Design Strategies

The knowledge of these energy demand profiles and climate conditions helped guide an integrated building systems approach in this research. The approach is to reduce loads first, then utilize energy efficient measures to reduce the energy demand of the building. There are synergistic savings in both energy and cost using an integrated, bundled approach to meeting the 2030 Challenge.

The integrated nature of both the project team structure and the technical solutions required are keys to successfully achieving a Targeting 100! hospital; the technology and innovations are available today using today’s codes, but they are not common practice in the healthcare market in the United States today. Many of the solutions work in synchrony, where energy savings can aide in first cost of construction savings. The strategies for achieving this level of energy savings must be approached from the beginning of a project’s development. While conceived here as bundles of architectural, building mechanical, and plant systems, an integrated approach to design means that all professionals from design to operation must provide insight and expertise in all of these categories. Having a project team structure and culture that enables cooperative decision making with key stakeholders is essential for meeting this deep of energy savings, with accompanying low first cost.


The schematic mechanical designs, energy models and cost estimates in this study are for a snapshot of strategies that accomplish the goal of achieving the 2030 Challenge. These strategies are a conceptual framework for this work, and can be seen as one solution for achieving this goal. However, there are a range of strategies that would be suitable for achieving the goal of reaching the 2030 Challenge. Strategies were identified through previous research efforts of this group and through the team’s expertise. Instead of parametrically analyzing each of the energy strategies individually, or groups of strategies compared side-by-side, three high performance, code compliant paths were modeled as integrated packages and compared to a Code Baseline model.

Design decisions for architectural systems, mechanical systems, and plant systems are intricately intertwined where they necessarily support each other, thus various components cannot be value engineered out of the projects, or replaced, without effecting the energy results overall. This is supported by the intricacy of hospital buildings, where a small change in one system tends to ripple throughout the building’s myriad of systems, especially in highly energy efficient designs. After several years of research we have come to realize that significant energy savings are only possible through close and continuous integrated efforts from the earliest stages of project planning, with involvement from core planning, design, construction and facility operation team members.

This integrated project delivery approach creates a re-formulated set of architectural, mechanical and plant systems that are developed from a holistic performance-based project perspective. Interaction between all disciplines including ownership, design, engineering, energy modeling, utility and construction teams is integral in producing the most energy efficient, highest quality outcome. The focus of this research effort has been to assess the whole-building performance of eight distinct hospital designs in each study city. Targeting 100! considers each of the designs to be an integrated whole, or a bundled set of strategies per hospital design option within each architectural scheme.