NEW RESILIENCE GUIDELINES FORTIFY HOSPITALS

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THROUGH THE EYES OF THE PATIENT

BY REBECCA MELNYK

The threat of climate change is about to play a larger role in designing future healthcare facilities in British Columbia.

The pace of rising temperatures and heavy-rain events is increasing awareness of how climate change could affect healthcare facility operations in British Columbia. Newly released guidelines offer a standard for approaching the planning and designing of capital projects from a resiliency perspective. The Climate Resilience Guidelines for BC Health Facility Planning & Design tops off a multi-sector collaboration to develop practicebased guidance for BC Health Authorities. It arises from a series of reports and a provincial climate risk assessment, all with roots in the CleanBC plan, which was tabled in 2018 to meet legislated climate targets of reducing greenhouse gas (GHG) emissions.

Doug McLachlan, associate director of IBI Group, was on the task force that helped prepare this document, released in December 2020. “Prior to the guidelines, the process in deliverables may have varied depending from project to project,” he said. “There is now a framework established for how we can address climate change and look at going beyond LEED Gold or code minimum requirements on a project.”

He was speaking at a seminar in May, “Planning for Climate Resilience in Healthcare Facilities,” hosted by the Canadian Centre for Healthcare Facilities. New RFPs will begin referencing these guidelines, so the discussion covered how they align with key design stages

“For patients and staff, it’s going to become increasingly more difficult if facilities are not designed for future climate conditions.”

and how climate resilience can be actualized.

PRIORITIZING RESILIENCE STEP BY STEP

The guidelines include six overarching principles, from anticipating changes with climate hazards to considering co-benefits related to GHG mitigation and pandemic preparedness.

Complementing a project’s four design stages, a climate risk and assessment process includes four steps: exposure screen; climate risk assessment; resilient design review; and compliance audit.

For instance, an exposure screen is first used to incorporate hazards right into the budget at the masterplanning stage. This informs what hazards the site is exposed to now and in the future. From there, a funneling process refines what is most vulnerable, prioritizes high-risk impacts like the quality of patient care, and confirms what design will move forward—making sure it aligns with other goals like COVID response. Ultimately, the design should comply with any resilience objectives that were flagged for reducing climate risks.

The guidelines are relatively new, so no project has implemented all four steps. But there are many ways to realize them on the ground. Lisa Westerhoff, principal at Integral Group, shared her experience, speaking as a member of the project team that developed the guidelines.

When conducting a hazard output for a long-term care facility in B.C., her team examined various climate data sources, the site itself, and the planning context to narrow down the scope of hazards and understand how expected changes in climate will affect them over time. “We then cross-checked that list with hazards required to be considered by LEED, so we could support the achievement of the resilient design pilot credit IPPC 98,” she said. “We were able to look at a broad range of hazards and make sure we achieved compliance with other goals as well.”

DESIGNING FOR THE FUTURE

“We need to be aware of the responsibilities of these key deliverables that will now be included on projects, such as climate risk assessment, perhaps additional concept designs early on and energy model options,” said McLachlan. He laid out some design strategies for improving facility resilience.

Mitigating flooding

From a site perspective, flooding can overwhelm local stormwater drainage capacity after an extreme rainfall—an event expected to increase in severity and frequency due to climate change.

“Many cities, such as Vancouver, had established minimum flood construction levels in flood-prone areas based on climate data,” he said. “As designers, we need to be aware because they are going to determine the ground floor elevations for access and egress out of the underground parking areas as well as determining location for equipment.”

Using the best available climate data for rainfall events will help plan a hospital for a lifespan of 50-plus years, he noted. The design should look at the 2100 Intensity Duration Frequency Curves and how those affect a site — exceeding a city’s requirements for its integrated stormwater management plan. This can also impact additional mitigation strategies like permeable pavement and green roofs.

A project can also increase stormwater retention and reuse that on-site for non-potable uses— something to consider early on as some aspects will affect the location of the tanks.

Maintaining indoor thermal comfort

Prolonged periods of abnormally hot weather, higher humidity, with increased frequency and intensity figure into a long-term climate reality. “For patients and staff, it’s going to become increasingly more difficult if facilities are not designed for future climate conditions,” McLachlan stressed. The design of the cooling plant, mechanical rooms, and HVAC systems are affected.

“As a principal on recent projects, we’ve looked at infrastructure that would be impractical to retrofit in the future, such as chilled water piping, to make sure that it is sized for 2080 peak cooling conditions,” he said. “And making sure there is space in the mechanical room for chillers and pumps to be added in the future as well.”

Daylighting and views

Since deep floor plates can create internal heat gains and little natural light, avoid them where possible and incorporate interior courtyards and multi-storey atriums to bring natural light as deep into the space as possible. Doing so will help avoid using artificial light and mechanically removing the resulting heat gain. Studies also point to a correlation between natural light access, quicker recovery, and staff wellbeing.

Building a better envelope

“By building a more efficient building envelope we can reduce the electrical load and therefore GHG emissions,” he said. “This is one of those cobenefits or synergies on the project.” He highlighted the benefits of improving the thermal performance of the windows with triple glazing, such as reducing peak heating loads, GHGs and annual energy use, and better visual and thermal comfort for occupants.

ANTICIPATING CLIMATE STRESSORS Robert Bradley, director of energy and environmental sustainability, at Vancouver Coastal Health, and another project team member, deciphered between climate shock (extreme events like a heatwave) and climate stressors (prolonged events like a drought or increasing temperatures).

Gordon McDonald, principal and director of engineering for Integral Group, and another project team member, urged more passive design solutions, rather than cutting-edge technologies. As he said, “I do believe for a building to be resilient, it needs to be simple.”

Extreme heat

To build resilience to warmer summers and longer periods of hot weather, passive design solutions can include building orientation, exterior shading and maximizing windowto-wall glazing ratios. Orientating a building from east-west, rather than north-south removes problematic solar control on the west facade, which leads to large cooling loads. Solar shades above windows are efficient for high sun angles, while planting deciduous trees provides shade in summer and allows sun penetration in the winter.

Glazing can also control solar heat gain. As it brightens outside, photovoltaic glass can limit the amount of solar heat coming into a building. As it grows cloudier, it can lighten to allow solar heat gain inside and improve daylighting. Maximizing window-to-wall glazing ratios is also key.

While reducing cooling loads buildings must also remain resilient in 2050 and even 2080 when temperatures are no longer at their current levels.

A BLEAK PROGNOSIS

Canadian regions will experience climate change fallout differently, but a global consortium of scientists is warning residents everywhere that severe conditions and extreme events are going to be more frequent and intense. The Intergovernmental Panel on Climate Change’s newly delivered compendium of physical science factors and their projected outcomes is the first installment of a three-part assessment report planned for release before the end of 2022.

The report — which is the product of 234 researchers based in 66 countries and was subject to more than 78,000 expert and government review comments prior to public release — synthesizes findings from a range of scientific disciplines and draws on ongoing advancements in global and regional climate simulation to track the evolving momentum of climate change. It outlines expected impacts of 1.5-degree and 2-degree increases in the global mean temperature and details the weather-related forces most likely to be in play in regions and topographies worldwide.

Cities are identified as the hotspots of climate change where built form, human activity and sparse vegetation combine to engender urban heat islands. Urban dwellers are expected to suffer amplified daytime temperatures and enjoy a lesser degree of nighttime cooling. They could be exposed to higher levels of air pollution due to heatrelated increases in ground-level ozone, and flash flooding is likely to be more problematic as impermeable surfaces channel cascading water to lower-lying catchments. Although these trends are already well established, scientists now have “high confidence” they will worsen.

The scientific team seeks to bolster commitment for an aggressive response. Following this study of the physical science basis for climate change, the pending two reports in the series focus on adaptation and mitigation.

“I do believe for a building to be resilient, it needs to be simple.”

As McDonald said, there are weather files now available that designers can refer to when calculating how many chillers will be needed in the future.

To avoid redundancy and the replacement of broken equipment, the idea is to install them when the time is right, making sure there is ample space in a mechanical room, enough electrical capacity and that chilled water piping is sized for the future to avoid costly and disruptive retrofits.

Air quality

Design solutions to protect against forest fires and airborne viruses include vestibules on all main entrances and tighter envelopes to hinder air infiltration, thus reducing outdoor contaminates. There should also be space allocated for the installation of future filters, intake louvers on different facades and increased humidity levels of 40 to 60 per cent, as viruses spread more easily in lower humidity ranges. The minimum CSA range stands at 30 per cent.

Low-carbon resilience

Lowering the energy associated with buildings comes down to passive design methods like massing, orientation and solar shading, and building better envelopes, roofs and windows, which also reduce carbon emissions. “On the west coast, we’ve seen Passive House get some traction recently, not necessarily in healthcare, but residential, institutional and commercial, said McDonald. “What this is doing is driving down those energy targets, so we’re using less energy inside the building.”

Since healthcare facilities move a lot of air throughout the building, a portion of which is outdoor air, the idea is to ensure the energy associated with heating and cooling is minimized. This translates to heat recovery ventilation, energy recovery ventilation, thermal wheels, or active heat recovery, which involves taking energy from the air, sending it through heat pump technology and using that to preheat domestic hot water or heat or cool a building.

In B.C., where electricity is hydrogenated, McDonald is seeing a trend where more buildings are choosing heat pump-driven technologies to achieve low emissions. “The move is to green the grid,” he said. “And if we could move to a more electric building solution that would make us more resilient in the long term.” | CFM&D

TARGETED HYGIENE PROGRAM For Workplaces and Public Facilities

The Canadian Centre for Healthcare Facilities mission is to improve healthcare environments for better care. For more information, contact ritamezei@cchf.net and visit www.cchf.net. scjp.com