Sustainable healthcare design Existing challenges and future directions for an environmental, economic, and social approach to sustainability

Purpose - Healthcare projects face multiple obstacles in achieving sustainability. This paper aims to provide information regarding the energy consumption of healthcare facilities, to identify barriers to sustainability and to suggest methods to improve the effectiveness of these buildings. Design/methodology/approach - This study investigates sustainability in healthcare buildings by examining national databases about energy use and energy savings. The authors then initiate a dialogue on this topic by interviewing experts in healthcare planning and design regarding the implications of this data, challenges to sustainability and potential solutions to these challenges. Findings - An analysis of data from the Energy Information Administration revealed that healthcare facilities rank second among building types in the USA in energy use per square foot and rank fourth in total energy use. Data from the US Green Building Council showed that only 1 per cent of healthcare buildings are registered with the Leadership in Energy and Environmental Design rating system, and 0.4 per cent have achieved certification, which is low compared with other building types. Research limitations/implications - Research and discussion must continue engaging all stakeholders to interpret the data and identify transformative solutions to facilitate sustainable healthcare design construction and operation. Practical implications - It is important to approach sustainability in healthcare from social, economic, environmental and health-related perspectives. The authors identify five major barriers to sustainable healthcare design and construction and discuss 12 practical solutions. Originality/value - Given the energy demands of healthcare buildings, facilitating their sustainability has the potential to make a significant difference in national energy use. Empirical research and evidence-based design can potentially help to accelerate sustainability by clarifying impacts and documenting the economic and operational returns on investment.