Home Health Care Take 5 With Ellen Mitchell Kozack

Take 5 With Ellen Mitchell Kozack

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In this series, Healthcare Design asks leading healthcare design professionals, firms, and owners to tell us what’s got their attention and share some ideas on the subject.

Ellen Mitchell Kozack is vice president, chief sustainability officer, with Leo A Daly (Dallas).

Here, she shares her thoughts on the importance of designing buildings to anticipate disaster scenarios, the rise of all-electric buildings, and why smarter material choices can help reduce a building’s embodied carbon and improve indoor air quality.

  1. Passive survivability

Defined as the ability to maintain livable conditions in the event of lost power, passive survivability strategies include aligning fenestration to promote cross ventilation, optimizing daylight in regularly occupied areas and even (gasp) operable windows. Because hospitals are critical facilities, thinking through how building occupants would function in the event of a long-term power failure is a worthwhile design exercise. We heard horror stories during Hurricane Katrina about how employees in a New Orleans hospital were forced to throw furniture through windows in order to get fresh air and combat the 100+ degree sweltering facility.

  1. Resiliency

A resilient building is one that can reasonably anticipate which disaster scenarios might affect them (floods, hurricanes, earthquakes, epidemics) and design accordingly. If flooding is possible, for example, locating the mechanical equipment on a higher floor and taking critical function spaces off of the ground level makes sense. The Rockefeller Foundation estimates that it costs 50 percent more to rebuild in the wake of a disaster than to build in a way that can withstand the shock in the first place.

  1. Embodied carbon

As the timeline for us to reduce our greenhouse gas emissions in order to avert the worst-case scenarios for climate change get shorter, it has become increasingly important that we not just focus on the energy consumption of our buildings, but also on the embodied carbon that’s emitted through the extraction, manufacture, and transport of our building materials. The three biggest offenders—concrete, steel, and aluminum—account for 11 percent of global greenhouse emissions. We’ve heard a lot about mass timber structures as a way to reduce the embodied carbon in our projects, but we have a long way to go before that’s a viable strategy for all healthcare projects. In the meantime, we need to get smarter about reducing the embodied carbon in concrete structures, which can typically be accomplished through reduced mass of structural systems (which also saves money) and variable cement mixes.

  1. Indoor environmental quality

Years ago, I attended a presentation by Dr. Claudia Miller, assistant dean at the School of Medicine at the University of Texas Health Science Center at San Antonio, in which she made a startling statement: “Architects have a greater ability to improve public health than medical professionals.” We know that people generally spend 90 percent of their time indoors, so the quality of our indoor spaces, such as the air we breathe or the amount of natural daylight we have access to, have a significant impact on everything from employee productivity to patient discharge rates. For healthcare facilities specifically, it’s important that we select furniture and finishes that aren’t comprised of toxic chemical compounds thus minimizing exposure for patients, especially those that may be immuno-compromised or critically ill.

  1. All electric buildings

This is a trend I have seen coming out of places like California (naturally) where the grid energy is getting cleaner. But I didn’t fully understand the impact until I saw a presentation from Panama Bartholomy, director of the Building Decarbonization Coalition, where he explained that natural gas is the number one driver of climate change globally. This is a little-known fact but makes sense when you consider that natural gas is comprised of 98 percent methane, a much more potent greenhouse gas than carbon dioxide. Research from the Rocky Mountain Institute has found that all-electric buildings cost less to build to code than those requiring additional gas infrastructure. Strategies such as heat pumps, solar hot water, and induction cookware not only provide energy-efficient options, but they also positively impact indoor air quality due to the elimination of combustion.

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