Sustainable Architecture for Health: A Mindset Shift

Abstract

The healthcare industry is in a pivotal position to lead the 21st-century reintegration of environment, health, and economic prosperity. By critically reinventing the hospital as a regenerative place of healing, marshalling purchasing power, and modeling health and wellness within a society in critical need of alternatives to fast food and retail culture, the healthcare industry can signal a new relationship to healing and health. (Guenther & Vittori, 2008)Moving to a Regenerative Healthcare ModelThe quote that closes our book, Sustainable Healthcare Architecture (Guenther & Vittori, 2008), was meant to usher in a broader, more relevant role for the healthcare industry in the development of sustainable design thinking, one that stands in sharp contrast to an early and widely held belief that sustainable design is about the negative consequences of production and the consumption of resources-that is about less. The mantra of reduce/reuse/recycle must be re-envisioned through the lens of healthcare as resilient/restorative/ regenerative. This is a critical distinction, because the former view fosters a dialogue based on the fear that reducing resources- whether energy, water, or building materials- produces less effective healthcare environments (Shepley, Baum, Ginsberg, & Rostenberg, 2009). On the other hand, the latter view, regenerative design, offers an opportunity to align the ecological profile of the built environment with the core mission of healthcare-that is, healing.Sustainable architecture as practiced in healthcare has, from its inception, been grounded in protecting health at all levels-building occupant (or site inhabitant), community, and global (American Society for Healthcare Engineering, 2002; Green Guide for Health Care, 2007). Former director general of the World Health Organization Lee Jong-Wook, MD, in the foreword to the Health Synthesis Report of the Millenium Ecosystem Assessment (Corvalan, Hales, & McMichael, 2005), challenged the healthcare sector to recognize this core value:Nature's goods and services are the ultimate foundations of life and health, even though in modern societies this fundamental dependency may be indirect, displaced in space and time, and therefore poorly recognized. This [is] a call to the health sector, not only to cure the diseases that result from environmental degradation, but also to ensure that the benefits that the natural environment provides to human health and well-being are preserved for future generations. (Corvalan et al., 2005, p. ii)Medicine cannot continue indefinitely oblivious to the large-scale constraints of ecosystems, which lie outside the four walls and beyond the property boundaries (and hence the direct control) of most U.S. healthcare systems. The healthcare sector should not have to argue that delivering highquality services entails excess waste production, toxic chemicals, and the disproportionate usage of energy and potable water-or that saving lives stands apart from the broader concerns of ecosystems and the environment. As healthcare expands and devours greater financial and labor resources in the United States, becomes larger and more ecologically intensive. In the coming years, as climate change alters weather patterns and disease vectors, will become more important to invest in and produce a resilient infrastructure to meet expanded healthcare delivery challenges. Aligning our built environments with regenerative design thinking will help us meet this future and, in the process, reinvent our hospitals. This requires a significant mindset shift.What Is a Shift?Mindset is the most important challenge to designing a successful, sustainable building. describes the mental models that form one's view of the world, green building, and healthcare design-the prevailing paradigm. Mindset can be thought of as the implicit worldview that we carry without even realizing that we're carrying it (Malin, 2005, p. …