Margaret Montgomery

Margaret Montgomery

Principal / Sustainable Design Leader, NBBJ, @MargaretMontgo1
Margaret is a nationally recognized sustainability leader. She has served on the board of AIA Seattle and co-chaired its What Makes It Green program, and is involved with Better Bricks, the Cascadia Green Building Council / International Living Future Institute and Seattle Climate Partners. She’s currently on an AIA Energy Education Working Group curating energy education for professionals across the nation.

A Healthier Planet Starts With Hospitals

Eleven Strategies to Reduce Energy Use and Increase Wellbeing

February 23, 2021

Principal / Sustainable Design Leader, NBBJ

@MargaretMontgo1

While hospitals are dedicated to healing, they are some of the most resource-intensive buildings on the planet. On average, they use twice the energy of most other building types. In the U.S., the healthcare system accounts for 10% of the nation’s total carbon dioxide emissions.

Typically complex and large, hospitals must operate 24/7. While essential, this results in higher energy use than a typical building. This has both an immediate and direct impact — in the cost of operational energy use — as well as longer term, significant effects of climate change on public and individual health. It’s important to address energy consumption in hospitals as it can lower operating costs, extend the life of utility equipment, reduce emissions and perhaps most important, create environments that support life especially at fragile moments.

How can hospitals reduce their energy use — as part of a holistic system of sustainable benefits — and stay operationally resilient, but still maintain solid, round-the-clock care? Fortunately, design can help hospitals tackle these sustainability issues.

In the U.S., hospitals have an average energy use intensity (EUI) — which is energy use per square foot — of 234 kbtu/sf/year. Yet a holistic system of design strategies now make it possible to reduce the energy use of healthcare buildings by almost 70%.

Two new hospitals in the Seattle area, including Overlake Hospital Medical Center’s FutureCare East Tower and St. Michael’s Medical Center Acute Care Expansion, utilize simple yet innovative design features to dramatically lower their energy use. Together, both hospitals illustrate key ways healthcare buildings can lower their energy use and achieve groundbreaking performance. Below are a series of sustainable design features hospitals can implement so they are more energy-efficient, employ healthier materials and reduce their carbon footprint.

Key Strategies to Lower Energy Use and Foster Sustainable Healthcare Systems

Energy Modeling as a Design Tool
Much in the same way that an institution begins a design and construction project with a budget — which is used as a constant measurement tool — a project can benefit from an “energy budget” to steer energy performance design. An energy budget sets an energy target at the beginning of the project and deploys modeling tools to measure the impact of a building’s needs and design changes on iterative energy, in a similar way that construction estimates work to track the progress of the work and keep the project on track. It’s critical to monitor energy and carbon budgets from the beginning so the client and design team can set and achieve sustainable goals, check progress and adjust at each phase to be sure the project is on budget.

Outside the Building
In new hospital construction and renovations, it is critical to address the exterior of the hospital. In climates with variable temperatures, outdoor design strategies can keep both heat out in the summer and the cold out in the winter. Shades on the outside of a building can help keep the interior from getting too warm, providing a triple benefit: it decreases the use of mechanical systems and lowers operational costs to cool the building, allows the use of smaller and more efficient heating and cooling systems and makes spaces more comfortable for patients, caregivers and visitors.

High-Performance Windows
Views to nature can speed healing. In patient rooms, windows with two or three layers of glass can reflect heat gain and provide insulation. In some facility types, patient rooms can benefit from operable windows — those that can open and close. Where that’s not feasible, amenity areas like caregiver break rooms and dining areas can benefit from both the natural ventilation and daylight, which can improve cognition, boost mood and decrease stress.

Efficient Heating and Cooling
Heating and cooling strategies that capture outdoor cool air to cool hospital interiors and heated air to preheat fresh air entering the building can reduce energy use by more than 200%. To build efficient heating and cooling systems, it can help to tune the amount of energy needed so equipment only runs when it is required. For example, hospitals can use high-efficiency air cooled chillers for the peak cooling loads in summer and high-efficiency condensing boilers for the coldest days in winter. It’s also important to invest in better controls, especially to allow unoccupied turndown of high-intensity spaces such as operating rooms. By building in adaptability, these smart systems can save significant amounts of energy.

Separate Thermal and Ventilation Systems
An additional building technique is to separate systems that distribute fresh air with those that warm and cool spaces, especially in hospital inpatient rooms. This goes hand-in-hand with exterior building strategies and sun protection touched on above. Used together, these techniques can create smaller energy demands and as a result, more efficient equipment for cooling and heating. In addition, keeping an air circulation system separate allows for more compact ducts and less dedicated space for these systems.

Lighting Strategies
Smart lighting strategies such as features that maximize abundant natural light via high-performance windows, light wells and skylights, particularly in cloudy climates, can help reduce energy use. Additional strategies include dimmable interior and exterior LED lighting that is programmed to turn off when not in use.

Utility Efficiency Funding
Although utility funding varies by country and jurisdiction, where available, utility rebates can compress the return on investment for high efficiency projects to a shorter timeframe, sometimes to just a year or two.

Innovative Materials
By prioritizing healthy materials, healthcare environments can reduce the amount of greenhouse gases emitted during the production and construction process and create spaces that better support healing. Although typically used in commercial buildings, cross-laminated timber (CLT) — pre-fabricated engineered wood panels — provide unique opportunities to transform healthcare environments. CLT has a low carbon footprint and the natural healing benefits of wood that calm and reduce stress. It can also be easily assembled off-site to save construction time and costs, increasing the timeframe in which clinical operations and revenue can take place.

Renewable Energy
Rather than rely solely on fossil fuels for energy, transitioning to clean, renewable energy, such as solar roofs in sunny climates, can provide a sustainable supplemental energy source. Other renewable energy sources such as wind power can provide a greener source of energy, and even help hospitals become energy independent. Transitioning to clean, renewable energy will be a key energy management move over the coming years as the cost competitiveness of renewables overtakes fossil fuel costs. Make a plan for electrification — if not immediately, then over time. This will enable healthcare campuses to wean themselves off fossil fuels and take advantage of a rapidly greening electrical grid and the attendant carbon emission reductions.

Landscape Elements
Outdoor landscape features like trees and green plants not only lower the temperature of their immediate surroundings in the summer, they can significantly increase air quality as they release oxygen, store carbon dioxide and filter out pollutants, making them natural purifiers. Views and exposure to nature has numerous restorative benefits for patients and caregivers, such as lower heart rate and blood pressure, and less need for pain medicine. Furthermore, hospital gardens with sustainably grown local food can nourish staff and patients while reducing costs associated with imported food.

Green Transportation
It’s important to consider what happens outside the hospital too. Staff, patient and visitor travel to and from a hospital can have a crucial impact. Transit connections, areas to wait for rideshares, walkability and bike-friendliness — via design strategies such as welcoming landscaped paths and covered designated areas for drop-off and pick-up — can reduce the reliance on cars and the costs associated with parking development and maintenance.

To Summarize
The conversation around energy-efficient and sustainable hospitals is only just beginning. As more hospitals consider sustainability as not just a “nice-to-have,” but a critical component of their overall strategy and business model, countries will continue to see accelerated progress. With the right policies, further breakthroughs and innovative systems — such as all-electric and net zero carbon facilities — hospitals can lower and even eliminate carbon emissions from energy consumption. As a result, they can reduce the use of critical resources, provide long term cost-savings and support a healthier environment for people and the planet.

 

Banner image courtesy Bruce Damonte.

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Five Questions About How Sustainability Improves Human Well-being Here and Now, Not Just the Distant Future

An Interview with NBBJ’s Sustainability Leader Margaret Montgomery

March 4, 2019

Principal / Sustainable Design Leader, NBBJ

@MargaretMontgo1

Editor’s Note: This post is adapted from an interview originally published in the Q4 2018 issue of DesignIntelligence Quarterly.

What sustainability priorities should we focus on?

High-performance, sustainable projects are the only future that is viable for our profession and our clients. Zero carbon is viable for many projects, and we’re able to steer clients toward an achievement that’s possible for them. Material selections for reduced environmental and health impact are easier every month. Planning and site development for resilience and for a healthier urban ecosystem are equally critical.

 

You mentioned materials transparency. What are you doing about that?

We’re tweaking our specifications in areas where we can knowledgeably improve our standard options. For example, if we want to include a product, and we have enough manufacturers that are willing to disclose what’s in their product, we can require that disclosure.

We’re getting a bit more sophisticated about reducing the carbon footprint of our projects, as well. For example, what are all the concrete mixes? What’s the lowest-carbon concrete mix we can use for that particular structural purpose? How can we make sure that we are fine-tuning those mixes for the lowest carbon while maintaining performance?

The largest carbon and environmental footprint tends to be in the structure and exterior materials. The health footprint, the complicated chemistry, and the disclosures tend to congregate around the finish materials and that end of the spectrum.

 

Where do the ideas of being practical and being effective intersect best for sustainability?

If we’re doing things in the right way, we shouldn’t need to add money. We should be able to reallocate resources in a smarter way to do almost everything we want to do. So, for instance, if we create a better conceptual design — with the right window/wall ratio, better orientation and massing for passive energy flows, and we put the effort into better architecture — we should be able to spend less money on mechanical heating and cooling. To me, that’s pragmatic and effective because we’re conserving first-cost resources and getting more from our client’s money. The goal is to do that while also creating a more comfortable, more livable place for everyone who experiences it.

 

In the years that you’ve been practicing sustainable design, what changes have you observed in clients’ viewpoints?

Many of our clients recognize the value of creating space that helps them and their people be more comfortable and perform better. This was an idea that probably didn’t resonate well a few years ago because there weren’t enough studies to show the connection between what we thought intuitively were good things for people and our quantitative goals.

 

What makes you hopeful? What challenges you?

What makes me hopeful is the human spirit and the desire to make things better. You see it a lot lately in various movements outside of the building industry as well as all of the groundswell around addressing climate change. At the core, I believe we all want to make the world a better place. The challenge is how hard it is sometimes to find a common understanding or a way to communicate that gets us all headed in the same direction.

Banner image courtesy Stuart Isett/NBBJ. 

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How High Is Too High?

In Our Race to the Sky, We Can’t Neglect Humans’ Inherent Need for Nature

October 22, 2014

Principal / Sustainable Design Leader, NBBJ

@MargaretMontgo1

I’ve had opportunities recently to participate in several conversations about the impact of biophilic design on our health and well-being. For instance, I facilitated a dialogue for the new Seattle chapter of the Council on Tall Buildings and Urban Habitat (CTBUH) with Bill Browning. Bill works a lot on these issues, and he focused his lecture on moves that are most desirable to high-rise occupants. It turns out that the most significant factors are daylight, views and air quality.

Air quality is an especially interesting finding. I know from personal experience that when the windows are open in my office I feel differently. There’s a sense of expansiveness, freshness and alertness that comes from breathing air from outdoors, even before the sounds, scents and breezes are factored in. These are all factors that can be considered in high-rise buildings too, but more direct incorporation of “Nature in the Space,” as Bill calls it, can be quite challenging as buildings get taller. It’s hard to step outside for a few minutes in the garden when you’re on the 78th floor. Even operable windows (for natural access to fresh air without a mechanical interface) are, if not impossible, challenging in tall buildings. And what about water?

At these heights, access to “real nature” is a challenge. Yet science indicates that we are biologically — if not consciously — able to tell the difference between the real thing and a fake [PDF]. We know that nature’s effects are positive, increasing immune system support, sharpening cognitive function, reducing the detrimental effects of stress.

So this leaves me wondering. Given that our bodies clearly know the real thing when we experience it, and that human-fabricated facsimiles (while better than nothing) are not as good as real nature, and that the link between nature and the 78th floor is tenuous at best, how tall is too tall?

To take tall-building living to an extreme, here’s a scenario: If we accept research that says five minutes a day of immersion in nature is enough to affect self-esteem and improve mood, imagine creating botanical chambers in our cities in the sky. We could make five-minute appointments, reserving space in the greenhouse like we might plan for an exercise class. When we go to work in the morning, we could rise via elevator to a transfer floor where there would probably be a coffee shop or café, then go to our desks and spend the day in the sky without needing to ever descend to the actual street (or park, or neighborhood) until the day ends. Good thing, because the elevator system in a super-tall building can’t move the entire population of a building fast enough to take lunch outdoors. Even more efficient, maybe we actually live in a condo in the same building, or one skybridge away. We could spend years in the same building without leaving it.

Singapore_National_Library-2009-06-12-web

Singapore National Library, designed by Ken Yeang (courtesy of Wikipedia)

Technically speaking, we already can do this; Ken Yeang has made a life’s work in blending nature and high-rise construction as inextricably as possible. I fully support such an aim, given that our need for density will require plenty of high-rises. But it won’t be cheap (either in dollars or in resources). And it will be only a partial solution.

As a blanket solution to urban existence, does this really serve our humanity? In my opinion, no. I wonder what metric will tell us we’re too far separated from real nature. Five minutes a day might solve the particular need measured in a particular research project, but people are more complex than that, and the science we lean on is young yet.

Equally importantly, when we lose connection with the real beauty and life of the natural world around us, will we care enough to fight for its survival? Will we survive if we don’t? When we say that “variety is the spice of life,” we’re not kidding. We know that biologically we are hardwired to react to variable sensory experiences and to tune our awareness to the natural elements surrounding us. We can recreate that as best as possible indoors, with intermittent puffs of air, scent or other mechanical tricks. But honestly, why not just invite nature in? And why not construct our cities so that we are never so far from it that we can’t take a short break and go outside?

I fully believe that our cities of the future must be as inextricably woven with nature as the buildings Yeang aspires to, and, yes, high-rise zones will be inevitable. But the vast majority of neighborhoods in most cities could be densified significantly and still maintain our connection with the earth — with less cost, fewer resources and less carbon burden. By doing this, we’d be creating a deeper opportunity to heal ecosystems, restore water cycles, breathe cleaner air, harmonize communities, live within our planetary means and experience deeper joy in our daily lives.

Image courtesy of Sarath Kuchi/Flickr.

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Finally, Some Good News on Climate Change

Recent Policy Developments Are Proving the Importance of United States Leadership

July 29, 2014

Principal / Sustainable Design Leader, NBBJ

@MargaretMontgo1

It has been a good few weeks for those of us who advocate for climate change action. Although the US Chamber of Commerce, in anticipation of the Obama Administration’s new climate rules, preemptively released a study announcing the $51 billion they calculate that the rules will cost the economy annually, Paul Krugman countered with a delightful editorial putting that number in context — .2% of the economy — and celebrating that climate change can be addressed so cheaply.

On June 2 President Obama announced new EPA rules on coal-fired power plants, and already there are indications that China intends to set a cap on carbon emissions by 2016. Obama’s announcement was hailed as the “most sweeping climate action ever taken by a US president,” admittedly not a high bar. But high or low, this is a truly significant move. US leadership has been missing in action for way too long on climate change, and this immediate news out of China reinforces that our country’s leadership is critical to cohesive and significant global climate action.

For the days when the news is not so exciting and you need to remind yourself of why we work so hard to reduce building energy use, or when you want to understand how climate change will affect a certain place, I suggest clicking over to the National Climate Assessment 2014. Another recent Obama Administration release, this report — available both as a pdf and as an elegant, interactive web resource — is thorough, local, strategic and clear in its messaging. It outlines comprehensive impacts to climate across the United States by sector, issue or region. It makes clear that climate change is not just on its way — it’s here.

My first reaction to the report was visceral — the backdrop of each key page is video footage of a pristine and beautiful place, and it sparked both my craving to experience those places and a sense of urgency to preserve them. Each is a poignant introduction to a great communication tool. The website can be taken in small bites, or you can geek out in as deep a dive as you want. Each section is elegantly presented, with enough citations and links to keep you reading for days — or simply to provide the key messages for the next time you need to explain why reducing energy use is so important.

The work is clear and pressing, and momentum is building. It’s our task to accomplish, and we can find no higher calling than to build a future safe for our children and grandchildren.

Image courtesy of Wikimedia.

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Garden of Proof

Can We Quantify the Benefits of Biophilia?

December 17, 2013

Principal / Sustainable Design Leader, NBBJ

@MargaretMontgo1

When you think about your childhood, what are your strongest memories? Many of mine are associated with the time I spent playing outdoors, climbing trees and “treasure” hunting alongside a creek. My family always had a big vegetable garden, so I remember picking beans; an orchard of pear and apple trees, a grape arbor and a walnut tree added to the richness (and to our summer diet). Now I live in Seattle. My watershed is Longfellow Creek, and I live near the crest of a hill, the first ridge encountered by weather fronts coming across Puget Sound.

My yard has its own microclimates; we can grow tomatoes on the parking strip to the south, but are hard pressed to ripen any but the shortest season tomatoes in the yard proper. Carrots, chard and potatoes do better. We have an ancient apple tree that shades us in the summer, letting in green-tinted dappled light. I often have the urge to thank the tree for sticking around. It’s not very “wild” nature, but it grounds me in a place where I belong.

I’ve been thinking a lot lately about why that matters, and especially why it matters as we become an increasingly urban species. We need nature; not just for the air we breathe, for the water that constitutes most of our bodies, and for the sun that warms us and provides energy and the earth that feeds us, but also for the way it enables us to be fully human and a part of the whole that surrounds us.

Biologist E.O. Wilson coined the term “biophilia” to refer to this innate affinity that humans have for nature, the love of capital-L Life. And in the past few years, I’ve been heartened that we appear to be rediscovering just how important that connection with nature is. A number of research studies have reinforced what appear to be instinctive affinities with scientific data, and connecting nature with health has broadened the field of interested designers and citizens considerably.

Across a range of themes, the findings are interesting:

Perception and Context: Although the frequency and sound patterns of freeway noise and ocean waves are very similar, our reactions depend upon our associations. A 2010 study by Hunter averaged the two and played them for listeners to determine their physiological responses through functional magnetic resonance imaging. When accompanied by beach images, the sound induced brain patterns consistent with tranquility, but the same sounds, when accompanied by images of freeways, did not. [1]

Simulated Nature: Another study by Peter Kahn and team at University of Washington exposed subjects to three different scenes – a blank wall, a plasma screen “window” (a webcam image of the landscape outside), and an actual window looking out into the landscape. Subjects were exposed to several creative and proofreading tasks, and their stress recovery (heart rate) was measured. When confronted variously with these scenes, their recovery heart rate reduction leveled out similarly with both the blank wall and the plasma window, but was significantly greater when exposed to the real window. [2] Real nature means something to us.

Forest Bathing: Shinrin-yoku, or “forest bathing,” the practice of spending time relaxing in the forest, has taken hold in Japan and research is noting the benefits. One study measured the amount of human natural killer (NK) cell activity before and after forest bathing, finding that greater NK activity, increased anti-cancer proteins and reduced stress were the outcome of time in the forest. [3] Another study shows that even five minutes in nature improves self-esteem and mood. [4]

I’m aware of the inherent conflict in quantifying something so seemingly intangible, and it’s true that we need to be careful about boxing in something that can be such a source of delight and liveliness. But our era carries a thirst for data that challenges us to a greater rigor of execution. It may be that we swing too far to the quantifiable on the way to creating places that make our hearts sing, but I have hope that we will find that balance, and that our work and our cities will be better for it.

Most importantly, if we are to thrive in our societies and our cities, nature must be a necessary participant. I dream of the day when we hear birdsong more often than traffic, and pollution has made way for the clean crisp scent of snow, the heady fecundity of blooming trees in the spring, or the often pungent odors of rotting leaves at fall’s end. I yearn for the time in the future when we can barely see cities from Google Earth, expecting to find them beautifully intertwined with forests, meadows or wetlands. I hope I see a time when even urban dwellers know their watershed, and understand what creatures belong there, and find their own place full of Life to love.

 


[1] Neuroimage. 2010 Nov 1;53(2):611-8. doi: 10.1016/j.neuroimage.2010.06.053. Epub 2010 Jun 30.The state of tranquility: subjective perception is shaped by contextual modulation of auditory connectivity. Hunter MD, et al.

[2] Kahn, P.H., Jr., Friedman, B., Gill, B., Hagman, J., Severson, R.L., Freier, N.G., et al. (2008). A plasma display window? The shifting baseline problem in a technologically-mediated natural world. Journal of Environmental Psychology, 28, 192–199.

[3] Li Q. Effect of forest bathing trips on human immune function. Environ Health Prev Med. 2009 Mar 25.  (http://forest-medicine.com/page11.html)

[4] J. Barton and J. Pretty, What is the Best Dose of Nature and Green Exercise for Improving Mental Health? A multi-study analysis. Environ. Sci. Technol. 44(2010); 3947-3955.

Image courtesy of Flickr.

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