UCSF Sustainability Stories

Deborah Fleischer, Green Impact, January 2015

Sustainability in a Hospital Setting:  The New UCSF Medical Center at Mission Bay Leading the Way

HospitalOpened on February 1, 2015, the new world-class UCSF Medical Center at Mission Bay is not only leading the way in health care, but has pushed the envelope on incorporating sustainability in a hospital setting.  The new medical center includes the UCSF Benioff Children’s Hospital San Francisco, UCSF Betty Irene Moore Women’s Hospital, UCSF Bakar Cancer Hospital, and UCSF Gateway Medical Building.  Upon entering the hospitals, the gardens, art installations, natural light, waterfront views, and children-friendly décor, along with the cutting-edge equipment and facilities, are a striking combination. 

There is also another key element at play at the 289-bed children’s, women’s and cancer hospital complex—something that might be less obvious to patients and visitors, but delivers a big impact.  Sustainability was a top priority for UCSF during the design process, resulting in ample amounts of natural light (daylighting); an energy-efficient design resulting in 50% less power usage than the average US hospital; water conservation elements that will save four million gallons of potable water per year; and design elements that will reduce toxic exposures.  The new hospitals are expected to receive the LEED (Leadership in Engineering and Environmental Design) Gold certification, but have actually gone beyond the LEED standards. 

“As a preeminent health care institution, we had the responsibility to do everything we could to create a healthful environment for patients while minimizing our impact on the environment.  We pushed hard to go beyond the typical LEED benchmark and we did.  We also aimed to put pressure on industry by demanding the chemical composition of products and making selective decisions.  These efforts are a small way the project could support the UCSF mission of advancing health worldwide,” explained Cindy Lima, executive director of the UCSF Mission Bay Hospitals Project.

Pushing Beyond LEED Standards

Greening the design and operation of a hospital is not a simple matter.  According to Becker’s Hospital Review, as of April 2012, only 25 hospitals in the United States met the LEED Gold certification. As one of the nation’s leading medical schools and academic health research institutions, UCSF saw the new medical center as an opportunity to do sustainability with a capital “S”.

It brought together an innovative design team, combining the skills of Stantec Architecture (formerly Anshen + Allen), a leading health care architect, with William McDonough + Partners, a well-known sustainability and eco-effective design firm, and MBDC, a green chemistry firm known for its Cradle 2 Cradle (C2C) certification, a process that looks at the full life cycle of a product from raw materials to use to end-of-life. UCSF pushed beyond the LEED standards by creating a database to screen products during the design phase. The design team used the toxic screening tool to ensure that the facility minimized the use of design elements with toxic components. 

Choosing Healthy Materials

The screening process for toxins took into account a variety of criteria, including cost, aesthetics, comfort level, flame resistance, and maintenance issues. Then, on top of these, the design team looked at ecological and human health elements such as known allergens or carcinogens. It was a big challenge balancing all these factors and finding acceptable materials for flooring, walls, paint, ceilings, and trim.  By choosing healthier materials, UCSF is confident that patient exposure to known carcinogens will be minimized.  With the opportunity to start from scratch, one of the first things the design team did was screen more than 100 patient and exam room finishes to reduce toxins. Using publicly available information, the team screened products for carcinogenicity, endocrine disruption, mutagenicity and teratogenicity (linked to birth defects), and reproductive toxicity.

This type of assessment, based on specialized research that focuses on the chemical toxicity of certain materials, had never before been done in a hospital or in any project of this scale.  The team quickly discovered that finding acceptable materials was difficult because many companies were not comfortable making public a detailed list of ingredients in their materials.  It also learned that for some materials, a greener alternative is not yet available. However, by asking the right questions, UCSF helped push manufacturers to begin thinking about new, greener products.  A big win for the new hospitals was designing fully sprinklered buildings, which exempted the hospitals from complying with the more stringent flammability standard (TB 133), reducing the level of flame retardants required in the foam, fabric, and/or barrier materials. According to Jean Hansen, LEED Fellow and Sustainable Interiors Manager at HDR Architecture’s Sustainable Design Solutions, “By complying with TB-117, rather than TB-133, UCSF minimized patients’ and staffs’ exposure to flame retardants, in addition to saving the organization a considerable amount of money.”  Flame retardants can escape from products and find their way into dust and ultimately our bodies (see our January post on flame retardants to learn more).

Green Highlights

This article provides a high-level overview of some of the new hospitals greenest features, focusing on material selection, energy performance, water conservation, and sustainable food.

  • Water Conservation: The hospitals’ efficient domestic water fixtures, water-saving appliances, green roofs, and cutting-edge irrigation plan will save four million gallons of potable water each year.  The project reduced potable water use by 39.2% from a calculated baseline design through the installation of dual-flush water closets, low-flow urinals, low-flow showers, low-flow sinks, and low-flow lavatories.  The new hospital complex hosts one of very few extensive water conservation systems located on a large, urban hospital site.  The landscaping and irrigation systems were designed to reduce irrigation water consumption by incorporating a state of the art irrigation control system. The controllers receive local evapotranspiration (ETo) data daily through an on-site weather station that automatically adjusts irrigation run times and frequencies based on weather changes over the course of the year. Cycle and delay times are automatically calculated based on soil type and slope to prevent erosion and runoff. An estimated 27% water savings can be realized using this control system.  In addition, storm water will be filtered by bioswales, landscape elements designed to remove silt and pollution from surface runoff water, and reused.  This design element will keep pollutants, such as vehicle fluid leaks and soot, out of the city storm drain system and San Francisco Bay.

  • Energy Performance:  UCSF Medical Center at Mission Bay was designed to reduce its energy needs on multiple levels. Energy savings were achieved through hospital complex design, including efficient mechanical systems, which will result in 50% less power usage than the average US hospital—making UCSF Medical Center at Mission Bay among the top performers in the United States.  Contributing to these energy savings will be a variable air volume air distribution system, which allows for precise control of air volume and temperature at different times and locations throughout the complex. Heat recovery ventilators will also help make the air distribution system more efficient by reclaiming energy from exhaust airflows.  A 750 kW photovoltaic system will help UCSF reduce its carbon footprint.

  • Garden
  • Innovative Green Spaces:  For a hospital in an urban setting, one of the most striking features of the hospital is the prominent use of green roofs and gardens.  16 separate gardens have been incorporated into the hospital for a total of 4.3 acres of green space, including over one acre of rooftop gardens.  The amount of green space contained within the hospitals is among the highest of any urban hospital in the United States. “According to evidence-based design, connecting views to the outside, providing access to nature and increasing natural light, promotes a healing environment,” explained Lima. 

  • Sustainable Food: The new hospitals will incorporate the same sustainable food practices currently being implemented at Parnassus, thanks to the vision of Dan Henroid, director of Nutrition and Food Services, including serving antibiotic free chicken and beef, incorporating local produce where feasible, and serving organic brown rice and cage free eggs.  To be patient centric and reduce waste, the new hospitals will offer an on-demand meal service program.  Patients will be able to order customized meals electronically, which will be delivered from the first floor by robots to help the kitchen deliver the meals in a timely manner.  The result will be reductions in food waste, as food is only provided upon request of the patient, except in special circumstances.

Other green features include:

  • 5% of total parking spaces (23) set aside as preferred parking spaces provided for low-emitting/fuel efficient vehicles.
  • 10 dual charge electric vehicle charging stations in the parking lot.

  • Flooring in patient areas is rubber, which only needs to be cleaned with plain soap and water, and buffed with a cleaning pad, compared to vinyl, which periodically must be stripped and waxed or refinished with harsh chemicals to maintain its shine.

  • Construction waste attained a 90% diversion rate, meaning that 90% of the waste was recycled instead of sent to a landfill.

  • Project used Forest Stewardship Council (FSC)-Certified wood for the majority of wood products.

Learn More

For more information of sustainability at the Mission Bay Hospitals, go HERE.

Photos from Green Impact.
Written by Green Impact, a sustainability consultant helping organizations make a greener impact.