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Community Health Center Asks: To LEED Or Not To LEED?

Healthcare Design | December 31, 2013 by Deborah Wingler and Ellen Taylor 

In November 2012, Adelante Healthcare, a system of seven federally qualified healthcare facilities serving the Phoenix metropolitan area and surrounding communities, opened the nation’s first LEED-Platinum community health center in Mesa, Ariz. Driven by a commitment to provide sustainable healthcare, Adelante Healthcare sought to understand the impact of LEED certification on the organization by conducting research designed to address gaps within current literature and develop a baseline for further investigation on green building within ambulatory environments.

Adelante’s initial report regarding the investment and implementation of sustainable building practices at Adelante Healthcare Mesa, a Pebble Project facility, was delivered in an educational session at the Healthcare Design Conference, held Nov. 16-19 in Orlando.

Prior research surrounding LEED certification has primarily focused on financial savings related to energy efficiencies and capital cost premiums in office and acute care environments. However, many research papers cite the U.S. Green Building Council definition of green buildings as “ones that have significantly reduced or eliminated negative impacts on the environment and the occupants.”

Unfortunately, the focus on more easily quantifiable measurements, such as water and energy use, provides minimal insight into the indoor environmental quality (IEQ) and its effect on occupants. Alone, this focus isn’t compelling enough for many providers, especially smaller clinic-based healthcare organizations, to commit to the process of attaining third-party certification for green design.

Addressing this narrow view, research conducted in 2013 by Guy Newsham and colleagues, in association with the National Research Council Canada, identified areas in need of further investigation, such as the measurable impact green buildings have on occupant health and well-being, job satisfaction, and satisfaction with the environment for factors including speech privacy, noise, light, access to windows, thermal comfort, and air quality.

A report prepared by the Institute for Innovation in Large Organizations for Practice Greenhealth further suggests the next generation business case should address areas like the economic benefit of staff outcomes that are linked to turnover and recruitment, and the community benefit of improved public perception that can boost philanthropic support for an organization. Doing so, the report states, would create a business case that’s “more persuasive for hospital executives and boards, especially in nonprofits that need to demonstrate community benefit to governmental funding.”

The concept
In response to this, Adelante Healthcare decided to conduct an extended business case focused on what’s often called the triple bottom line, using the factors of people, planet, and profit to create the study’s framework.

However, these factors were then expanded to include outcomes through both direct and indirect measures related to the mission, vision, and goals of the organization in the areas of staff, community, stewardship, and influence.

For the study, Adelante Healthcare decided to compare the Mesa facility to another of its newest outpatient clinics. Adelante Healthcare Surprise opened in December 2011 in Surprise, Ariz., and influenced the design of Mesa, which opened in November 2012.

Both facilities were built using evidence-based design (EBD) principles, such as decentralized nurses’ stations, natural daylight in public areas, the use of art as a positive distraction, and culturally relevant design. They both also offer similar comprehensive services through a medical home model of care.

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