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

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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Three Ways of Reimagining the Emergency Department

Ideas for Shaping the Emergency Department of the Future

February 12, 2019

Principal, NBBJ

Editor’s Note: This post is adapted from a white paper co-authored by Bryan Langlands and Durell Coleman, Founder/CEO of DC Design, and originally published by the Facility Guidelines Institute (FGI). The white paper is based on the “Reimaging the ED” workshop sponsored by FGI and the American College of Emergency Physicians (ACEP) and held at the 2017 Healthcare Facilities Symposium & Expo in Austin, TX, where more than 100 ED clinicians, design professionals and students gathered.

Today in the United States, nearly 50 percent of all hospital care begins in the emergency department (ED) and, over the last 20 years, ED patient volume has increased by 23 percent as many Americans use the ED to access primary care services. Many factors have contributed to these trends, including:

  • The aging of the baby boomer generation
  • Increased longevity of people with chronic diseases
  • Gaps in provision of care for behavioral health patients
  • Limited operating hours of primary care providers
  • Lack of affordable insurance and other issues affecting individual access to medical care
  • Requirement of the Emergency Medical Treatment and Labor Act (EMTALA) for EDs to treat everyone, whether they have insurance or not

While the U.S. health care system struggles to determine how to address these difficult and complex issues, there are changes that can be implemented now to improve the function and flow of emergency department services and facilitate quality patient care: by (1) improving arrival and front-end operations, (2) reducing patient length of stay, and (3) improving the experience of behavioral health patients.

 

(1) Improve arrival and front-end operations with technology.

Technology could be deployed to make patient arrival, sorting, and waiting processes more efficient. One idea: providing a registration kiosk for low-acuity patients. Another idea is a vitals-monitoring bracelet that could be used to assess and monitor patients in the waiting area. Such approaches could result in reduced stress and better flow for triage and front-end operations.

 

(2) Reduce low-acuity patients’ length of stay.

A significant problem is the treatment of low-acuity, non-emergency patients in spaces designed for patients who require a bed. Some solutions: smaller treatment spaces for these “vertical” patients, or treatment rooms that could easily and quickly be converted to hold multiple low-acuity patients during peak hours. Such spaces would speed up delivery of care for low-acuity patients and reduce the amount of time they — and consequently all patients — spend in the ED.

As one way to identify these low-acuity patients, the ED could be zoned by Emergency Severity Index (ESI) level. Creating ESI zones would support more flexible and efficient use of space and could decrease patient waiting times. Each area in the ED would be designed with patient care stations sized appropriately for the type of patient seen there.

 

(3) Create spaces for behavioral health patients.

There are many concerns surrounding behavioral health services provided in the ED setting, including the tendency to hold these patients in the ED for two to three days before placement in an inpatient unit or transfer to a psychiatric hospital. Spaces are needed that better suit this patient population. Because the ED is not specifically designed to provide care for the behavioral health population and the typical patient stays longer and requires different attention than typical ED patients, the flow and throughput of the entire emergency department is negatively affected when suitable behavioral health facilities are not provided.

 

It is important to remember the ED is not a “place” but a “process,” a point that underscores that many problems seen in EDs are the result of operational processes rather than design issues. Further, the primary factors of many problems are neither design nor operational, but issues that result from demographic changes, behavioral health and insurance deficiencies, and EMTALA requirements. For this reason, quite a few problems might not require specialty operational or design solutions if the overall health care system were doing a better job of addressing the larger issues that bring many patients to the ED.

Nonetheless, it is an important first step when health care organizations and designers work together to address operational and design problems through careful project planning.

Banner image courtesy of Frank Oudeman/NBBJ.

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Timber Construction Doesn’t Have to Be “All or Nothing”

How Hybrid Curtain Walls Can Drive Sustainable Innovation in Architecture

December 5, 2018

Principal, NBBJ

Editor’s Note: This post was adapted from the white paper “Hybrid Timber: Performative, biophilic and beautiful” [PDF].

The increased use of timber in construction is a growing and robust opportunity. Wood evokes deep passion and motivation, but why? For one, it’s exciting to have technological and structural advancement within an industry that has been fairly constant since wood balloon framing was invented.

In addition, the prospect of managing our forests sustainably is the future. It supports the use of wood while avoiding the use of old growth species, instead using young saplings or beetle kill forests. It creates sustained carbon capture by circumventing the carbon release that occurs at the end of a tree’s life through decomposition, thereby reducing greenhouse gas emissions. Other benefits include low embodied energy, low thermal conductivity compared to aluminum or steel, better indoor air quality (IAQ), biophilic connections supporting a sense of well-being and health, and the outperformance of other building materials “cradle-to-cradle.”

The use of wood in curtain wall construction, in particular, is an emerging trend. A typical approach to long-span exterior curtain wall design is an aluminum curtain wall framing with secondary steel support—but this convention is being challenged by the use of wood as the primary structural support of the glazing.

Given the industry’s unfamiliarity incorporating wood within typical curtain wall assemblies, this proves to be a challenge, for several reasons:

  • Interest in bidding: The curtain wall market has been busy, making it difficult to draw interest in bidding, especially for smaller scale work.
  • Atypicality: The use of wood is not familiar to most large-scale builders.
  • Cost: The prior two variables drive cost upwards, even though the cost of glue-laminated timber is more cost-effective than steel at similar spans.
  • Engineering: Wood does not possess the same properties as steel, and in fact its strength varies by species.

However, the appropriate application of wood is not a matter of “all or nothing.” Hybrid options using wood as the lateral supporting system or as a dead load support, combined with more conventional aluminum systems or a semi-unitized curtain wall system, can yield a more conventional and familiar system design, making wood a more viable option for cost and schedule.

In one example I worked on, the curtain wall subcontractor provided the engineering of the curtain wall and attachments to the glue-laminated timber, and the structural engineer of record provided the engineering of glue-laminated timber and its attachment to the primary structure of the building, similar to the use of a more conventional secondary steel system.

In another example, the curtain wall subcontractor provided the entire engineering of the composite system, including the wood dead load supports, which transfer the window system loads to the primary structure.

With both of these options, the curtain wall consultants worked closely with the full engineering team as the point of intersection and peer-review for the system as a whole. Wood suppliers provided design information on the wood and glue-laminated timbers available, and communicated their unique strength characteristics by species to the design team.

Essential to the success of these projects was our strategic and proactive planning toward connecting markets and suppliers and building consensus between them, defining engineering roles and responsibilities, and effectively addressing fire and combustibility concerns.

Photo © Lawrence Anderson

Building a proper team with supportive and knowledgeable industry partnerships is paramount in being able to meet these challenges with clarity. Therefore, it is critical to partner with both an experienced timber/curtain wall engineer and forestry partners that have an in-depth knowledge of the process and the fluency to ask the right questions at the right time to support success and mitigate risk. I also recommend partnering with local fire authorities early in the process, onboarding them to the use of timber prior to permit submission.

Our hope is to create a ripple effect for the imperative change needed at a larger, industry-wide scale. Similar to code related energy requirements, only larger-scale demand will propel cross-industry advancement and expertise. This will drive innovation towards higher performance, reductions in our carbon footprint, less harmful chemical dependency and beautiful biophilic outcomes. The ultimate outcome will enhance our human experience with respect for our planet.

For more on timber construction, please read my white paper “Hybrid Timber: Performative, biophilic and beautiful” [PDF].

Banner photo courtesy of NBBJ/Sean Airhart.

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