Lean and Green Healthcare Facilities: Improving the Delivery Process of Children's Hospitals

Open Access
Enache-Pommer, Elena
Graduate Program:
Architectural Engineering
Master of Science
Document Type:
Master Thesis
Date of Defense:
Committee Members:
  • John Messner, Thesis Advisor
  • Michael Horman, Thesis Advisor
  • green strategies
  • building delivery process
  • hospitals
  • lean principles
Healthcare is one of the most significant built environment markets today with over 120,000 buildings in the United States. Moreover, in the next 15 years, an estimated $300 billion will be spent on hospital construction across the United States; therefore, there is a great opportunity for research and improvements to be made in this area. The built environment has a great impact on healthcare, particularly on the health, safety and well-being of patients and staff. Green healthcare offers benefit of improved clinical outcomes, reducing operating costs, energy consumption and water use. Children’s hospitals are the most specialized centers for care, providing care for children with complex and rare conditions and they are therefore amongst the most complex types of facilities to design, construct and operate. This research study outlines the findings from four children’s hospitals with different levels of sustainability in regards to the project delivery process, greening strategies, lean principles and key factors that are most important in the delivery process. The key factors investigated are: transparency in relation to green outcomes, owner commitment, early team selection, team experience, early adoption of green, commissioning process, energy modeling and the role of the construction management team in the delivery of a green building. The findings provide a detailed description and analysis of the delivery process for each case study. The results show that certain delivery process attributes vary with the level of sustainability, with the top three attributes being: owner commitment, expertise on sustainable delivery and early timing of sustainable objectives being introduced. Owner commitment has played a very important role, and this outcome leads to intriguing and potentially significant future research on the delivery of green buildings.