Health Management Associates, Inc.

Green with healthGreen and sustainable practices are the repeat prescription for Health Management Associates, Ruari McCallion reports. Healthcare is about more than pills, potions and operations. Health Management Associates, Inc. (HMA), based in Naples, Florida, is following a ÔÇ£greenÔÇØ and sustainable route to patient well-being.ÔÇ£HMA has reduced the quantity of volatile organic compounds by using low-VOC materials in our buildings. We follow a ÔÇÿbake-outÔÇÖ process,ÔÇØ says Randy Holly, vice president of design and construction for HMA. ÔÇ£Prior to taking occupancy of a new facility, we raise the internal temperature of the building to a warmer-than-normal temperature and run it for a period of 48 hours. Then we replace all the air filters in the HVAC system. This helps eliminate any toxic off-gassing in the building. From the moment a new project is conceived, the focus is on conserving energy, reducing waste, minimizing environmental impact and improving the patient care environment.ÔÇ£In order to be competitive in the healthcare sector,ÔÇØ Holly continues, ÔÇ£we must have state-of-the-art facilities. Our mission includes improving the quality of healthcare delivery, which means improving the design of our new or renovated hospitals.ÔÇØ The HMA difference is apparent from the moment a patient enters a hospital. ÔÇ£We operate a ÔÇÿnurse-firstÔÇÖ approach that begins in our emergency departments. A nurse is the first person who approaches you. Working closely with our architects, HHCP Healthcare, we optimize key functional relationships and the efficient flow of patient, doctor, visitor and staff from one area to another in our departmental planning. As a result, our buildings are very patient-friendly and way-finding is vastly improved. The layout is easy to follow and allows us to maximize staff effectiveness in our patientsÔÇÖ care.ÔÇØHMA operates 59 hospitals from Washington State in the west to North Carolina in the east and from Florida in the south to as far north as Pennsylvania. The largest contains over 400 beds, at the Central Mississippi Medical Center, with the majority of the facilities having 100ÔÇô150 beds. In 2007, HMA invested over $200 million in new and expanded buildings.┬á Their current projects total in excess of $175 million of construction value. ÔÇ£We are determined to minimize our environmental impact,ÔÇØ says Holly. ÔÇ£Part of our hospital site in Naples, Florida, is subject to the Wetlands Protection Act, and we have been able to introduce sustainable storm water controls and have worked to minimize actual and potential sources of pollution. All our facilities provide community connectivity with public transit and safe pedestrian access to our garden areas and other open spaces. We have minimized the heat island effect generated by our project development with landscaping, and light and reflective color in our roofing. Our land planning engineers, ECOS Environmental Design, Inc., have helped us develop on-site retention ponds for automated natural irrigation, and closed-loop systems to recycle our processed water. Effective bubbler systems mitigate the amount of water we use, yet we are still able to ensure the site remains as green and attractive as a park or a golf course.ÔÇØIn HMAÔÇÖs new buildings you will find high-performance glass that reduces the need for air conditioning in hot weather or heating in cold weather. Interiors, designed by The JNichols Group, feature low-VOC, non-toxic materials, and the carpeting, supplied by Shaw Carpets, is made from recycled and recyclable materials. During the construction phase on-site rock is excavated, crushed and used as the stone base for the underlayment of the asphalt finish surface.┬á Indigenous exterior natural finishes feature local stone, brick and stucco. Every patient room is provided with a view of nature, and patients are able to control the thermal comfort and lighting of their own room, leading to a significant reduction in power consumption, as well as an increase in patient satisfaction.ÔÇ£In close coordination with our design engineers, X-nth, Inc., we have an energy conservation program throughout the company,ÔÇØ Holly continues. ÔÇ£We monitor climate control on a daily basis. Whether in Washington State or Florida, we look at temperature and humidity and use state-of-the-art efficient chilled water and boiler reheating systems. WeÔÇÖre constantly adjusting our HVAC systems to ensure temperatures stay at a prescribed setting and are well monitored, which is great because systems tend to drift away from their factory settings. We inspect every facility annually as part of our CEOÔÇÖs quality improvement drive. Whenever we notice something out of specificationÔÇömaybe the air conditioning is out of balance, giving us more cooling in one area and less in anotherÔÇöwe go in, rebalance and ensure the chilled water is working properly. We consistently monitor our systems for quality and safety issues, and we commission all our buildings, recommissioning as needed.ÔÇØ┬á HMAÔÇÖs drive for environmental and utilities energy conservation began nine years ago but has received new impetus over the past few years. In order to achieve continuity in its design and construction delivery process, it has developed long-term partnerships with its architects, engineers and contractors. Together they are working to deliver savings on a lifecycle-cost basis. It may sometimes mean spending more up front, but the longer-term efficiencies are where the sustainable value is delivered.ÔÇ£In our existing facilities, we wanted to reduce ongoing utility overhead by around $6 million this year. As of August, we have achieved 64 percent of that goal, so weÔÇÖre headed in the right direction. We are evaluating chilled water recirculation loops, more effective recycling, and the possibilities of solar power. Facility by facility weÔÇÖre insulating and replacing worn insulation at valves, using smaller electric boilers rather than large, gas versions, examining control systems, and installing energy-efficient lamps,ÔÇØ says Holly. ÔÇ£We have standards that have to be met for patientsÔÇÖ health, and within that structure weÔÇÖre doing everything we can to improve patient experience while introducing long-term operational efficiencies.ÔÇØ HMA projects have won the American Building AssociationÔÇÖs Order of Merit for Excellence in Construction in 1999 for the Biloxi Medical Office Building in Biloxi, Mississippi, and in 2006 for the Brooksville, Florida, replacement hospital. Also in 2006, HMA was presented with the Eagle Award from the Associated Building Contractors for the Physicians Regional Medical Center constructed by M.J. Harris, Inc. in Naples, Florida.ÔÇ£Awards are great, but they just prove we are doing the right thing,ÔÇØ Holly says. ÔÇ£HMA won the awards because of the excellent design team and proven approach that works for us.ÔÇØ┬á