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HOK's Take on Sustainable Healthcare Design ~ A Global Trend


HOK, one of the world’s most influential design firms has made a commitment to keep sustainable healthcare design as its core value. They work with international organizations to find opportunities which lead to creating solutions for success.

When hospitals and healthcare facilities decide to choose and focus on sustainability, they are in essence deciding to do what is right for the long term in support of patients and the environment. HOK provides support at any and every stage of the project, to work through the concept, strategy, planning, and implementation processes in order to achieve success.

Commitment to Sustainability

There are numerous ways in which a healthcare facility can either convert to “green” or start from the ground up. However they decide to make these changes, there are a set of criteria that must be followed. HOK follows a “Ten-Step Approach to Sustainable Design” inclusive of Site Evaluation, Concept Design, Design Optimization and Post Occupancy.

HOK takes advantage of opportunities to re-use and recycle materials on their projects while striving to obtain building materials locally as well. The firm employs more than 2,000 professionals linked across a global network of 24 offices on four continents. Of those employees, more than 945 are certified LEED accredited professionals through the U.S. Green Building Council.

William Roger, Vice President and Leader of HOK’s Healthcare Designs, has been involved on several sustainable healthcare design projects and believes that this “Green” Trend is here to stay. “It comes down to the alignment of an organization’s mission. Hospitals are in the business of caring for people and mankind at large. They are a machine to heal,” says Roger. “Doesn’t it make sense that a hospital should be designed as a healthy place?”


An intimidating factor of “going green” is often the perception that it will be costly. Hospitals who build a green facility from the ground up do not generally see an increase in cost opposed to a hospital that is not implementing green practices. An inpatient facility that has higher energy usage due to constant air conditioning and operating medical equipment will be more difficult to maintain.

However, with proper planning, HOK states that they can reduce energy by about 35%. Ways to reduce energy and cut costs include proper heat management and use of natural ventilation.

A Glance into HOK’s Projects

Jurong General in Singapore is a public hospital that is expected to be completed in early 2014, and achieve Greenmark Platinum status.  Complete with 700 beds, every patient will have their own window. Research suggests that patients with a “view” and access to nature require fewer medications, experience less pain and recover more quickly that those without views.  Additionally, the rooms are designed in a staggered fashion, creating more privacy for each patient while cutting outside noise and reverberations (See diagram).

Singapore has a uniform temperature and pressure settings, but suffers from high humidity and abundant rainfall, experiencing significant monsoons at various times during the year. Jurong General grounds include gardens that consist of both horizontal and vertical planted spaces on rooftops and outside the hospital rooms. There are also angled planters that serve as shading devices, reducing the “heat island effect”.  

The continuous vertical construction of the gardens provide a “water cycle” that starts with capturing cycle rainwater and drainage from the roofs and planters, channeling it into a bio-filtered reservoir, and then pumping it back up to the Sky Gardens and to other landscaped areas for irrigation. The Sky Garden also harvests fruits and vegetables for use in the hospital’s kitchen.

Parkway Health Holdings Novena Hospital, is also located in Singapore within the private sector hospitals. HOK strategized with Parkway Health in designing a new hospital that specifically targeted international patients and formulated a medical tourism approach. This 350-bed hospital is Greenmark Platinum.  Much like Jurong General, Novena Hospital cultivates vegetables on the roof which are used within the hospital’s food service system.  

This roof top configuration also acts as a shading device, keeps the temperatures mild and generates electricity. Parkway’s rationale for building the new sustainable healthcare facility was largely a case of good planning and economic viability.  

Given the green light to expand, the project became an economic incentive. But their decision to go “green” was that it was simply the right thing to do. “I don’t have a client that isn’t expecting us to bring green ideas to the table,” stated William Roger of HOK.

Alameda County Medical Center, a public hospital in Oakland, California is the first hospital to allow natural ventilation in patient’s rooms. Due to city codes, the use of air conditioning in rooms was required. Alameda County is the first hospital to permit patients and doctors to use their discretion and shut off air conditioning. The mild air temperatures in Oakland, California allows for comfortable natural ventilation, thus cutting energy use.

Green Initiatives Effect on Medical Tourism

As an industry we are ‘seeing green’ on a global scale. Certain countries are in the forefront of converting to eco-friendly building and design.  The desire to go green is extremely prevalent in Asian and European countries, due to their high-energy demand. Costa Rica, perhaps one of the “greenest” countries, has made it a way of life.  About 90% of its energy supply comes from renewable sources and new construction projects must get a certificate from the national environment office stating no damage is caused to the environment.

Whether it is an economic decision or a moral one, there is no denying that this trend is on fire and spreading quickly. Medical tourists are seeking the best medical care available. Sustainable healthcare facilities are in a business to heal people–not make them any sicker. It only makes sense that medical travelers are seeking the top international hospitals who are taking steps to reduce their carbon footprint and go green.

About the Author

Chelsea D’Ariano is the Global Communications Coordinator for the Medical Tourism Association and is involved in managing the Public Relations and Marketing Department of the MTA. Chelsea is also a Contributing Editor for both Medical Tourism Magazine and Health Tourism Magazine. She can be contacted at

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