Why We Need to Redesign Hospitals for Resilience

Hurricane Katrina struck just as I had begun my last year in architectural school at Tulane in New Orleans. Charity Hospital had served impoverished New Orleans residents for more than 80 years. It was first built in the 1920s with fully operable windows, but when the hospital underwent mechanical system retrofitting years ago, the windows were sealed shut. A mechanical ventilation system was substituted for fresh air. The system failed during the storm, internal temperatures rose to over 100 degrees, and the building was subsequently evacuated. Taking more than 1,000 lives and forever changing the city, the hurricane profoundly demonstrated how fragile our healthcare buildings are.

In October 2012, power failures and loss of water during Hurricane Sandy caused many New York City hospitals to shut down. With the ability to produce power and harvest water on-site, both of these instances could have been prevented. Recent history has illustrated the extreme vulnerability of healthcare facilities during times of catastrophe—the very moments when we need them most.

My firm, Perkins+Will, recently completed the Spaulding Rehabilitation Hospital located on Boston Harbor. The design team incorporated various resiliency measures, including plantings and retaining walls to lessen flood waters, mechanical services located on the building’s roof, and operable windows for passive ventilation. When it comes to disaster planning and building resiliency, the hope is that these changes will allow hospitals to continue operating amid extreme weather conditions.

Modern hospitals tread a paradoxical line, focusing on restoring patients’ health in the short term while also emitting harmful chemicals that degrade health over time. In addition to resiliency, architects and designers must reinforce the fact that our built environment has a profound impact on human and ecological health and currently, that impact is negative. These two problems are not mutually exclusive, but rather closely related, supporting a synergistic solution that can enable healthcare institutions to move beyond crisis response and proactively foster global wellness. In this model, they can support the most primary principle of medicine: “First, Do No Harm.”

The average 200-bed hospital can use as much energy in a year as 3,500 households and is primarily supplied with fossil fuel through the municipal grid. The same hospital might use up to 51 million gallons of water per year, consuming our most precious resource while burdening water treatment facilities. Besides having the obvious detrimental environmental impacts, this singular reliance on the municipal infrastructure grid inherently causes vulnerability, which we have personally observed in recent history.

An energy-effective hospital can drastically reduce energy consumption through a focused demand reduction process that utilizes alternative energy systems, which can continue functioning despite damages to public infrastructure. The overarching goal is to first reduce demand as much as possible and develop on-site sources, such as rainfall harvest or condensate capture. How can the effluent of one process become the feedstock for another?

This mindset allows buildings to become self-reliant and produce the necessary resources to operate during inclement weather. Not only is this improvement safer, it is also cost effective. I recently led a research project that identified the capital cost premium of large hospitals that achieve LEED certification to be .67 percent of construction costs—significantly less than what is commonly believed within the industry.

Both scientific and financial data stands firmly behind the importance of creating healthy, resilient and energy-efficient healthcare buildings. In order to provide the best possible care, we must ensure that built environments actively reduce negative environmental impacts and instead provide healthy, stable conditions for all.

Image courtesy of Perkins+Will

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Amazon's "The Man in the High Castle" debuted the first episode of its final season last week.

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Chick-fil-A is the third-largest fast food chain in America, behind McDonald's and Starbucks, raking in over $10 billion a year.

But for years, the company has faced boycotts for supporting anti-LGBT charities, including the Salvation Army, the Fellowship of Christian Athletes, and the Paul Anderson Youth Home.

The Salvation Army faced criticism after a leader in the organization implied that gay people "deserve to die" and the company also came under fire after refusing to offer same-sex couples health insurance. But the organization swears it's evolving on such issues.

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The Fellowship of Christian Athletes explicitly announced it was anti gay marriage in a recent "Statement of Faith."

God instituted marriage between one man and one woman as the foundation of the family and the basic structure of human society. For this reason, we believe that marriage is exclusively the union of one man and one woman.

The Paul Anderson Youth Home teaches boys that homosexuality is wrong and that same-sex marriage is "rage against Jesus Christ and His values."

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In 2012, Chick-fil-A's CEO, Dan Cathy, made anti same-sex marriage comments on a radio broadcast:

I think we are inviting God's judgment on our nation when we shake our fist at Him and say, "We know better than you as to what constitutes a marriage". I pray God's mercy on our generation that has such a prideful, arrogant attitude to think that we have the audacity to define what marriage is about.

But the chicken giant has now decided to change it's says its charitable donation strategy because it's bad for business...Not because being homophobic is wrong.

The company recently lost several bids to provide concessions in U.S. airports. A pop-up shop in England was told it would not be renewed after eight days following LGBTQ protests.

Chick-fil-A also has plans to expand to Boston, Massachusetts where its mayor, Thomas Menino, pledged to ban the restaurant from the city.

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"There's no question we know that, as we go into new markets, we need to be clear about who we are," Chick-fil-A President and Chief Operating Officer Tim Tassopoulos told Bisnow. "There are lots of articles and newscasts about Chick-fil-A, and we thought we needed to be clear about our message."

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Instead, the Chick-fil-A Foundation plans to give $9 million to organizations that support education and fight homelessness. Which is commendable regardless of the company's troubled past.

"If Chick-Fil-A is serious about their pledge to stop holding hands with divisive anti-LGBTQ activists, then further transparency is needed regarding their deep ties to organizations like Focus on the Family, which exist purely to harm LGBTQ people and families," Drew Anderson, GLAAD's director of campaigns and rapid response, said in a statement.

Chick-fil-A's decision to back down from contributing to anti-LGBT charities shows the power that people have to fight back against companies by hitting them where it really hurts — the pocket book.

The question remains: If you previously avoided Chick-fil-A because it supported anti-LGBT organizations, is it now OK to eat there? Especially when Popeye's chicken sandwich is so good people will kill for it?


Oh, irony. You are having quite a day.

The Italian region of Veneto, which includes the city of Venice, is currently experiencing historic flooding. Venice Mayor Luigi Brugnaro has stated that the flooding is a direct result of climate change, with the tide measuring the highest level in 50 years. The city (which is actually a collection of 100 islands in a lagoon—hence its famous canal streets), is no stranger to regular flooding, but is currently on the brink of declaring a state of emergency as waters refuse to recede.

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via Twitter / Bye,Bye Harley Davidson

The NRA likes to diminish the role that guns play in fatal shootings by saying, "Guns don't kill people, people kill people."

Which is the same logic as, "Hammers don't build roofs, people build roofs." No duh. But it'd be nearly impossible to build a roof without a hammer.

So, shouldn't the people who manufacture guns share some responsibility when they are used for the purpose they're made: killing people? Especially when the manufacturers market the weapon for that exact purpose?

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