GREEN HOSPITAL

By Dr.Mahboob ali khan Phd

GREEN HOSPITAL
Refers to a structure and using process that is
environmentally responsible and resource efficient
throughout a Hospitals life cycle : from sitting to
design, construction, operation, maintenance,
renovation, and demolition.
Green Hospital also known as sustainable or high
performance Hospital increases the efficiency with
which Hospitals and their sites use and harvest energy,
water, and materials.
GREEN HOSPITAL CONCEPT
The GREEN HOSPITAL concept is gaining
importance in various countries, including India.
These are Hospitals that ensure waste is minimized
at every stage during the construction and
operation of the Hospital, resulting in low costs,
according to experts in technology.
A Green Hospital is a structure that is environmentally
responsible and resource efficient throughout its life
cycle.
OBJECTIVE
Green Hospital are designed to reduce the overall
impact of the built environment on human health and
the natural environment by :
Efficiently using energy, water and other resources.
Protecting occupant health and improving employee
productivity.
Reducing waste, pollution and environment
degradation.
Goals of green Hospital
Green Hospital brings together a vast array of practices and techniques
to reduce and ultimately eliminate the impacts of Hospitals on the
environment and human health. It often emphasizes taking advantage
of renewable resources, e.g., using sunlight through passive solar, active
solar, and photovoltaic techniques and using plants and trees
through green roofs, rain gardens, and for reduction of rainwater run-
off. Many other techniques, such as using packed gravel or permeable
concrete instead of conventional concrete or asphalt to enhance
replenishment of ground water, are used as well.
Fundamental principles : Structure Design Efficiency, Energy
Efficiency, Water Efficiency, Materials Efficiency, Indoor
Environmental Quality Enhancement, Operations and Maintenance
Optimization, and Waste and Toxics Reduction
Structure design efficiency
The foundation of any construction project is rooted in the concept and
design stages. The concept stage, in fact, is one of the major steps in a
project life cycle, as it has the largest impact on cost and performance.
In designing environmentally optimal Hospitals, the objective is
to minimize the total environmental impact associated with all
life-cycle stages of the Hospital project. However, Hospital as a
process is not as streamlined as an industrial process, and varies from
one Hospital to the other, never repeating itself identically. In addition,
Hospitals are much more complex products, composed of a multitude
of materials and components each constituting various design variables
to be decided at the design stage. A variation of every design
variable may affect the environment during all the Hospital's
relevant life-cycle stages.
Energy efficiency
To reduce operating energy use, high-efficiency windows and
insulation in walls, ceilings, and floors increase the efficiency of
the Hospital envelope, (the barrier between conditioned and
unconditioned space). Another strategy, passive solar Hospital
design, is often implemented in low-energy homes. Designers orient
windows and walls and place awnings, porches, and trees to shade
windows and roofs during the summer while maximizing solar gain in
the winter. In addition, effective window placement (day lighting) can
provide more natural light and lessen the need for electric lighting
during the day. Solar water heating further reduces energy costs.
Onsite generation of renewable energy through solar power, wind
power, hydro power, or biomass can significantly reduce the
environmental impact of the Hospital. Power generation is generally
the most expensive feature to add to a Hospital.
Water efficiency
Reducing water consumption and protecting water quality are key
objectives in sustainable Hospital. One critical issue of water
consumption is that in many areas, the demands on the supplying
aquifer exceed its ability to replenish itself. To the maximum extent
feasible, facilities should increase their dependence on water
that is collected, used, purified, and reused on-site. The
protection and conservation of water throughout the life of a Hospital
may be accomplished by designing for dual plumbing that recycles
water in toilet flushing. Waste-water may be minimized by utilizing
water conserving fixtures such as ultra-low flush toilets and low-
flow shower heads. Bidets help eliminate the use of toilet paper,
reducing sewer traffic and increasing possibilities of re-using water on-
site. Point of use water treatment and heating improves both water
quality and energy efficiency while reducing the amount of water in
circulation. The use of non-sewage and greywater for on-site use
such as site-irrigation will minimize demands on the local
aquifer.
Materials efficiency
Green Hospital materials are composed of renewable, rather than
nonrenewable resources. Green materials are environmentally
responsible because impacts are considered over the life of the product.
Depending upon project-specific goals, an assessment of green
materials may involve an evaluation of one or more of the criteria listed
below.
Green Hospital material/product selection criteria :
Resource efficiency
Indoor air quality
Energy efficiency
Water conservation
Affordability
Resource Efficiency
Recycled Content: Products with identifiable recycled content,
including postindustrial content with a preference for post consumer
content.
Resource efficient manufacturing process: Products manufactured
with resource-efficient processes including reducing energy
consumption, minimizing waste (recycled, recyclable and or source
reduced product packaging), and reducing greenhouse gases.
Locally available: Hospital materials, components, and systems found
locally or regionally saving energy and resources in transportation to
the project site.
Durable: Materials that are longer lasting or are comparable to
conventional products with long life expectancies.
Indoor environmental quality enhancement
Indoor Air Quality seeks to reduce volatile organic compounds, or
VOCs, and other air impurities such as microbial contaminants.
Hospitals rely on a properly designed ventilation system
(passively/naturally- or mechanically-powered) to provide adequate
ventilation of cleaner air from outdoors or recirculated, filtered air as
well as isolated operations (kitchens, dry cleaners, etc.) from other
occupancies.
Low or non-toxic: Materials that emit few or no carcinogens,
reproductive toxicants, or irritants as demonstrated by the
manufacturer through appropriate testing.
Moisture resistant: Products and systems that resist moisture or
inhibit the growth of biological contaminants in Hospitals.
Systems or equipment: Products that promote healthy IAQ by
identifying indoor air pollutants or enhancing the air quality.
Operations and maintenance optimization

No matter how sustainable a Hospital may have been in its design and
construction, it can only remain so if it is operated responsibly and
maintained properly.. Every aspect of green Hospital is integrated into
the O&M phase of a Ensuring operations and maintenance(O&M)
personnel are part of the project's planning and development
process will help retain the green criteria designed at the onset of
the project Hospital's life. The addition of new green technologies also
falls on the O&M staff. Although the goal of waste reduction may be
applied during the design, construction and demolition phases of a
Hospital's life-cycle, it is in the O&M phase that green practices
such as recycling and air quality enhancement take place
Waste reduction
Green architecture also seeks to reduce waste of energy, water and
materials used during construction. For example, in California nearly 60%
of the state's waste comes from commercial Hospitals .During the
construction phase, one goal should be to reduce the amount of material
going to landfills. Well-designed Hospitals also help reduce the amount of
waste generated by the occupants as well, by providing on-site solutions
such as compost bins to reduce matter going to landfills.
To reduce the impact on wells or water treatment plants, several options
exist. "Greywater", wastewater from sources such as dishwashing or
washing machines, can be used for subsurface irrigation, or if treated, for
non-potable purposes, e.g., to flush toilets and wash cars. Rainwater
collectors are used for similar purposes.
Centralized wastewater treatment systems can be costly and use a lot of
energy. An alternative to this process is converting waste and wastewater
into fertilizer, which avoids these costs and shows other benefits.
HOW TO MAKE GREEN HOSPITALS
Cost and payoff
The most criticized issue about constructing environmentally friendly
Hospitals is the price. Photo-voltaics, new appliances, and modern
technologies tend to cost more money. Most green Hospitals cost a
premium of <2%, but yield 10 times as much over the entire life of the
Hospital. The stigma is between the knowledge of up-front cost vs. life-
cycle cost. The savings in money come from more efficient use of
utilities which result in decreased energy bills. It is projected that
different sectors could save $130 Billion on energy bills. Also,
higher worker or student productivity can be factored into savings and
cost deductions.
Studies have shown over a 20 year life period, some green Hospitals
have yielded $53 to $71 per square foot back on
investment. Confirming the rentability of green Hospital investments,
further studies of the commercial real estate market have found that
LEED and Energy Star certified Hospitals achieve significantly
higher rents, sale prices and occupancy rates as well as lower
capitalization rates potentially reflecting lower investment risk.
Regulation and operation
The Indian Hospital industry is highly de-centralized with
people and/ or groups engaged in design, construction,
equipment provision, installation, and renovation working
together. Each group may be organized to some extent, but there
is limited interaction among the groups, thus disabling the
integrated green design and application process.
Hence, it is very important to define and quantify sustainable
Hospital practices and their benefits. It is also important to
separate the role of different participants in ensuring that the
Hospital consumes minimal resources over its entire life cycle
and leaves behind a minimal environmental footprint.
Indian Green Hospital Council
The Indian Green Building Council (IGBC), was formed in the year 2001
by Confederation of Indian Industry (CII). The vision of the council is to
usher in a green Hospital movement in India and facilitate India to become
one of the global leaders in green Hospitals by 2015.
With a modest beginning of 20,000 sq ft (1,900 m2). green built-up area in
the country in the year 2003, today more than 1053 green Hospitals ( as on
April 2011) with a built-up area of over 648,000,000 sq ft (60,200,000 m2).
are being constructed all over India, of which 147 green Hospitals are
certified and fully functional
LEED India for New Construction
LEED India for Core and Shell
IGBC Green Homes
IGBC Green Factory Hospital
IGBC Green SEZ
IGBC Green Townships
Green Rating
for Integrated Habitat Assessment
GRIHA has been developed after a thorough study and understanding
of the current internationally accepted green Hospital rating systems
and the prevailing Hospital practices in India. The team has researched
on several international rating systems. A few team members were also
sponsored under a study tour by USAEP (United States Asia
Environmental Partnership) to understand the eco-rating systems
prevalent in the US. The team has vast experience in providing design
assistance to green Hospitals in the country and long and varied
experience in carrying out energy conservation studies in existing
hotels, offices, and other commercial Hospital. The team has effectively
utilized the several multi-disciplinary strengths and experiences of the
colleagues at TERI to arrive at the tools that addresses cross-cutting
issues in the design, development, and operation of a green Hospital.
 Suzlon Energy
Limited - Pune
Several accolades continue to
shower upon Suzlons global
headquarter in Pune - One
Earth - ever since the facility
has been LEED Platinum
rated and certified as an eco-
friendly Hospital by the Green
Hospital Council. Built to
perfection on an area of 41,000
square meters (10.13 acres),
One Earth can be counted as
among the largest green
Hospital projects in India and
is living proof that our world
can be replenished with a little
green effort, everyday.
Biodiversity
Conservation India
Ltd (BCIL) -
Bangalore
As a green builder who strives for
the conservation of diversity in
vegetation, forests, culture and
urban lifestyles, BCIL has created
some of the most energy-efficient
residential homes India has ever
set eyes upon. The companys TZed
No home at BCIL TZed Homes uses
homes in Whitefield, Bangalore incandescent lamps, halogens and
has been certified as the first fluorescent tubelights
residential apartment in the world
to be rated Platinum under LEED.
TZed, which means Towards
Zero Energy Development is a
2,49,000 sq.ft. green project
spread across 5.5 acres and is
designed to reduce lighting and
energy by nearly 70 per cent.
ITC Green Centre -
Gurgaon
Renowned as one of the early
adopters of the green Hospital
movement in India, the ITC Green
Centre is still considered a
benchmark for green Hospitals. It
was the first 'Platinum' rated
Hospital in India and has
endeavored to adopt green
practices that go beyond recycled
More than 10% of the Hospital materials are
waste and day-lit offices. Within a
built-in area of 180,000 sq.ft., the refurbished from other sites and 40% are
Hospital features alternative from within 500 miles of the project site
transportation facilities, storm
water management system,
solar thermal technology,
reflective high-albedo roof
paint, minimal exterior
lighting, separate smoking
rooms with exhaust system and
zero-water discharge
The Druk White
Lotus School -
Ladakh
In this desert landscape of severe
climatic conditions, 3,500 meters
above sea level, was born a modest
school that is adjudged as an
outstanding example of
sustainable, green, cost effective
Hospital development. This multi-
award winning structure is the
recipient of the Best Asian
Hospital, Best Education
Hospital and Best Green
Traditional mud brick masonry is used
Hospital awards. It combines internally to provide increased thermal
the best of traditional Ladakhi performance and durability
architecture with 21st century
engineering excellence and is
built with traditional materials
such as locally excavated stone,
mud bricks, timber and grass.
Who is Green
One of the most innovative
green Hospitals in the country
is the CIMS care institute of
medical science at Ahmedabad
that best demonstrates the use
of solar energy to produce
steam. Right from the bricks,
air conditioning, lighting &
heating systems to harvesting
rain water, the hospital has
spent around Rs 50 crore extra
on the Rs 150-crore project.
"We not only save money in
the long run but also make our This Hospital puts to use appropriate
contribution to save the technologoes and passive solar concepts to
planet," said Dr Milan Chag, achieve energy-efficiency
managing director, CIMS.
Doon School -
Dehradun
Authorities can rightfully
claim that this establishment
is one of India's first green
school campuses that opted
for recycling measures and
successfully achieved cent
per cent self-sufficiency in
energy, water and organic
fertilizer. Several old
Hospital blocks that were Doon school drastically reduced the need for
part of the 69 acre school artificial heating/cooling air conditioning
were redesigned and solar through solar thermal systems and cross-
thermal systems, waste ventilation
management processes as
well as biomass gasification
systems were introduced as
part of its green initiatives.
Raintree Hotels -
Chennai
Here is an eco-sensitive hotel for
the eco-savvy traveler. The entire
chain of Raintree business hotels
across Chennai city are the first
eco-sensitive hotels in South India.
Everything about this hospitality
range is green: right from the
rubber wood, bamboo and
medium-density fiber used for
construction down to the
Portland Pozzalana cement
containing 15 to 20 per cent fly
Setting new standards of environmental
ash. The George Fisher responsibility without compromising on
concealed cistern installed at guest experience
the hotel controls the water
used in toilet flushes and the
sewage treatment plant recycles
water for use in air conditioners.
Rajiv Gandhi
International
Airport -
Hyderabad
Indias first Greenfield airport is
undeniably among the top 10 green
Hospitals in India and the first
airport in Asia to be awarded the
LEED Silver rating certification by
US Green Hospital Council.
Featuring 100,005 sq. m. of glass This greenfield airport has been built at a
encased terminal, this green
Hospital ensures optimal use of
cost of Rs 2,478 crore
natural light and minimal
wastage of electricity or energy
consumption. Yet another of its
green features includes the
recycling of treated wastewater
for landscaping, air
conditioning and flushing
requirements.
Patni Knowledge
Centre
* Climate responsive architecture
* Over 50% green area
* 75% of the area receives natural
daylight
* 95% of the occupants get access
to outside views
* Zero discharge Hospital; 100%
recycling of sewage
* Drip water irrigation and solar
water heating
* Interior materials with low
volatile organic compound (VOC)
emissions
* Healthy air quality with CO2
Set up with an investment of Rs.. 175 crores,
sensors for adding fresh air on this Green IT-BPO centre is spread over 5
demand acres of land and seats over 3,500 people.
* Maximum use of eco-friendly
recyclable material.
Nokia - Gurgaon
Among Indias most sustainable
Hospitals is the corporate office of
Nokia in Gurgaon which has been
granted accreditation as one of the
worlds leading green Hospitals by
the U.S. Green Hospital Council
(USGBC). This is the first time that
a commercial interior fit-out
project in India is being awarded
the Green Hospital Award and
prestigious LEED Gold rating.
What makes this green office stand
out from the rest is its smart
lighting and ventilation
systems, high-efficiency
chillers, high-performance
double glazing, heat recovery
wheel, green guard certified
furniture and online CO2
monitoring system.
START THINKING GREEN
THANK YOU !