It is not an Engineering Problem

The recent Targeting 100! event at the BSA brings to light some fundamental hurdles to achieving energy efficiency through building design. Presenting theories contrary to common perception, the speakers demonstrated that energy reduction measures are not necessarily tied to technology. Why aren’t new hospitals in North America today maximizing energy efficiencies similar to European models?

The discussion addressed an important issue about the diverse groups involved in building a new hospital; frequently they do not share an energy conservation initiative. Code authorities, designers, developers and builders, community organizations and even owners tend to focus, correctly, on the health and wellbeing of the patients. Their collective focus works very well to bring necessary advanced healthcare to the marketplace. So, what are the specific obstacles these groups face in regards to achieving an energy efficient building?

The problem may lie in the structure of the system itself. Each organization has a defined task and role to play. Responsibilities occasionally overlap, but each entity serves as a silo of responsibility and rarely works outside its realm of jurisdiction. There is certain efficiency in this organizational hierarchy, but at the same time, limitations.

Adding to the challenges of bringing sustainable efforts into healthcare design, these independent silos of responsibility rarely overlap regarding this very issue. Even within organizations there are often some degrees of compartmentalization. For example, the panel’s discussion highlighted various entities within the Owners organization that are structured such in a way to make sustainable decisions difficult to achieve even in the face of significant savings. Specifically, capital construction budgets and potential operational budgets are often not considered holistically. Little deference is paid to energy efficiencies if they increase the build cost. Quite often capital decisions are made without reviewing payback or present day values.

Of course this issue is exponentially problematic when we consider other organizations. What would drive regulators to adapt or enforce sustainability? What are the metrics that the Department of Health, the Joint Commission on the Accreditation of Healthcare Organizations or Building Departments need to comfortably balance energy efficiencies with the Public Health and Welfare? Interestingly, when we consider European models, we find that energy efficient strategies do not negatively impact health and welfare of the public. On the contrary, many of these strategies have a directly attributable positive impact. If we are to truly targeting energy reductions like 100 EUI, we may first have to deal with the systemic problem of compartmentalization or at least find our common vision.