministry for the Environment, Climate and Energy (UM) offers funding for buildings built with certain sustainability practices.
Local programs are also available for sustainable transformation support, such as the city of Munich which offers comprehensive support for sustainable buildings, from consulting to financial support under its Funding for Climate Neutral Buildings program (“Förderung Klimaneutrale Gebäude”).
These funding opportunities are just some of the potential ways the healthcare sector can strive toward sustainability in a cost-effective way. These supports can mean improvements for both the healthcare sector, as well as for its stakeholders. As such, these kinds of opportunities work to protect the environment and everyone living in it, especially patients, not only now but also moving forwards to a more sustainable future.