Long-term approach drives green thinking

5/31/2016 1:51 PM CET

Hospitals’ operating rooms, medical equipment and intense heating and cooling require vast amounts of energy – it’s tough to make a hospital green. But Stockholm County’s New Karolinska Solna will be one of the world’s most sustainable and environmentally friendly hospitals, in part because it’s being designed and built with a long-term focus under a public-private partnership (PPP).

Having responsibility for operations and maintenance under the PPP agreement incentivized Swedish Hospital Partners to find the best, most efficient solutions for the long term. Lighting, flooring and heating and cooling were among the systems that benefited from this approach.

Under the PPP agreement, Skanska's Swedish Hospital Partners (SHP) consortium is responsible for not only financing, designing and building this 330,000-square-meter facility, but also operating and maintaining it until 2040. (The project is rapidly proceeding – SHP is delivering the first patient wing June 1, on schedule.)

Having responsibility for operations and maintenance incentivized the project team to find the best solutions for the long term. That's because if energy bills or maintenance costs are higher than anticipated in the contract, the extra cost is borne by the Skanska consortium.

Further driving green solutions were Stockholm County Council's stringent environmental requirements, which included evaluating New Karolinska Solna's (NKS) 3,000 different materials against the Byggvarubedömningen building materials database – no potentially environmentally harmful products were allowed. Also, the facility must meet the standards of two external green rating systems: Sweden's Miljöbyggnad system, with the highest ranking as the target, and the international LEED system, with a Gold level as the objective.

Guaranteed energy

These strict green requirements layered onto one of Europe's largest construction projects presented enormous challenges – and opportunities. Full collaboration between the County Council, Skanska, the designers, facility operator Coor Service Management and more was the only way to succeed.

With energy, the County Council set an ambitious goal for the amount of energy the hospital would use. They then established that if the energy consumed for the facility's heating, cooling, lighting and other nonmedical uses exceeds the expected amount during the operations and maintenance period through 2040, SHP is responsible for paying the higher value. If the energy use is less than predicted, the savings are shared between the County Council and SHP. (Skanska has implemented similar energy guarantees with PPP hospital projects in the UK.)

New Karolinska Solna's tough environmental standards and its massive size helped push the construction industry forward. PVC-free flooring and lead-free faucets are more commonplace now, thanks in part to NKS.

Pushing the boundaries

This long-term outlook helped spur such highly energy-efficient solutions as a geothermal heating and cooling system, elevators that recycle energy on the way down, and “double-skin” facades. Overall, NKS’ purchased energy consumption will be about 51 percent lower than Swedish building standards. 

“The buildings were designed to use energy in the best ways possible, and to reuse energy when possible,” said Martin Kron, SHP operations director. “Compared to other university hospitals, we definitely pushed the boundaries.”

Stringent materials requirements

Considerations for green and long-term use influenced every aspect of the project, particularly NKS’ 3,000 different materials. And being a hospital, hygienic requirements were also very important. On top of the other environmental requirements, the County Council banned three traditional building materials from NKS because of health concerns: PVC plastic, copper that is in contact with water, and pressure-impregnated wood. 

Faced with these stringent requirements for materials, Skanska’s design-build team and Coor Service Management worked together to find solutions that met aesthetic, technical and environmental needs, and that were also highly durable and easily cleaned with minimal use of chemicals.

This light well provides natural light to aid with healing, and to help NKS meet the standards of two external green rating systems: Sweden's Miljöbyggnad system, with the highest ranking as the target, and the international LEED system, with a Gold level as the objective.

Planning for the future

Typically, those responsible for facility operations and maintenance aren’t involved when materials are being procured, and that results in a lost opportunity for the project to benefit from their expert input. However, in the PPP model – which consolidates design, construction, financing and operations and maintenance responsibilities into a single consortium – the facility’s needs throughout its lifecycle are considered from the very beginning. With NKS, for example, the floor covering is extended 15 centimeters up the walls to protect those surfaces when the cleaning machines are being used. 

Advancing the market

These tough demands for materials helped push the construction industry forward. For instance, when much of NKS’ materials were being procured, there wasn’t a good PVC-free flooring option available. But through NKS’ tremendous scale, manufacturers were persuaded to produce green alternatives that are now commonplace. The same was true for lead-free faucets, which weren’t available early in the project.

The project team feels much pride in creating not just a highly sustainable hospital, but in helping elevate environmental standards for future projects of all types.

“It’s been a tough journey, but through tremendous collaboration between everyone involved with this project we have raised awareness of building in a more environmentally friendly way,” said Klara Gunnarsson, Skanska environmental engineer. “That’s what I’m really proud of – the NKS project has shown it’s possible to make environmental issues more visible, and make everyone more aware of them.”

The university hospital of tomorrow

New Karolinska Solna is setting new standards for sustainability and value-added delivery through a long-term public-private partnership (PPP). In the Projects section you can learn more about the project and view more images.

Robots and much more

Automatic guided vehicles (robots), equipment tracking and modular assembles are some of the smart solutions being used at NKS.