RICHMOND, Va. — The leadership and staff of the Parrish Medical Center in Titusville, Fla., believe that the physical environment can play a significant role in patient care. When constructing its flagship inpatient facility in 2002, Parrish created a healing environment that contributes to good health and patient-centered outcomes through the creative use of evidence-based design. This approach helped the organization emerge as a leader recognized for creating one of America's finest healing environments.
Evidence-based design seeks to understand the effects of the environment on patients and staff, and helps to guide decisions based on the best information available. For example, in 2004 Parrish surveyed its 734 staff members and found that design features such as access to natural light, improved airflow, and "homelike" patient-room design had a positive effect on the staff's work life and patient care.
Parrish is applying what it learned from the PMC project to the construction of its outpatient facility, the Parrish Healthcare Center at Port St. John. This time, the organization is taking an even larger step toward sustainable design and construction by building green. The new facility is slated to receive Leadership in Energy and Environmental Design (LEED) certification. It will be among the first outpatient facilities in the nation to achieve this distinction.
Healthcare Industry Slow to Adopt Green
The healthcare industry is in a challenging position. Healthcare providers are responsible to the communities they serve and must recognize that the environmental impacts of their facilities span both operations and construction. The root of healthcare is, after all, to "first, do no harm." Since the mid-1990s, the industry has made considerable progress in reducing operational impacts on the environment; healthcare providers now stand poised to begin transforming design and construction practices.
The explosive growth of the U.S. Green Building Council is evidence that the business and design communities are taking up the challenge to build more environmentally responsible buildings, yet the healthcare industry has been slow to take up the challenge and opportunities of green building. According to the U.S. Green Building Council, of the 3,617 LEED-registered projects in the United States, 74 are healthcare buildings. That's only about 2 percent.
While some attribute this in part to the relatively poor fit between LEED processes and hospital buildings, others believe it is because this industry is already so highly regulated and financially stretched. Certification is a voluntary, consensus-based national standard for developing high-performance buildings. To receive LEED certification, a building must meet stringent criteria in five categories: sustainable site development, water conservation, energy efficiency, conservation of materials and resources, and indoor environment quality.
Parrish Healthcare Center -- Port St. John
The 72,500-square-foot, $27 million diagnostic treatment center will house up to 16 doctors in six suites. The two-story building includes outpatient health care facilities and a medical office. The healthcare center also contains a wide range of outpatient diagnostic services, including cardiopulmonary, MRI, mammography, ultrasound, CT scans and other radiology exams, stress testing, a sleep lab, and rehabilitation.
The architectural and interior designs of the outpatient center reflect nature's beauty and incorporate the seven elements of a healing environment: nature, color, healthy lighting, healthy building, physical security, wayfinding and cultural responsiveness. Examples of these include:
- An atrium with exterior planters and a three-tiered interior fountain that, when observed as a whole, provide light, color, texture and sound. These reinforce a natural feel and have shown to be healing elements.
- An array of warm textures, bright finishes and sophisticated lighting technology create a hospitable environment.
- Quiet patient areas, excellent indoor air quality and attention to patient flow.
- State-of-the-art security systems that protect patients, visitors and employees alike.
- A structure built to withstand hurricane storm events and is build above the 100-year flood plain, per code in the state of Florida.
- Wayfinding graphics/signage that are clear and visible denoting the different areas of the building.
- Colors, fabric textures and artwork which are specific to the site's habitat area.
The physical building reflects the values, beliefs and philosophy of the people responsible for creating the healing experience. The grounds also contribute to the overall environment. The 33-acre campus also includes a nature preserve and trail. The Brevard Zoo will help with placing signs along the trail that are both environmentally friendly as well as educational.
Combining Evidence-based Design and LEED
"Research has shown that environment plays a key role in healing. Our mission is 'healing experiences for everyone, all the time,'" said Chris Fox, director, PHC at Port St. John. "We wanted to create the best possible environment for the people who will be treated at our Port St. John facility."
Parrish is one of the few healthcare facilities in the United States to apply evidence-based design to the LEED certification process.
"Interesting parallels exist between evidence-based design and the LEED certification process," said Fox. "By combining the two, a healthcare facility can maximize benefits to patients, the environment, clinical performance and administrative efficiency."
Parrish's leadership consulted with area residents to ensure that the facility would meet their needs. The hospital created an advisory group of residents to learn what was wanted and expected from the largest healthcare investment ever made in the community.
Parrish also worked with Johnson Controls to integrate the construction and design with the facility's operational mission and commitment to environmental stewardship. Johnson Controls provided LEED-certification consulting and served as the construction manager for the mechanical, plumbing, electrical and technology building systems. It will also provide service of primary-building systems.
In building the Parrish Healthcare Center at Port St. John to meet LEED specifications, the long-term outcome will be a building that is healthier for its occupants and the environment.
"The LEED certification process serves as an incredible guide to create something that is so much more than just a building. LEED supports our evidence-based design approach by incorporating elements we've found to be important while providing additional benefits to our operations. Over the entire lifespan of the building, the actual cost of going green can be negligible," said Chris Male, a medical center developer with Parrish.
The entire process has been so successful that Parrish its leaders are frequently approached by other healthcare leaders with questions on building green. Parrish believes sharing their experiences is a key part of the facility's mission.
By building green, Parrish found a way to design, construct and operate a healing environment that will benefit patients and staff, consume less energy, and have a positive environmental impact.
"We feel we have created a superior facility that will positively affect everyone who comes into contact with it. Using LEED guidelines and evidence-based design were keys to achieving that," said Fox.
Jenny Stentz is the director of healthcare solutions for Johnson Controls.
