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Prince Sultan Military Medical Complex Cardiac Excellence Center | Sustainability Report by Unanime

1. INTRODUCTION

Prince Sultan Military Medical Complex has a mission to add a Cardiac Center to their existing medical complex.

The allocated plot area is 3,200 m2 and the project BUA is of 26,000 m2 approximately.

The facility adds 200 beds of cardiac care to the existing Prince Sultan Medical Complex and will feature the latest technologies in cardiac care such as: Hybrid OR, Cath labs, cardiac diagnostics, digital imaging technology, etc.

This document presents our primary intent in approaching the LEED Certification and credits that could be targeted.

1. 1. 1. Advantages of applying sustainability for healthcare facilities

Sustainable healthcare facilities are the triple bottom line in action, benefiting people, planet, and profit. The Cardiac centre will be designed and operated to consume less water, less energy, fewer natural resources, and ultimately aims to reduce the overall impact of the development on the local, regional, and global environment. It is helping the healthcare industry achieve lofty sustainability goals while also helping building-level projects generate significant savings on operating costs.

1. 1. 2. Issues that are unique to healthcare projects

Healthcare projects often have different energy and water needs, high equipment loads, unique ventilation requirements, 24/7 operations that make pursuing strong efficiency measures challenging.

• Source reduction for persistent, bio accumulative, and toxic Mercury and Lead, Cadmium,    

   and Copper

• Integrated Project Planning and Design

• Environmental Site Assessment

• Special Furniture And Medical Furnishings

• Design For Flexibility

• Places Of Respite

• Direct Exterior Access Additional credits that are not unique to healthcare, but have     

   Healthcare specific requirements: 

• Surrounding Density & Diverse Uses

• Access To Quality Transit

• Interior Water Use Reduction

• Minimum Indoor Air Quality Performance

• Thermal Comfort

• Interior Lighting

• Quality Views

• Acoustic Performance

1. 1. 3. Process of certifying healthcare facilities under LEED

LEED Building Design and Construction (BD+C): Healthcare is the appropriate rating system for the Cardiac Center as it is a new construction and operates 24 hours a day, seven days a week and provides inpatient medical treatment, including acute and long-term care.  At least 60% of the project’s gross floor area must be complete by the time of certification and the project must include the entire building’s gross floor area, including areas dedicated to both administrative and support-related functions.

1. 1. 4. LEED minimum program requirements

All projects applying for LEED certification must meet a set of minimum program requirements (MPRs) to determine project eligibility for LEED:

1. Minimum Program Requirement #1: Must be in a permanent location on existing land.

2. Minimum Program Requirement #2: Must use reasonable LEED boundaries

The LEED project boundary must include all contiguous land that is associated with the project and supports its typical operations. This includes land altered as a result of construction and features used primarily by the project’s occupants, such as hardscape (parking and sidewalks), septic or stormwater treatment equipment, and landscaping. The LEED boundary may not unreasonably exclude portions of the building, space, or site to give the project an advantage in complying with credit requirements.

3. Minimum Program Requirement #3: Must comply with project size requirements

The LEED rating system is designed to evaluate buildings, spaces, or neighbourhoods of a certain size.

1. 2. STRATEGY

The medical programming, planning and design will be simultaneously developed in order to streamline the process, reduce environmental impact and effectively optimize performance and lower costs of operation, as well as enhance the well-being and health of the building occupants. The project aims to target LEED Silver by achieving the following credits:

(IN) INTEGRATIVE PROCESS

• IN PREREQUISITE | Integrative project planning and design

In order to maximize the opportunities for an optimized design that is integrated, green and cost-effective, cross-discipline design decision making will be undertaken at the pre-design phase to define PSMMC’s project requirements, rating goals, integrated design team and design charette.

• IN CREDIT | Integrative Process

Further to the prerequisite and continuing throughout the design phases, further interrelationship analysis among different systems will be performed to inform the owner’s project requirements (OPR), basis of design (BOD) as well as design and construction documents. The integrative process will identify synergies and strategies to optimize the building.

(LT) LOCATION AND TRANSPORTATION

• CREDIT | Surrounding density and diverse uses.

The Cardiac Center being located in the heart of Riyadh will makes it geographically close to surrounding diverse uses and within an 800-meter walking distance of the main entrance of at least seven operational and publicly accessible functions.

• CREDIT | Access to quality transit.

The Cardiac Center will be located within an 800-meter walking distance of planned metro stations making it accessible to transit transportation.

(SS) SUSTAINABLE SITES

• SS PREREQUISITE | Environmental Site assessment

Site assessment will be undertaken to determine whether contamination exists and remediate the site if contaminated.

• SS PREREQUISITE | Construction activity pollution prevention

In order to reduce pollution from construction, soil erosion must be controlled. An erosion and sedimentation control plan will be created for all construction activities associated with the facility.

• SS CREDIT | Heat Island Reduction

The project will reduce the heat island effect through using a combination of high reflectance roofing, the solar reflectance of pavement and external surfaces as well as using vegetated roofs.

• SS CREDIT | Open space

Open spaces will constitute 40-50% of the building footprint, this will be achieved by creating two exterior landscaped open spaces for patients, visitors and staff to relax, a spacious terrace at level 1 and an open vegetated accessible roof at level 6.

Connection to the natural world will be achieved by vegetating these open spaces, 40-60% of the space will be planted with native species in order to minimize irrigation.

(WE) WATER EFFICIENCY

• WE PREREQUISITE | Outdoor Water Use Reduction

This prerequisite will be achieved through reducing water consumption of the landscaping from a set baseline.

• WE PREREQUISITE | Indoor Water Use Reduction

This prerequisite will be achieved through reducing aggregate water consumption by 20% from the baseline and using Water Sense labelled sanitary fixtures.

• WE PREREQUISITE | Building-level water metering

Minimum water metering is required to support water management. This will be done by installing permanent water meters that measure the total potable water use of the building, readings from the meter should be reported for a five-year period.

• WE CREDIT | Water metering

Further to the prerequisite, water subsystem metering will further support water management and identify opportunities for water saving.

• WE CREDIT | Outdoor water use reduction

Further to the prerequisite, strategies will be set in place to reduce irrigation of the external vegetated areas, use of native plants will help reduce water use and achieve this credit.

• WE CREDIT | Indoor water use reduction

Further to the prerequisite, strategies such as using alternative water sources will be put in place to increase potable water savings by 30-40%.

(EA) ENERGY AND ATMOSPHERE

• EA PREREQUISITE | Fundamental commissioning and verification

Fundamental commissioning is required, this is achieved through commissioning process activities for the building systems in accordance with AHRAE Guidelines, this activity also includes the review of the Owner Project Requirements (OPR), Basis of Design (BOD) and project design.

• EA PREREQUISITE | Minimum energy performance

Energy efficiency must be addressed at a minimum through whole-building energy simulation or prescriptive compliance to AHRAE Standard 90.1-2010 or equivalent.

• EA PREREQUISITE | Building-level energy metering

Building-level energy metering identifies opportunities for energy savings, this is achieved through the installation of building-level energy meters, and reporting the readings to LEED for a five-year period.

• EA PREREQUISITE | Fundamental Refrigerant management

In order to reduce ozone depletion, refrigerant management is required in order to minimize CFC-based refrigerant use in new HVAC systems.

• EA CREDIT | Advanced energy metering

Further to minimum building-level metering, advanced metering to be installed for all whole-building energy sources used by the building. All meters must be capable of reporting hourly, daily, monthly and annual energy use.

• EA CREDIT | Optimize energy performance

Further to the prerequisite, increasing levels of energy performance will be achieved through establishing a performance target of source energy use.

(MR) MATERIALS AND RESOURCES

• MR PREREQUISITE | Storage and collection of recyclables

This prerequisite will be achieved through providing accessible receptacles for the collection and storage of recyclable materials for the entire building. Appropriate measures should be taken for the safe collection, storage and disposal of batteries, mercury-containing lamps and electronic waste.

• MR PREREQUISITE | Construction and demolition waste management planning

To reduce construction waste disposed of in landfills, a construction waste management plan should be developed and implemented.

• MR PREREQUISITE | PBT Source reduction – Mercury

Mercury-containing products to be identified and methods will be set for their recycling and disposal.

• MR CREDIT | Building life-cycle impact reduction

In order to optimize the performance of products, existing building resources will be reused and materials will be evaluated and selected based on their life-cycle impact.

Green concrete for example, could be used as it reuses aggregates waste as a component in its mix.

• MR CREDIT | Furniture and medical furnishings

In order to enhance the environmental and human health performance associated with furniture, 80-90% Furniture will be selected to meet the minimal chemical content.

• MR CREDIT | Construction waste management

Further to the prerequisite and in addition to the waste management plan, 75-85% of construction waste will be diverted from landfill by setting reducing, reusing and recycling strategies.

• MR CREDIT | Building product disclosure and optimization – material ingredients

This credit to be achieved through material ingredient reporting, using products and materials for which life-cycle information is available and supply chain optimization.

• MR CREDIT | PBT source reduction -mercury

Further to the prerequisite, release of toxic chemicals to be reduced by specifying lamps with low mercury content.

• MR CREDIT | PBT source reduction - lead, cadmium and copper

Further to the prerequisite, substitutes to be specified for materials manufactured with lead and cadmium.

(IEQ) INDOOR ENVIRONMENTAL QUALITY

• IEQ PREREQUISITE | Minimum indoor air quality performance

Meet the minimum requirements for ventilation and monitoring of mechanically and naturally ventilated spaces.

• IEQ PREREQUISITE | Environmental Tobacco smoke control

To prevent exposure of building occupants to smoke, smoking will be prohibited inside the building except in designated external smoking areas located at least 7.5 meters from all entries, outdoor air intakes and operable windows.

• IEQ CREDIT | Quality Views

In order to give patients a connection to nature and the exterior world and achieve quality views, 80-85% of regularly occupied areas such as patient rooms will have access to non-obstructive views through clear glazing.

• IEQ CREDIT | Enhanced indoor air quality strategies

As patients’ comfort is of critical importance in healthcare facilities, strategies will be set to improve air quality to promote patients’ well-being.

• IEQ CREDIT | Low emitting materials

To reduce concentrations of chemical contaminants, levels of volatile organic compounds (VOC) will be addressed through specifying material and furniture with low VOC content.

• IEQ CREDIT | Construction indoor quality management plan

Problems associated with construction and renovation will be minimized by implementing plans addressing the reduction or elimination of the following: moisture, particulates, VOCs, tobacco, noise, vibration and infection. This is particularly important for the Cardiac Center as it sits in an operational healthcare complex.

• IEQ CREDIT | Indoor air quality assessment

To establish better indoor air quality in the building after construction, flush-out or air testing to be implemented at the end of construction and once the building has been completely cleaned.

• IEQ CREDIT | Thermal comfort

Thermal comfort will be insured by providing occupants with suitable thermal levels and HVAC control.

• IEQ CREDIT | Interior lighting

At least 90% of individual occupant spaces in staff and patient areas will have readily accessible lighting controls. In private rooms, exterior window shades, blinds or curtain control that are accessible from the patient bed to be provided.

• IEQ CREDIT | Daylight

To connect building occupants with the outdoor, reinforce circadian rhythms and reduce the use of electrical lighting, 85-90% of perimeter rooms will have glare control devices.

• IEQ CREDIT | Acoustic performance

Meet or exceed the sound and vibration criteria from the 2010 FGI Guidelines for Design and Construction of Health Care Facilities and the reference document on which it is based, Sound and Vibration Design Guidelines for Health Care Facilities.

(IN) INNOVATION

• IN CREDIT | Target innovation

All five innovation points will be targeted through other categories (pilot credit, exemplary performance and innovation).

• IN CREDIT | LEED Accredited Professional credits

At least one principal participant of the project will be a LEED Accredited Professional (AP) with BD+C specialty.

(RP) REGIONAL PRIORITY

• RP CREDIT | Regional Priority

Target regional priority credits: Heat Island reduction, outdoor water use reduction, indoor water use reduction.