On the surface, it would seem that keeping built healthcare facilities as environmentally friendly and healthy as possible would be a no-brainer; after all, if the first rule of medicine is to first, do no harm, the building itself should be free from harmful materials, and as “green” and sustainable as possible. Doesn’t it make sense that a building you visit to get healthy would itself be healthy?

In reality, of course, financial and other concerns mean that this isn’t always the case. While there has been growing awareness of environmental issues in healthcare design over the last decade-plus, there is still work to be done, and that’s where Mara Baum, AIA, LEED AP BD+C, comes in.

Baum is at the forefront of the movement via her role as Sustainable Design Leader for HOK’s Healthcare practice, making the firm’s work as green, sustainable, and healthy as possible. In the first of a two-part interview, I spoke to Baum about how her role at the firm—and in the healthcare design community as a whole—has  evolved over the years, the term “green” versus “sustainable,” and much more.


Todd Hutlock: In the 2012 healthcare design market, what exactly does a Sustainable Design Leader for Healthcare at a major A/E firm do?

Mara Baum: I figure that out on a day-by-day basis; it is constantly changing. One of the things I spend a lot of time on, of course, is working with HOK’s project teams to try to make our projects as green, sustainable, and healthy as possible. I am based out of San Francisco, but I work with our project teams around the world. In some cases, I have a significant amount of direct contact with the design team and the client, and in other cases, I work in parallel with other Sustainable Design Leaders that are specific to other locations to support them in keeping their healthcare projects on track and focused—they are experts in other building types or sustainability in general, so I provide the extra level of healthcare knowledge that’s so important for these types of projects. One size definitely does not fit all for healthcare. I work on three or four projects at any given time, and I touch maybe another half a dozen on a lighter level.

I also do a lot of work with staff development in all of HOK’s healthcare offices worldwide, helping architects to step up to the plate and effectively take over the sustainability work on their projects. Sometimes it is as simple as explaining how to register a project for LEED online, and sometimes I push teams to take that extra leap into subjects like a deeper understanding of the details of energy efficiency in healthcare. I also set general guidance for all of HOK Healthcare to meet  firmwide sustainability metrics and goals. I work with our firmwide healthcare leadership on those goals, and with our individual office leaders, as well.

In addition, I work with HOK’s healthcare research staff, which is based in our New York office. I have a research background, which helps me to work effectively with them. We are not collaborating on a formal project in place right now, but we do bounce a lot of ideas off of each other. I also sit on a six-person global sustainability strategy team, representing healthcare, and collaborate regularly with our Marketing and Business Development staff.

Hutlock: You just mentioned the terms “green” and “sustainable” in that response. There is still some confusion in the marketplace that those two terms are interchangeable, but they are, in fact, two different things. How does your “green” work differ from your “sustainable” work?

Baum: We view sustainability in the context of the “triple bottom line” or the “three-legged stool” – that includes social equity, financial issues, and ecological or “green” issues. But to really answer your question, it depends on who I’m talking to. I started my career at HOK in the late 1990s working on HOK’s first Guidebook to Sustainable Design. Being involved with environmental issues during that era and in the Midwest, I learned that I needed to communicate with project teams—including designers, owners, contractors, and the like—in a way that allowed me to meet them where they are (not interested in environmental issues) and not where I want them to be (deeply engaged in sustainability). That often meant changing the language that I used to describe these concepts.

These days, the word “green” is far more accepted than it once was.  I can use that term and people more or less understand that it is related to environmental issues and not the color of paint on your wall. The word “sustainability” is still interpreted in different ways, however.

Hutlock: You mentioned that your job is changing every day. Looking back at the big picture, however, what has changed since you started doing this in the late 1990s?

Baum: The biggest change is the social awareness and political and emotional attitudes by the public at large toward the importance of environmental issues and, fundamentally, the existence of environmental issues at all. These issues went from being  highly politicized to being much more bipartisan, relatively speaking. I think that has affected the mindset and awareness levels of the general population, especially as the economy has changed and the public has become more sensitive to the cost of utilities.

When I first started at HOK, we were in a period of change. The notion of the Sustainable Design Leader was just getting off the ground within the firm, and it was certainly before most other firms even had such a role. We were called different things, like Green Champions. Occasionally we would have amazing clients who were aware of sustainability issues as we currently know them, but this was pre-LEED or during the LEED pilot era, so general knowledge was very different. The simplicity of LEED definitely did a lot to raise awareness.

Hutlock: So is your job easier now that this general knowledge has increased?

Baum: I would say that some things are easier for sure, but on the other hand, we now have to step up to a bigger challenge.  I do not have to spend as much time with fundamental issues like the old “doom-and-gloom” speech to help people understand the impact that buildings have on the environment, or to spell out the value of simple payback analysis.

While I don’t have to spend as much energy on that, the stakes are much higher and the bar for sustainability has been raised considerably. Instead of talking about potentially pursuing LEED, the conversation is now more like, “Of course we’re going for a LEED Gold rating, but can we hit net zero energy, and if not, how close can we come within a 15- or 20-year payback?” We are no less challenged, and now that there is more public awareness, there is also more pressure to respond to these higher goals.


Click here to read part 2 of this interview.