The 2023 HCD Conference in October will offer a variety of educational sessions. In this Q+A, speaker HOK’s Kathleen Schwartz and Vlad Torskiy discuss new sustainability strategies and initiatives and how they’re set to impact facility planning and design.

The 2023 Healthcare Design Conference + Expo will be held Nov. 4-7, at the Ernest N. Morial Convention Center in New Orleans, La. The annual event will offer a variety of keynote and breakout sessions on a range of topics.

Healthcare Design is previewing some of the upcoming educational sessions in a series of Q+As with speakers, sharing what they plan to discuss and key takeaways they plan to offer attendees.

Session: “Population Health & Safety : A Look Through the Environmental Lens”

Speakers: Kathleen Schwartz, senior healthcare consultant, HOK, and Vlad Torskiy, principal, regional leader of healthcare, HOK

This sessions sets out to help attendees understand the healthcare industry’s environmental impact, and the negative long-term impacts if action is not taken. Additionally, speakers will discuss the U.S. Department of Health and Human Services’ (HHS) sustainability strategy, new Office of Climate Change and Health Equity (OCCHE) requirements, and how those pertain to future healthcare design. The presentation will share ideas for incorporating environmental sustainability efforts without affecting patient health and safety, as well as understanding current policy-making initiatives from the Environmental, Social, and Corporate Governance perspective.

Healthcare Design: What’s driving changes in the conversation about resiliency and sustainability in the healthcare sector?

Vlad Torskiy

Photo credit: Eugene Kaydanovsky

Vlad Torskiy: Sustainability as the architecture-engineering (AE) industry knows it has been transformed in recent years into a much bigger and broader category: Environment, which in turn is part of the government ESG (environmental, social, and governance) implementation strategy.

Specifically, the U.S. Department of Health and Human Services (HHS) established a new department, Office of Climate Change and Health Equity (OCCHE), that monitors commitments toward emission reductions and climate resiliency in healthcare. Other developments include the Centers for Medicare & Medicaid Services (CMS) changes to its Conditions of Participation requirements to include environmental policies and guidelines, while in September, The Joint Commission (TJC) introduced a Sustainable Healthcare Certification for hospitals and health systems.

These executive branch agencies are now actively engaged in the sustainability and environmental aspects of healthcare delivery and the AE industry must become intimately familiar with their requirements to advise clients at all stages of the planning, design, and construction process.

What should be top of mind for healthcare organizations?

Kathleen Schwartz

Photo Courtesy of HOK

Torskiy and Kathleen Schwartz: The impact of the new strategies, policies, and guidelines on healthcare organizations’ level of funding, reimbursement, and investment.

As an execution mechanism, any new requirements are typically translated into a set of standardized compliance measures (similar to the pay-for-performance quality-of-care measures). Compliance versus non-compliance can result in reimbursement levels being dropped, certifications being revoked, and financial penalties or grant awards.

OCCHE states that in healthcare “despite a growing recognition of the health problems associated with climate change and the need for action, many organizations—and particularly those serving the most at-risk communities—struggle to make investments in sustainability and resilience because of insufficient funding”. These financial risks have a ripple effect not only on healthcare delivery but on the entire health sector industry, including architecture, engineering, transportation, equipment, supply chain, waste, etc.

What’s challenges do healthcare organizations face when trying to incorporate environmental sustainability efforts—and how can they overcome it?

Torskiy: The recently introduced TJC certification concentrates on four fields of environmental sustainability implementation: transportation, building and energy use, anesthetic gases, and waste. Using anesthetic gases as an example, these gases can be divided into two categories: volatile and non-volatile. From the volatile category, nitrous oxide and desflurane receive the most attention from the TJC, and other organizations concerned about greenhouse gas emissions.

Both gases have a direct impact on quality of care/life of the patient and hospital infrastructure/building systems. The average surgical case use of desflurane is equal to driving 198 miles, while nitrous oxide has 300 times the warming power of carbon dioxide. While desflurane can be substituted with sevoflurane there is no comparable and safe replacement for the nitrous oxide.

The “puzzle-solving” ideas and solutions are extensive, and we will review them as part of the presentation.

What’s a takeaway from your session that you hope attendees walk away with?

Schwartz: Awareness is the major takeaway. First, we need the AE industry to understand the ESG and how it’s much bigger than sustainability. Architects and engineers need to learn the ESG’s impact on healthcare operations and functionality, the economy of ESG social factors, and the governance implications. All of the above will become a critical element of planning and design in the future.

Second, health administrators in the audience needs to understand what they are committing to. They need to bring understanding and knowledge to their entire institution as the front-line staff/boots on the ground will be paramount to the success or failure of requirements, policies, and guidelines compliance and implementation.

For more on the HCD Conference schedule and registration, visit