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.

Komal Kotwal is the sustainable design leader for health, well-being, and equity at HOK (Houston). Here she shares her thoughts on climate resilience, community health, and new drivers behind sustainable design.

  1. Carbon neutrality

Mounting concerns about climate change are compelling healthcare institutions to adopt policies and practices that reduce emissions. It’s imperative that organizations  not only set goals to achieve carbon neutrality, or net-zero carbon dioxide emissions, but also have clear plans in place to achieve these goals. Bold steps, like carbon accounting, net-zero carbon strategic roadmaps. and the use of renewable energy sources such as solar or wind power, will help to ensure success. New technologies and design strategies are making designing net-zero carbon buildings more mainstream and commercially viable.

  1. Climate resilience

A recent report from non-profit research and technology group First Street Foundation (Brooklyn, N.Y.) shows that 25 percent of the nation’s critical infrastructure, including hospitals, are at risk of flooding. This number is only expected to grow due to sea level rise and extreme weather events resulting from climate change. Climate resilience is—and must be—a critical aspect of emergency preparedness. In low-lying areas such as Louisiana, Florida, and Texas (or as recently seen in many northeastern states, healthcare buildings should be designed to operate in an emergency connected to flooding and sea level rise. Design strategies for climate resilience, including selecting low-impact development sites, incorporating green space and afforestation, and building systems designed for continuous operations in emergencies, can help healthcare organizations prepare for extreme climate events.

  1. Community health

Health, equity, and climate change are inextricably linked. The number of extreme weather disasters has increased dramatically over the last 50 years. Failure to respond or operate during a climate event puts communities served by a healthcare system at risk. As large public buildings in the heart of our communities, hospitals should give back to their neighborhoods through green infrastructure that improves air quality, open spaces for the community to gather, and biophilic design solutions the help support patients and staff.

  1. New drivers behind sustainable design

A decade ago, the decision to invest in sustainable projects had to come from leadership at the top of an institution. Now everyone from the government to investors to stakeholders and staff are pushing organizations to set ambitious sustainability goals. Under the current administration, The U.S. Department of Health and Human Service established The Office of Climate Change and Health Equity (OCCHE; Washington, D.C.) to encourage hospitals to cut carbon emissions and provide sustainable healthcare facilities. Climate reporting and environmental and social governance policies will be integral for healthcare institutions moving forward. The good news is that investing in sustainable buildings comes with a long-term financial, cultural, and environmental payback. Green buildings are statistically proven to lower operational and maintenance costs, reduce the transmission of infectious diseases, increase productivity and job satisfaction, and create a sense of community, according to USGBC.

  1. Waste management and mitigation

As much as 71 percent of a healthcare organization’s environmental footprint is generated via the supply chain production, transportation, and disposal of goods such as pharmaceuticals, food, equipment, and devices. Systems can positively impact the environment by setting waste diversion targets and developing pathways to net-zero waste. Additionally, they can harness their influence and purchasing power to encourage vendors and suppliers to move away from single use plastics and towards sustainable packaging. Establishing purchasing criteria that requires vendors to adhere to social and environmental guidelines and share yearly Environmental, Social and Governance reports is another way to make a change.


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