Urban medical centers play an important role in protecting and fostering public safety through a wide variety of spaces and services. But how do their physical campuses support the mission of public health?
The reality of climate change is particularly alarming. According to Health Care Without Harm, an international nongovernmental organization focusing on environmental and justice, nearly four percent of global net emissions from the climate crisis are due to the healthcare sector.
What can be done to help reduce the industry’s climate impact? There are many opportunities to make a difference and address climate change through planning and design. For campuses with high operational energy use and large land-area footprints, it can be possible to reduce carbon emissions through the implementation of more efficient and sustainable building systems. Design teams can also work together to address other climate-related needs in the future, such as supporting alternative transportation options or managing stormwater to help communities protect against flooding.
These are the goals of architects and urban designers who want to make an impact in planning and designing.
- Utility management and energy efficiencyMultifamily and commercial office sectors have seen designers push clients towards higher levels of energy efficiency by using solar arrays and other on-site power generation. Design teams must encourage healthcare clients to adopt forward-looking building systems, utility management practices, and promote public health from an environmental and climate justice perspective in order to improve public health. On the building scale, specifying efficient LED lighting, low-flow fixtures in washrooms, or even modern MRI machines and laundry equipment can provide significant energy savings and a positive impact on an institution’s carbon footprints.
Technology and the design of mechanical, electric, and plumbing (MEP), systems can help to reduce local emissions and energy and resource consumption. Greywater reuse systems, for example, treat used water with chlorine or ultraviolet light and then recycle it to flush toilets and other similar functions. This reduces water consumption.
- Transit alternatives and active design.Active design’s core principles, such as the placement of stairs to encourage movement, have gained wide acceptance over the past decade. This has allowed architects to use architecture to support public healthcare. Another useful strategy for improving public health outcomes and reducing carbon emissions in the context of urban medical campuses is to approach active design on a larger scale.
Master planning initiatives or building initiatives should consider the possibility of locating primary entries and patient programming within walking distance from a transit hub or stop. This is a recommendation made by many planning groups, such as the Institute for Livable Cities. Also, pedestrian routes that are safe and easily accessible can be designed around hospitals and healthcare campuses. This will encourage transit use and reduce emissions.
- Plan for severe weather eventsExtreme flooding is becoming more common in urban areas. It is important to work to reduce carbon emissions (mitigation), to protect medical campuses and surrounding communities from the severe effects of climate change. Many medical campuses are strategically located, large and have extensive landholdings. This gives them the opportunity to find solutions that will increase their ability to withstand severe flood events. The best solutions will depend on many factors such as climate, hydrogeology and existing building sitings and characteristics, as also local policy and utility management practices.
In general, however, design teams should prioritize upgrades to on-site water retention and detention through the creation of robust and resilient stormwater systems—an approach that allows for low-impact mitigation against severe weather by absorbing and channeling rainfall and groundwater away from vulnerable areas such as building entrances, public plazas, and pedestrian rights of way. For the new research campus for the Children’s Hospital of Philadelphia (CHOP; Philadelphia), Cooper Robertson developed a solution to address not only current conditions but also future challenges, using a combination of green roofs, rain gardens, and underground cisterns that enable the collection, conveyance, and retention of 85 percent of the stormwater generated on the site.
By taking a holistic approach to the urban medical campus, it’s possible for design teams to address multiple and wide-ranging, yet interconnected, challenges at the same time. Public health, climate change, and resilience are all interconnected. Creative design solutions that take all three issues into account will benefit the entire community.