health of patients in a green hospital –our experience ramanujan coo of usgbc at tenth...

Green factory Certification

“First Green Hospital in North-East India”GNRC Hospitals 1

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Dr.J.P.Sarma, MBBS, MS, MBA

Director Strategy & Growth

Desun Hospitals, Kolkata

Health of Patients in a Green Hospital – Our Experience


Design & Construction practices that significantly reduce or eliminate the negative impact of buildings on the environment and occupants

1. Sustainable site planning2. Safeguarding water and water

efficiency3. Energy efficiency and renewable

energy4. Conservation of materials and

resources5. Indoor environmental quality

Intergen, LEED-CI Certified

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What is a Green Building / Hospital ?

Why Green Building? Because, buildings have a significant negative impact on the environment..…

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Sources: DOE, EPA, U.S. Geological Survey, Worldwatch Institute

Sustainable buildings consume less resources, gene rate less waste, cost less to operate, and provide healthier living and

working environments than traditional buildings.


• Green building design, construction and

operations techniques provide an integrated

approach to :

REDUCING

ENERGY , OPERATIONS & MAINTENANCE COSTS

IMPROVING

PRODUCTIVITY ,HEALTH, & WELL BEING OF

OCCUPANTS AND THE ENVIRONMENT

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Pyrotek India Pvt Ltd 6


An introduction

� Powered by the impassioned dedication of Dr. Nomal Chandra Borah

� First ever super specialty health care centre in this part of the globe -1987.

� The coveted British Standard Institute, London, has accredited the organization

with ISO 9001: 2008 and ISO 14001:2004

� In continuation of its process of evolution in the field of Health Care at a Global

level, the Indian Council of Medical Research (ICMR) has also accredited this centre

for Medical Research under ICMR since the year 2002.

� It is also a recognized research centre under the Department of Science and

Technology, Government of India. This centre has also been supported by WHO for

a medical library.

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About the project:

Situated at: Guwahati

Building Type: Hospital

Site area : 67050 Sq.m

Built up area: 16772 Sq.m (excl parking etc)

Project completion: October 2014 (December 2013)

Architects and PMC: RJB Architects

HVAC Consultants: Sterling & Wilson

Landscape Consultant: RJB Architects

Green Consultant: Ecologikol Advisors India Pvt Ltd

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Site Selection & Planning:

Green features:

� Fertile Top Soil Stock Piling – For landscaping post construction.

� Compound wall around the site – To prevent water from eroding fertile soil

� Construction Of sediment trap, Storm water drains and Pond.

� Bicycle storage, changing rooms & Public transportation access

� Night Sky Pollution Reduction

�Development Density- 10 Amenities within walking distance from the main entrance

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Top Soil Stock Piling

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Site Selection & Planning


GNRC Hospitals 12




GNRC Hospitals 13




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Development Density- Amenities in and around the Site

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Temple

School

Recharge

Shop

Saloon



GNRC has provided free

shuttle services for employees

from the hospital premises to

Guwahati.

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GNRC has provided rideshare

options for free to the nearest

bus stop and railway station.

Storm water Design – Quantity & Quality control

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Natural

pond in the

campus

Silt Trap

Vegetation

along the

boundary

wall

Storm water

drains


Green Belt Development

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Site Selection- Natural Topography retained

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Natural Topography within the campus being

retained.


Other Notable contributions

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• Provision of Bicycle storage and

Changing Rooms

• Provision of Differently abled toilet.

• 100% Storm water run-off collection.

• No night sky pollution – zero trespass

of light from premises – helps conserve

nocturnal ecology.

Effective Water Management :

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Green Features:

�Reduction of Turf & focus on plantation of native species

�Well planned landscapes that demand less water and efficient irrigation systems

that optimize & restrain water requirements.

�An efficient STP that ensures safe conversion of Effluent discharge for irrigation

purpose.

� Savings via Low-flow plumbing fixtures above 33 %

�Pond Capable of harvesting 100% Storm water Run-Off


Water Conservation - Low Flow Fixtures

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•Dual Flush Closets

•Sensor based urinals

•Low Flow Fixtures

Used the Building

Effective Water Management:

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STP & ETP- Waste water recycled and reused for Landscaping and Flushing:



Energy Conservation :

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Notable contributions:

�CFC and HCFC free Systems

�T5 & CFL lightings throughout the hospital saves

significant energy annually

�Efficient HVAC results in huge energy savings and comfort

�Metering at all the important junctions enable monitoring,

logging and energy auditing an easy affair. Electricity Consumption

is always under the scanner this way.

�Solar Street Lamps have been installed in GNRC to reduce

external lighting energy consumption.


Energy Conservation:

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Efficient

HVAC systems

Solar lamps

for External

lightings

CFC & HCFC

free Fire and

HVAC systems

Energy Conservation:

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Solar water heater

Capacity 3000 LPD

No. of units 5 units/day

No. of sunny days 270 days

Total power =150 x 270 days

= 40500 units

Conventional power

savings (@ Rs

6/unit)

2.43 lakh/year


Material Conservation:

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�Proper collection, storage and re-use of construction waste

�Central scrap yard provided for post-occupancy waste management

�Preference given to Recycled materials

�Locally sourced materials.

Material Conservation – Construction Waste Management

LEED India 2011 NC Slide 30

Collection of

Construction

waste

CONSTRUCTI

ON DEBRIS

used for

filling up Low

lying areas in

the site


Material Conservation-Central Scrap yard

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Material Conservation

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Fly ash Brick

with recycled

content over

40% used for

construction


Material Conservation- Bamboo reuse

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Locally abundant

bamboo

Used for shuttering Spliced after use Boric Acid

treatment – pre

seasoning

Sun drying /

seasoning Cut to size and used for façade

cladding and decoration

Bamboo cladding

provides insulation



Effective Bio-Medical waste management

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Material Conservation

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CRAZY

STONE

FLOORING

done on the

RCC Roof

top for Heat

reflection

Broken Fly

Ash Bricks

are re used

for Drop

Slab filling


Indoor Environment Quality & Occupational Health

GNRC Hospitals37


�The hospital is a no smoking zone, asbestos free and Eco-friendly

�Ample openings for Natural Ventilation.

� Increased Fresh Air Ventilation in all Air conditioned areas.

�Flush out was Scheduled after completion of Construction

�Low Emitting Materials- Paints , Sealants & adhesives been used.




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Environmental

Friendly AHU

Systems.

Monitoring

Oxygen Level

Window

openings for

Natural

ventilation

Louvers for fresh

air intake in air

Conditioned areas


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Highly

efficient Filter

systems being

used.



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Low Emitting

Adhesives and

Paints been used.




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LAYING OF VITRIFIED TILES AND KOTA STONE in floor with

Cement Mortar only. No Adhesive is used to fix Tiles or

Stone or Marbles

GNRC Hospitals:

3 Campuses

•Dispur – 72,000 Sq.Ft

•Sixmile – 42,000 Sq Ft

•GNRC Medical – 175,000 Sq Ft

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Innovation in Equipment selection :

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Financial Benefits: EnergyOn an average, green buildings are 28% more efficient than conventional

buildings and generate 2% of their power on site ,typically from photovoltaics.

Evaluation of LEED submission documentation for buildings shows an average

kWh reduction in energy use of 30% and an average peak kW reduction of

40%


ENERGY EXPENDITURE:

DISPUR SIXMILE NGP

APRIL 1,424,439 618,094 682,636

MAY 1,696,858 768,737 774,109

JUNE 1,769,843 816,316 753,258

JULY 1,934,055 902,447 870,033

AUGUST 1,756,494 894,606 930,421

SEPTEMBER 1,747,011 852,179 932,623


ENERGY EXPENSE:

ENERGY EXPENSE:


WHO Defines:


• Health is a state of Complete Physical, Mental and

Social Well being and not merely the absence of

Disease and infirmity : Preamble to the Constitution of the World

Health Organization as adopted by the International Health Conference, New York, 19-

22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official

Records of the World Health Organization, no. 2, p. 100) and entered into force on 7

April 1948.

• The Definition has not been amended since 1948.

• People Spend 90% time Indoors in the USA

• Indoor pollutant levels may be 2 – 5 times

higher than outdoor levels58

GNRC Hospitals 1


Publication of Environmental Health SciencesPublication of Environmental Health SciencesPublication of Environmental Health SciencesPublication of Environmental Health Sciences

� Increasing evidence suggest several compounds found in buildings harm human health.

� When electricity usage is reduced,the amount of coa l being burnt is reduced which has a direct effect on human health.

Douglas Fischer in “The Daily Climate”

Mahesh Ramanujan COO of USGBC at Tenth Mahesh Ramanujan COO of USGBC at Tenth Mahesh Ramanujan COO of USGBC at Tenth Mahesh Ramanujan COO of USGBC at Tenth International Conference on Green & Energy International Conference on Green & Energy International Conference on Green & Energy International Conference on Green & Energy Efficient Buildings, ChinaEfficient Buildings, ChinaEfficient Buildings, ChinaEfficient Buildings, China

� The Building Environment has profound effects on Hu man Health.

� In countries like US & China, COPD is the second mo st leading cause of death.

� The American Public Health Association notes that t he IEQ can negatively affect occupant’s physical health s uch as increasing asthma & respiratory diseases.

� It leads to more absenteeism

� Lowers Productivity


American Journal of Public Health:American Journal of Public Health:American Journal of Public Health:American Journal of Public Health:

� Another study at the Michigan State University conc ludes that a Green Building may contribute to reductions in absenteeism and work hours lost due to asthma, respiratory allergies and stress.

� The greenness may also be a factor in increased productivity

Other Studies:Other Studies:Other Studies:Other Studies:

� Increased productivity

� 7% increase in productivity following move to daylit facility

� Flexible design features cut employee relocation costs by 90%

� Studies conducted by Judith Heerwagen, Heerwagen & Studies conducted by Judith Heerwagen, Heerwagen & Studies conducted by Judith Heerwagen, Heerwagen & Studies conducted by Judith Heerwagen, Heerwagen & Associates.Associates.Associates.Associates.

� Studies conducted at the Harvard School of Public HealthStudies conducted at the Harvard School of Public HealthStudies conducted at the Harvard School of Public HealthStudies conducted at the Harvard School of Public Health

� Enhanced health

� $43 – $235 billion in potential US annual savings or productivity gains from better indoor environments William Fisk, William Fisk, William Fisk, William Fisk, ““““Health Health Health Health and Productivity Gains from Better Indoor and Productivity Gains from Better Indoor and Productivity Gains from Better Indoor and Productivity Gains from Better Indoor Environments,Environments,Environments,Environments,”””” Indoor Air 7(3), 1997: pp. 158Indoor Air 7(3), 1997: pp. 158Indoor Air 7(3), 1997: pp. 158Indoor Air 7(3), 1997: pp. 158----172172172172


Publication of the National Academy Of Sciences, USAPublication of the National Academy Of Sciences, USAPublication of the National Academy Of Sciences, USAPublication of the National Academy Of Sciences, USA

� Enhanced health

� Sunlight in Healthcare facilities associated with substantial reduction in medical costs

� Lighter and Brighter rooms contributed to stress reduction

� Reduced mortality among heart attack patients hospitalised in bright & sunny rooms.

CLINICAL RESULTS :::;

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DISPUR SIXMILE NGP

ALOS 6.72 4.43 3.89

SSI 6NOS 2NOS NIL

VAP

MORTALITY 4.49 3.39 1.93


STAFF RESULTS:::;

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DISPUR SIXMILE NGP

NEEDLE PRICK

INJURIES

6 NOS 5 NOS 2 NOS

MEDICATION

ERRORS

2 NOS 1 NOS NIL

NEAR MISS 2 NOS 2 NOS NIL

BED SORES 0.06 0.05 0.26


Substantial Reduction in absenteeism

Perceived improvements in Health

Employees perceived a Positive effect of

the new environment on their productivity.

American Journal of Public Health

Amanjeet Singh,et al

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�Have you visited other Hospitals earlier ?

�Are you happy to see the Greenery?

�Have you seen any other Hospital so green ?

�Did it have the look of an Hospital ?

�Are you happy to see fewer lights?

�Are you comfortable with the ventilation?

�Will you come again ?

�Are you happy with the overall cleanliness?

�Are you happy with the cleanliness of the

toilets?

�Will you recommend this Hospital to others ?

SAMPLE SURVEY WE DID :


Results of a Survey Conducted

by Turner Construction Company

• Turner solicited the views of > 700 U.S. executives involved with buildings either as an owner of rental buildings, owner-occupant, developer, designer, consultant or builder:

• 75% said their green buildings had lower operating costs

• 91% reported greater health and well-being among occupants

• 84% believe that building green yields higher building values

• 75% said they generated a higher ROI than traditional

buildings

• 51% expected the number of green buildings in their

organization to increase substantially over the next three years69

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CONCLUSIONS:


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health of patients in a green hospital –our experience ramanujan coo of usgbc at tenth...

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