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Credit: Henry Obasi

Would you pass up the opportunity to partner with a renowned university to research significant energy-use reductions in acute-care hospitals while also improving the quality-of-care environment for both patients and staff? Neither could we.

With a good portion of our work at Stantec dedicated to sustainable healthcare design, we’re well aware that hospitals consume a lot more than their share of energy and provide a lot less daylight and views than other building types do. We’ve been conducting hospital configuration and system-integration studies for several years, and have begun to implement strategies that reduce energy and increase daylight in real projects. The aim of a recent collaborative study we’ve undertaken is to see how far we can push the boundaries of energy efficiency and indoor environmental quality, using simple and resilient systems that harness natural forces and imbed nature’s beauty in the care environment. The model we’re testing embeds a wide range of strategies that would also make real hospitals more efficient, flexible, and generative of communication within and between care teams.

There is a tremendous sense of shared purpose within the healthcare design community that leads to collaboration and knowledge sharing among academics and practitioners. Stantec’s office in Vancouver, British Columbia, Canada, the University of Cambridge’s Department of Architecture in Cambridge, England, and the BP Institute for Multiphase Flow, also at the University of Cambridge, are leading this research effort, with a good chance that other firms and universities will be added to the mix in later phases.

Designing Naturally

In sustainable design, many innovations have taken their inspiration from nature—a trend that’s become known as biophilic design. In the scorching Australian Outback, colonies of termites, known as white ants, construct amazing meters-high earth towers that utilize natural forces and the collective will and intelligence of everyone in the colony to keep the queen comfortably housed at between 30 C and 30.5 C. To keep their queen happy, her subjects use their bodies to modulate airflow through a multitude of intake and exhaust tunnels, scurry down to the water table with leaf bits to fetch water droplets for evaporative cooling, and cultivate mushrooms that release heat when they bloom at night.

Before the advent of mechanical heating, cooling, ventilation, and artificial lighting systems, humans also configured buildings to take advantage of daylight, natural forces, diurnal temperature swings, and occupant intelligence to provide comfort. Alan Short, an architect and professor of architecture at the University of Cambridge, was inspired by these premodern buildings as a student and has combined their principles with modern control systems to produce daylit, comfortable, and energy-efficient buildings ever since. When Frank Mills, an English engineer that worked on many of Short’s buildings, offered to introduce us to Short, we jumped at the opportunity. Short had recently completed the design of a prototype hospital for the National Health Service and had been grafted onto the indicative design team for a major private-finance initiative hospital in the U.K. Short spent an afternoon with us in his London office and by the end of the dinner that followed, a joint Cambridge and Stantec research project had been tabled. Short would pull in Andy Woods, head of the Institute for Multiphase Flow at Cambridge and a frequent collaborator, and an application to the Stantec Research Fund would resource it.

By the end of the first two-day workshop in Cambridge, however, the team had seriously broadened the project’s original scope. An application for additional funding to the energy utility BC Hydro in British Columbia was accepted on the condition that the team find a B.C. health authority or hospital to provide a portion of the additional funds needed. Soon, the Fraser Health Authority stepped up.

Progress to Date

Fast forward two years from that initial meeting in Short’s office and the study is well under way, with the goal of completion in the fall of 2011. Stantec’s prototype 250-bed acute care hospital has evolved along with the team’s understanding of the interrelationship between the systems that will be tested and the natural forces that will affect energy performance. Ideally, the full-on systems-integration approach will allow most of a hospital in a Cascadian or U.K. climate to provide thermal comfort with very little energy consumed throughout the summer and not a lot more required in winter. How? By configuring the building and its systems for natural energy flows and diurnal temperature swings, and then applying intelligent controls, much as the Australian white ants do.

In a living, breathing hospital, the bulk of the heating and cooling work will be done very efficiently by the thermally active building structure itself. Automatic exterior solar shading will allow the occupant safety, comfort, and energy benefits of displacement ventilation to be exploited. Ventilation air will then move upward through rooms and vertical ventilation shafts by natural forces: the heat given off by bodies and equipment and the pull of even light breezes. Booster fans will kick in only as needed, much like a gas engine on a hybrid car, and usable energy will be extracted from warmed air before it is exhausted. Building-integrated thermal storage will warm air at night with midday’s heat and cool it during the day with nighttime’s chill.

Courtyards will provide daylight to virtually all regularly occupied spaces with hybrid natural ventilation used—as is required in the U.K.—everywhere there isn’t a clinical reason not to use it. Distributing air in vertical shafts will reduce floor-to-floor heights, increasing the penetration of daylight into the courtyards.

The Road Ahead

Our hope with this research project is to get a step closer to the hospital buildings we really want to build: hospitals that add all of the senses to the cherished patient-world relationship, and connect patients and their caregivers to nature, to the passing of the day and the cycle of the seasons; hospitals that touch the Earth lightly and are resilient to the stresses and deprivations caused by climate change.

The beauty of the world and our happiness within it are intertwined—as patients or not. After half a century of artificial lighting and conditioning, we engineers and architects need to reintroduce the beauty of the world and the forces of nature to the design agenda.

Paul Marmion is a buildings engineering senior principal in the Vancouver office of Stantec. Ray Pradinuk is an architecture principal in that office. They can be reached at paul.marmion@stantec.com and ray.pradinuk@stantec.com, respectively. The team behind the Living, Breathing Hospital project is anticipating completion in the fall of 2011. stantec.com.