Sustainable used nowadays. Fig 1. Three levels of

Sustainable construction has become one of the major trends in the real estate industry in recent years. A key issue with respect to sustainability, which is often neglected, is the long period of use and operation of the facilities.For facilities and their operation to be considered truly sustainable, all the stakeholders (their views and needs) should be integrated in real estate development and for existing buildings. This Research Lab addresses precisely these issues and aims to explore methods and tools for each stage of a facilities life cycle through active networking with all involved stakeholders and disciplines.(Moodle information).

Sustainability means meeting our present needs without compromising the ability of future generations to meet their own needs (Brundtland commission). Sustainability is not just about the environment or building. Embedded in most definitions of sustainability we also find concerns for social equity and economic development. The main aim of sustainability is to make sure the building of today doesn’t devalue the existence of the next generation.Sustainable building operation is more concerned about the use of buildings, it is not only the physical use of buildings, it also involves every other aspect of the running of the building e.g procurement, lease, management e.t.c.

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Adopting sustainable building practices whether small, or large has very significant positive effect in the long run. Sustainable building operations encourages owners and operators of existing buildings to implement sustainable practices and reduce the environmental impacts of their buildings over their functional life cycles. Sustainable building operation is related to the life cycle of the building from the buildings inception till the end of the buildings life cycle. The financial aspect of sustainable building operations involves life cycle of the building.The term sustainability is commonly examined through three dimensions: the effect of a phenomenon or system on society (often referred to as social sustainability), its impact on the environment (often referred to as environmental sustainability), and its economic implications (often referred to as economic sustainability).

This threefold dimension (Figure 1) is called the triple bottom line of sustainability; firstly, it was introduced by Elkington in 1994 and is still used nowadays.                  Fig 1. Three  levels of  sustainability                              Source (Elkington, 1994)The term Green building and Sustainability are used interchangeably to mean the same thing in this report.

 2.0.    SUSTAINABLE BUILDING CERTIFICATIONS / RATING SYSTEMSIn this report we would be looking at three (3) building certifactions which are widely used and more appropriate in the context of this research lab.1)      Leadership in Energy and Environmental Design (LEED): This is a rating system devised by the United States  Green Building Council (USGBC) to evaluate the environmental performance of a building and encourage market transformation towards sustainable building design. The system is credit-based, allowing projects to earn points for environmetally friendly actions taken during construction and use of a building. Leed Operations & Maintenance is a set of performance standards for certifying the operations and maintenance of existing commercial or institutional buildings and high-rise residential buildings of all sizes, both public and private. Its aim is to promote high performance, healthful, durable, affordable, and environmentally sound practices in existing buildings. Specifically, the rating system addresses exterior building site maintenance programs, water and energy use, environmentally preferred products and practices for cleaning and alterations, sustainable purchasing policies, waste stream management, and ongoing indoor environmental quality.

2)      Building Research Establishment Environmental Assessment Methodology (BREEAM): BREEAM is one method of assessing, rating, and certifying the sustainability of buildings. It is typically undertaken to demonstrate compliance with environmental regulations but it can also be a planning requirement. There are different categories in which a domestic or non-domestic project (in-use, new build or refurbishment) is assessed.  3)      German Sustainable Building Council DGNB: This is building certification system with mission of developing and promoting methods of solutions for sustainable designs, constructions and management of buildings. The DGNB awards certificates in three levels of quality.

They are Gold, Silver and bronze. It incorporates the full life cycle of a building in sustainability and places it in an economic category.                                             TABLE 1 Summary of the main features of rating systems. Source: (Bernardi et., al 2017)       3.0     LIST OF STAKEHOLDERS IN HEALTHCARE INDUSTRY  Source: (A.RELLER, 2015)The role of stakeholders is very important in ensuring a sustainable environment which includes the development of a building and operations in the building.

Each stakeholder has a unique role to play in ensuring that the building is used in a sustainable way.  3.1.    SUSTAINABLE PRACTICES IN HOSPITALSHospitals are a major sector in sustainability, the healthcare sector and especially hospitals account for a large, but often neglected or most times ignored its impact on the environment and face high costs for use of water, energy and disposal of material (waste).

  Hospitals have specific and complex structures that do not belong to the industry but rather to the service sector. What makes hospitals different is that the most important concern in the healthcare sector is safety: hospital processes have to be safe for staff and the patients. Secondly, another main concern in hospitals is the ability to be profitable as they must be led economically.

Finally, the environmental impact of the hospitals operations. 3.1.1.    HOSPITAL ADMINISTRATIONThe facility management of a hospital usually manages and supervises the healthcare services. In this segment, best practices can be introduced to the office areas that often use a greater amounts of energy and produce substantial volumes of waste.Use of office equipment : Office equipment, such as computers, printers and others consume electric power even when they are not in use.

Encouraging staff to turn computers off at night and on weekends is the most effective way to reduce electricity consumption. Activating the standby feature when the computer is not used for a short period of time can save up to two thirds of its energy consumption.Lightning : Reduce general lighting during daytime and make sure that exterior lighting is switched on only at night.

Use energy-saving bulbs, especially in high consumption areas. Install timers and movement detectors to reduce lighting time. Lighting can be adjusted to the actual needs through usage of time switchers, occupancy and movement sensors as well as day-light or temporal dimming. These measures altogether can save up to 70% of electricity.” (Source: Klinergie 2020, Energy Efficiency in German Clinics).Office waste: Office waste mainly consists of paper. The use of paper cannot be limited in offices but paper waste can be limited. Reducing the amount of paper being used, recycling and using recycled paper are low cost and easy measures to make administration processes more sustainable.

Water: In hospitals the amount of water used for cleaning can be as large as 10% of overall water consumption. Water use for cleaning purposes is a question of good housekeeping and staff’s behavior. To achieve this, the staff should be trained to use water efficient.

3.1.2     FOOD COURT AND CAFETERIAFood waste: Disposable dishes and eating utensils are often used in hospitals. Most of the waste typical of Cafeteria & Food Service can be prevented by using washable plates, cups, glasses and eating utensils for staff and visitors cafeterias and for patient service.

For Example In a Swiss hospital in Bülach a flexible ordering of meal sizes (half portion, quarter portion) is practiced in order to prevent leftovers. The meal orders are taken each day in advance by trained service staff. Such measures save money when purchasing food as well as when disposing kitchen waste. Energy Food: preparation needs large amounts of energy, especially when kitchen appliances are electric. Switching to gas and teaching kitchen staff in energy-efficient behavior will help to save energy and costs.Water: Water in hospital kitchens is mainly used for cooking and cleaning. A reduction of water usage can be achieved through using efficient equipment such as high pressure, low volume nozzles and again, through training staff in water efficiency.  4.


1     ENERGY EFFECIENCY: already accounts for around 18% of a hospital’s delivered energy consumption and it represents over 50% (international average) of a hospital’s energy costs. By reducing a hospital’s energy consumption, it is possible to achieve the twin benefits of saving money and ensuring a less polluted environment for the local community. In a typical hospital, the amount of energy consumed each year is equivalent to 16 tons of CO2 per bed space or, in total, about 8’700 m3 of CO2, which is enough to fill over 60 six-bed wards”. (EEBPp, 1989).  General operations should include: a)       Monitoring regularly energy consumption by checking the electricity meters at least once a month.

b)      Identify areas/equipments having high energy consumption.c)       Implement measures such as installing energy-efficient 1)      USE OF LIGHTNING IN THE HOSPITALSBellin Hospital, in Wisconsin, U.S., saved USD 21’000 per year by using variable speed drives in hot water pumps, eliminating exhaust in unnecessary areas, and recovering boiler heat. ( A. Reller,2017).

The following are sustainable practices;(a)    Reduce general lighting during daytime and make sure that exterior lighting is switched on only at night.(b)     Use energy-saving bulbs, especially in high consumption areas. (c)     Install timers and movement detectors to reduce lighting time. 2)      HEATING AND AIR-CONDITIONINGThe use of air conditioner and heaters contributes largely to the use of energy in the healthcare industry, hospitals require a maximum indoor air quality therefore the aspect of energy efficiency is very essential. Combined heat and power system is 70-95% more efficient than conventional power production. Cogeneration systems are available from as small as 30 kW to more than 100 MW. By making continuous use of both electricity and thermal energy, customers can save up to 35% on overall energy cost. The following processes should be introduced into the use of the facilitiesa)       Inspect or install a combined heat and power systemb)      Use solar collectors for hot water c)       Use night-time temperature lowering thermostatsd)       Install several small boilers instead of one large boiler for load dependent operatione)        Install double glazed windowsf)        For air-conditioning, check specific room parameters (temperature, humidity, air exchange) g)       Check air flow reductions are in place in unused roomsh)       Clean and change the air conditioner filters regularly 3)      LAUNDRY SERVICES Sustainable practices can be introduced to laundry operations in the hospital and the following are processes which the FM can incorporate:a)       Use heat recovery to warm up clean incoming water b)      Avoid wasting energy from over-drying the laundry by fitting humidity sensors to dryers c)       Use direct firing of gas for tumble dryers and finishing equipment d)      Plan to use laundry equipment during periods of low consumption (off-peak hours) e)       Use low temperature washing programmes to reduce energy consumption 4)      FOOD COURT AND CAFETERIAThe following processes are encouraged in hospitals to reduce excess use of energy in kitchens and cafeterias;a)        Invest in high-performance cooking units and refrigerators when replacing equipmentb)       Defrost refrigerators and clean the door seals monthly  4.

1.2           WASTE MANAGEMENT Medical waste incineration is a leading source of dioxin, mercury and other dangerous pollutants that threaten human health and the environment. It is important to minimize the amount and toxicity of waste generated by the healthcare sector, to ensure the proper management and segregation of medical waste and to eliminate the dangerous practice of incineration by promoting and implementing alternatives, such as non-incineration treatment. Recycling and composting can also be a valuable solution for waste valorization. General operations should include;a)       Elaborate a waste management plan to establish a framework of policies and procedures with an overall goal of zero waste b)      Understand waste categories and segregation: domestic wastes (paper, glass, plastics, etc.); regulated medical waste (biohazardous waste, potentially infectious medical waste, biomedical waste, etc.); hazardous waste; low-level radioactive wastec)       Implement non-incineration technologies: thermal, chemical process, irradiative or biological processes d)      Promote waste recycling: paper, plastics, glass, batteries, etc.e)       Encourage composting wastes,such as grass, leaves, flowers, etc.

f)       Track the treatment and disposal costs of waste from individual sections and departments g)      Separate bags used for the regular solid wastes and recyclablesh)      Regulation of pharmaceutical wastes. Regulating entering products (green purchasing, appropriate dose packaging, etc.) and modify management practices”A hospital pharmacy generally stocks between 2’000 and 4’000 different items, each of which must be evaluated against state and federal hazardous waste regulations before being thrown away.” (Hospitals for a Healthy Environment). 4.1.3           WATER CONSERVATIONWater use is driven by the number of equipment used, inpatients and outpatients, types of services facility size, number, facility age and maintenance requirements. Other contributors include sterilizers, autoclaves, medical processes, heating ventilation and air conditioning, sanitary, x-ray equipment, laundries and food services.

All these areas should be evaluated to identify activities to help reduce water consumption.General operations should include: a)       Check the water supply system for leaks and turn off unnecessary flowsb)      Install automatic water volume controls that operate independently of the water pressure to control the amount of waterc)        Read water meters monthly in order to identify leaksd)       Recycle and reduce water use wherever possible, consistent with health requirements.e)       Consider using low-volume irrigation, such as a drip system. 1)      WATER USE IN LAUNDRY: a)       Wash only full loads in the dishwasher b)      Investigate a treated rinse water system to reuse rinse water for other purposes or recycle it in the wash cycle c)       Instruct cleaning crew to use water efficiently for mopping d)      Wash only full loads of clothes and materials. 2)      WATER USE IN CAFETERIA AND FOODCOURT:a)       Wash only full loads of dishes in the dishwasherb)       Reuse the rinse water from the dishwasher as flush water in garbage disposal unitsc)        Upgrading of equipment with water-efficient modelsd)       Turn off the continuous flow used to wash the drain trays of the coffee/milk/soda beverage 3)      WATER USE IN COOLING AND HEATING :a)       Adjust boiler and cooling tower blow down rate to maintain total dissolved solids at levels recommended by manufacturers.b)       Return steam condensate to the boiler for reuse c)       Shut off water-cooled air conditioning units when not needed, or replace water-cooled equipment with air-cooled systems 4)      WATER USE IN BATH AND RESTROOMS:a)       Shut-off the water supply to equipment and areas that are unused .

b)      Install electronically controlled valves c)       Replace toilets with low-volume modelsd)      Install low-volumes showerheads 4.1.4          SUSTAINABLE PURCHASING: The term Sustainable purchasing is an effort to buy greener, healthier, and more sustainable products from greener, more sustainable companies. It is based on the simple concept that every single purchase has hidden human health, environmental, and social impacts and that it is possible to reduce adverse impacts by buying better products. Purchased products must be considered in their totality (life cycle).

Indeed, the different stages of the life of a product (manufacturing, marketing, use and disposal) all have an impact on the environment. General operations should include:a)       Buy only what is needed (avoid unnecessary supplies) b)      Buy in bulk rather than individually packaged items c)       Buy recycled contents (office paper, paper towels, etc.) d)      When purchasing new equipment, take their water and energy consumption into consideration e)       Educate and train the purchasing department f)        Use standard labels and choose the right suppliers g)       Prefer reusable products to disposable products  5.0   CONCLUSIONThe use of sustainable practices in buildings cannot be overemphasized as these days sustainable buildings have a higher value than other properties. Sustainability operations should be adopted by healthcare industries to boosts the performances of their buildings. The use of a building in a sustainable way has a lot of environmental, social and economic benefits. Sustainability ranges from energy efficiency, waste management, water management and sustainable purchasing.

If managed properly, all these practices would mean a sustainability potential for the building.