WORKSHOPGREEN HOSPITAL IN

RUMAH SAKIT KANKER DHARMAISACTION PLAN

Jakarta, 11 november 2009

Ikatan arsitek indonesa (iai jawa barat)

Woerjantari Soedarsono & Tuty Zardania

Implementasi Konsep“Green Building”

pada Rumah Sakit

GREEN HOSPITAL = ECO FRIENDLY HOSPITAL

Renewable energy

Sustainable materials Ecological value

Health and wellness

Sustainable transport

Passive strategies

Whole life cost

Prinsip Dasar Rumah Sakit Hijau1) Protecting the immediate health of building occupants

The health of patients, staff, and visitors can be profoundly affected by the quality of the indoor air which in turn is dependent upon physical and mechanical design (such as ventilation and location of wastes and toxics), the choice of building materials, the management of construction emissions, and building operations and maintenance. Additionally, access to daylighting has been found to favorably affect staff productivity and patient outcomes.

2) Protecting the health of the surrounding community Local air and water quality is also significantly affected by building design choices. Off-gassing building materials and finishes, construction equipment and HVAC systems directly emit VOCs, particulates and other materials that can result in the formation of ground level ozone (smog), and cause allergic attacks, respiratory problems and other illnesses. Land use and transportation planning, landscape and water management on the grounds and water conservation efforts within the building will influence the amount of toxic emissions released to the water and air throughout the life of the building.

3) Protecting the health of the global community and natural resources The health impact of a building stretches far beyond its immediate community. The production of building materials can result in the release of persistent bioaccumulative toxic compounds, carcinogens, endocrine disruptors and other toxic substances. These compounds threaten communities where the materials are manufactured, and, because of the long life of some of these compounds, can risk the health of communities and ecosystems far from their release.

Rumah Sakit Hijau

• planning, design, construction, operations and maintenance

• designers, owners, and operators

• U.S. Green Building Council’s Leadership in Energy and Environmental Design (LEED®) Green Building Rating System– LEED® for Existing Buildings– Green Healthcare

Construction Guidance Statement

LEED® for Existing Buildings: Operations & MaintenanceSeptember 2008

• Sustainable Sites• Water Efficiency• Energy & Atmosphere• Materials & Resources• Indoor Environmental Quality• Innovation In Operations

LEED Certified Design and Construction Building Exterior and Hardscape Management Plan Integrated Pest Management, Erosion Control, and

Landscape Management Plan Alternative Commuting Transportation Reduced Site Disturbance: Protect or Restore Open Space Storm water Management Heat Island Reduction: Non roof Heat Island Reduction: Roof Light Pollution Reduction

Sustainable Sites

Project Totals

85 possible base points plus 7 for IO

• Certified 34–42 points

• Silver 43–50 points

• Gold 51–67 points

• Platinum 68–92 points

LEED for Existing Buildings

The BCA Green Mark Scheme was launched by the Building and Construction Authority (BCA) in January 2005 to promote environmental awareness in the construction and real estate sectors.

Benefits of BCA Green Mark

BCA Green Mark provides a meaningful differentiation of buildings. The benefits of having a BCA Green Mark building include:- A reduction in water and energy bills;- An improvement in indoor environmental quality for healthy living; and- A reduction in potential negative impact on the environment.

Green Mark Criteria and Scoring SystemThe Green Mark assesses five key environmental areas: - Energy Efficiency- Water Efficiency- Environmental Protection- Indoor Environmental Quality- Other Green Features

Green Mark Rating Green Mark Points

Green Mark Platinum

90 and above

Green Mark GoldPlus 85 to <90

Green Mark Gold 75 to <85

Green Mark Certified

50 to <75

Features of a Green Mark building

Version 2.2 January 2007 Best Practices for Creating High Performance Healing Environments

GGHC GreenGuide for Health Care

• Green Healthcare Construction Guidance Statement

• American Society for Healthcare Engineering (ASHE) - January 2002 , versi terbaru jan 2007

• Energy and water waste• Use of dangerous materials and chemicals in

healthcare facilities• Environmentally unfriendly building standards (carbon

neutrality) • The perception that sustainable strategies cost more• Concern over meeting the costs of the proposed limits

on carbon emissions• The risks and challenges posed by climate change on

healthcare facilities

GGHC

• Integrated Design• Construction – 97 point• Operations – 72 point

Panduan tiap tahap GGHC

Construction 97point

• Integrated Design

• Sustainable Sites (21 point)

• Water Efficiency (6 point)

• Energy & Atmosphere (21 point)

• Material & Resources (21 point)

• Environmental Quality (24 point)

• Innovation & Design Process (4 point)

Operations (72 point)

• Integrated Operations (5 point) • Transportation Operations (3 point)• Energy Efficiency (18 point)• Water Conservation (8 point)• Chemical Management (5 point)• Waste Management ( 6 point)• Environmental Services ( 9 point)• Environmentally Preferable Purchasing (11 point)• Innovation in Operation (7 point)

• Building Operations & Maintenance: Staff Education

• Building Systems Maintenance

• Building Systems Monitoring

• IAQ Management: Maintaining Indoor Air Quality

• Reduce Particulates in Air Distribution

Integrated Operations

(5 point)

Energy Efficiency (18 point)

• Optimize Energy Performance

• On-Site & Off-Site Renewable Energy

• Energy Efficient Equipment

• Refrigerant Selection

• Performance Measurement: Emission Reduction Reporting

• Food: Organic or Sustainable

• Food: Antibiotics • Food: Local Production

/ Food Security • Janitorial Paper & Other

Disposable Products • Electronics Purchasing

& End of Life Management

• Toxic Reduction: Mercury

• Furniture & Medical Furnishings

Environmentally Preferable

Purchasing (11 point)

Dasar Pemilihan sebuah material

Harga

Penampilan visual

Performance

Ketersediaan

Dampak pada lingkungan?

Pemilihan Material dan energi yang terkandung (Embodied Energy)

Menjelaskan kaitan antara material bangunan, proses konstruksi dan dampaknya pada lingkungan

Perhitungan energi dalam setiap pemilihan material berkaitan dengan:

• Ekstraksi bahan mentah

• transportasi ke tempat pemrosesan/pabrik

• energi yang digunakan di pabrik

• transportasi ke lokasi proyek

• energi yang digunakan di da;am tapak untuk

memasang material

Energi terkandung (embodied energy) adalah seluruh energi yang digunakan dalam produksi dan distribusi.

Saat ini energi terkandung dalam material menyumbangkan 15-20 % energi yang digunakan oleh bangunan dalam 50 tahun umur bangunan.

Prinsipnya semakin rendah energi terkandung dalam material makin baik secara ingkungan

GREEN MATERIALS

Avoid ozone-depleting chemicalsAvoid foam insulation made with HCFCs. Consider cellulose.

Use locally produced building materials.Transportation is costly in both energy use and pollution generation. Look for locally produced materials such as stone.

Use salvaged building productsor products made from recycled material such as cellulose insulation,

Seek responsible wood supplies.Use lumber from independently certified well-managed forests

Avoid materials that will off gaspollutants: Solvent-based finishes, adhesives, carpeting, particleboard, and many other building products release formaldehyde and volatile organic compounds (VOCs) into the air.

Energi terkandung berulang, dalam bangunan merepresentasikan energi yang tidak terbarukan yang digunakan untuk merawat, memperbaiki, menyimpan, menggantikan material, komponen dan sistem selama bangunan berdiri.

Bila bangunan semakin efisien secara energi, perbandingan energi yang terkandung terhadap konsumsi sepanjang hidup bangunan menjadi meningkat. Jadi untuk bangunan yang mengklaim “zero-energy”, energi yang digunakan dalam konstruksi menjadi sangat signifikan.

canadianarchitect.org.cn

Penambangan, pengangkutan, pemrosesan, pengolahan, distribusi,konstruksi

Energi operasional minimal 50 tahun umur bangunan

Persoalan penerapan green hospital di Indonesia

Keengganan pemilik danpengelola rumah sakit untuk menerapkan karena persepsi bahwa green design tidak ada korelasinya dengan revenue dan hanya menjadi beban komponen initial cost yang tinggi

Kurangnya motivasi arsitek untuk menerapkan karena dihadapkan pada kendala waktu, biaya dan sikap

Kurang lengkapnya informasi yang memadai tentang green hospital dari pihak yang berwenang termasuk dari produsen

Belum berjalannya lembaga yang bertanggung jawab dalam perumusan kebijakan, peraturan dan penyusunan indikator-indikator keberhasilan sebuah green building

healing garden

• PENGGUNAAN ENERSI YG TIDAK TERGANTIKAN

• PENGGUNAAN MATERIAL YG TIDAK RAMAH LINGKUNGAN

• PEMBUANGAN LIMBAH YANG MENCEMARI LINGKUNGAN

• PENGGUNAAN MATERIAL YANG TIDAK TERGANTIKAN/ MELALUI EKSPLOITASI LINGKUNGAN

REDUCE

REUSE & RECYCLING

• ENERSI PANAS YG KELUAR DARI GENSET, BOILER

• AIR BUANGAN MANDI DAN CUCI DARI KAMAR MANDI

• AIR CURAHAN HUJAN DARI ATAP DAN LIMPAHAN DRAINASE HALAMAN LUAR

• KERTAS BEKAS FOTOCOPY

REDUCE

KONSUMSI LISTRIK

- pemanfaatan cahaya alami

- menggunakan switch timer

- menggunakan jenis lampu hemat enersi

- menggunakan AC automatic control

- membuat ventilasi alami berfungsi pada ruang tertentu dan saat tertentu

KONSUMSI AIR BERSIH

- menggunakan kran otomatis

- menggunakan air bekas untuk flushing dan siram taman, cuci mobil

PENCEMARAN LINGKUNGAN

- mengurangi penggunaan material polutant

- mengubah perilaku manusia terhadap lingkungan

- mengusahakan Ruang Terbuka Hijau

- memperbanyak tanam pohon

- membuat sumur resapan, biopori, kolam penampungan air hujan

EKSPLOITASI SUMBER ALAM

- menghemat penggunaan kertas dengan menggunakan teknologi informasi

- menghemat penggunaan bahan bakar

REDUCE

REUSE & RECYCLING

AIR BUANGAN CUCI DAN MANDI + AIR HUJAN DARI TALANG ATAP

• digunakan untuk flushing toilet

• digunakan untuk siram taman cuci mobil

• sebagai cadangan air pompa kebakaran

EENERSI PANAS YANG KELUAR DARI GENSET/TRAFO/BOILER

• dimanfaatkan sebagai sumber enersi lain

KKERTAS BEKAS FOTO COPY• digunakan kembali pada

sisi belakangnya• digunakan untuk

keperluan lainnya

LABORATORIUM PEMANTAU LINGKUNGAN

Pengolahan limbah cair, padat, gas (Reduce, Reuse, Recycle)

Penerapan Teknologi Informasi :• HIS (hospital information system), • CIS (clinical information system)

HEMAT PENGGUNAAN KERTAS

MENGUBAH PERILAKU MANUSIA TERHADAP LINGKUNGAN

• Stop penggunaan bahan mengandung mercury dan PVC

• Tidak menggunakan incenerator yg menghasilkan racun/polusi udara

• Hemat penggunaan enersi (lampu, AC)

• Hemat penggunaan air dan kertas

• Memilah sampah di tempat pembuangan

ACTION PLAN

1. MELAKUKAN SURVEY UNTUK PENDATAAN KONDISI EKSISTING MELIPUTI ;

* seluruh instalasi mekanikal elektrikal

* seluruh peralatan medis dan kantor

* seluruh jenis material finishing gedung

2. MELAKUKAN PENGKAJIAN TERHADAP KONDISI EKSISTING, MENENTUKAN BAGIAN APA YG PERLU DIPERBAIKI/ DIGANTI DENGAN MATERIAL/SISTEM YANG RAMAH LINGKUNGAN :

* pertimbangan biaya

* pertimbangan waktu dan pentahapan

3. MEMBUAT RENCANA DETAIL UNTUK PERUBAHAN SISTIM UTILITAS YANG RAMAH LINGKUNGAN (AIR CONDITIONING, WATER RECYCLING, WATER & ENERGY SAVING)

4. MEMBUAT RENCANA DETAIL UNTUK MERUBAH JENIS MATERIALNON TOXIC (flooring, painting, wall covering, roofing, insulation etc)

5. MELAKUKAN ‘PUBLIC CAMPAIGN’ DI LINGKUNGAN RUMAH SAKIT UNTUK MERUBAH PERILAKU MANUSIA (karyawan, pasien dan keluarga pasien)

ACTION PLAN

hanya satu bumi