Energy Efficiency Built Into Swedish/Issaquah; Planners Intend to Make the new Eastside Medical Offi

Energy Efficiency Built Into Swedish/Issaquah; Planners Intend to Make the new Eastside Medical Office Building and Medical Center the Most Energy-Efficient Facility in the Region

ISSAQUAH, WASH., Sept. 2, 2010 – Lee Brei, Swedish’s director of Facility Services, and Susan Gillespie, senior project manager for the Swedish Issaquah Campus, are on a mission. They intend to make Swedish’s first major Eastside site the most energy-efficient facility in the region. 

Swedish broke ground last October for a new 175-bed hospital and five-story medical office building (MOB) on 12.5 acres just off I-90/Exit 18. It is the first full-scale medical complex to be built in King County in more than 25 years. Plans call for 500,000+ square feet of built space, with the MOB targeted to open in July 2011 and the hospital seven months later.

“We have one chance to do this project right and take advantage of the best practices in new hospital construction,” explains Gillespie. “The key goals are to integrate advanced technologies and processes that significantly reduce energy consumption, cut our carbon footprint, and lower overall operating costs so we can provide the most cost-effective care.”

Brei adds, “The Issaquah Highlands is known for its ‘green’ building strategies, so we’ll fit right in with the community perception of what a new facility should be.”

Hospitals spend more on energy per square foot than any other commercial building type, notes the American Society of Heating Refrigerating and Air Conditioning Engineers. The Hospital Energy Alliance (HEA), a new industry-led partnership between the national health-care leaders and the federal Department of Energy, estimates American hospitals use 836 trillion Btu (British thermal units) of energy annually or the equivalent of the power needed for more than one million homes per year – and have more than 2.5 times the energy intensity and carbon dioxide emissions of commercial office buildings. The total annual energy bill for hospitals in the United States is more than $5 billion, often equaling 1 percent to 3 percent of a hospital’s operating budget or an estimated 15 percent of profits.

According to HEA, every hospital should be concerned about its total energy use, supply reliability and price volatility, and the potential impact of greenhouse gas reduction policies on operations and profitability. All that is driving the industry’s demand for innovative yet cost-effective solutions.

Swedish’s response was to set an energy usage goal of 150 kBtu (150,000 British thermal units) per square foot per year or the equivalent of the power needed by more than 2,200 homes per year. “Experts told us, ‘It will be too difficult and expensive to get there; that’s too aggressive,’” says Brei. “Hospitals built to the current energy code use 200 to 210 kBtu range and a typical existing hospital uses 240 kBtu, but we wanted to do much better than that.”

How It All Started

Senior Vice President Kevin Brown has always vowed that Swedish Issaquah would be ‘practical green.’ Brei and Gillespie, along with Swedish development partner and MOB owner Hammes Company, brought all the key design, construction and advisory players to the table at the outset. After conducting an ‘eco-charette,’ a planning gathering where many strong ideas were thrown out, they followed a process called Integrated Project Design.

Every major project element and internal system was adjusted based on a specific energy usage target. The planning team used computer simulation models to assist, among other things, in creating an efficient building envelope, setting insulation requirements for walls and ceilings, and selecting high-efficient heating/cooling equipment and lighting systems to maximize energy performance.

Patients, staff, physicians and visitors will all benefit from the energy efficiencies. The Issaquah buildings will be cooler in the summer and warmer in the winter. Swedish targeted a 10-year payback for its investment in energy efficiency and will easily meet that, says Brei. The entire hospital is designed for flexibility and adaptability, as Swedish’s needs change in the future. Most patient rooms are the same size, so very little additional construction or retrofitting will be required.

From the outset, Swedish worked closely with regional electricity and gas utility Puget Sound Energy (PSE). Engineer Holly Townes was PSE’s liaison to the project, and she and her team helped Swedish apply for up to $4 million in grants and rebates from the utility to fund the energy-improvement initiatives. 

“We are particularly interested in working with hospitals because they’re so energy hungry,” Townes explains. “It’s conceivable that PSE will underwrite 100 percent of Swedish/Issaquah’s investment in energy-efficient upgrades.”

Why does PSE pay customers to use less of its product? “Conservation is much cheaper than building new power plants,” says Townes. “The Pacific Northwest really can’t add many more hydroelectric resources, and any new power generation facilities, including wind and other alternative sources, take time to build and are expensive. In the short run, energy efficiency really makes the most sense.”

Townes adds that PSE’s Integrated Resource Plan estimates that 20 percent of the utility’s forecasted load growth over the next 20 years can be met with conservation. And one good way to do that is through integrating better systems into new commercial construction.

Core Components

“Swedish will never stop looking for ways to improve its energy performance in all our facilities,” says Brei. “The communities and patients we serve should expect nothing less of us.”

Here are some of the key elements that will help make Swedish Issaquah an energy conservation leader:

  • Hydronic heating. In the MOB, Swedish and Hammes Company decided to install an advanced hydronic heating system instead of traditional electric radiant heat. PSE recommended this approach and awarded a $1 million grant that covered 100 percent of the additional initial cost of the natural gas-based system.
  • Ventilation. Swedish worked hard to reduce building ventilation requirements. Outside air needs to be heated and cooled, but the design team was able to reduce the amount of potential air ‘re-heat’ required. 
  • In the main hospital, Swedish will install high-efficiency, heat-recovery chillers that capture waste heat to help heat the buildings and water.
  • The main hospital will have high-efficiency, variable air volume systems that create more effective air-delivery and provide better control of room pressures. If room uses change, flexibility is built into the system to make sure rooms are properly pressurized to medical codes – all at lower expense and with fewer air-flow issues for maintenance people.
  • Swedish has ordered much more advanced boilers and stands to gain at least a 15 percent improvement in operating efficiency.
  • Green roof. On the flat podium between the building towers, plans call for 6,000 square feet of landscaped area with abundant plant life and greenery. “It will be a beautiful open field that will help keep the whole campus cooler,” says Gillespie.
  • Building commissioning is vital to verifying Swedish/Issaquah’s operational efficiency – and it can have a 30-percent positive impact on energy use. Swedish wanted to monitor all systems and control them properly, so PSE suggested outside verification and was able to fund 50 percent of the commissioning costs. This process is particularly important to verify the sophisticated controls, that improve efficiency, are operating correctly.  “What’s unique about this is that the commissioning agent is an independent third-party and works directly for the building owner to see that a quality-control process is followed and to assure systems work,” says Townes. The agent thoroughly reviews the initial building design, visits during construction, and then tests the systems to be sure everything works at the end. Commissioning is required by building codes, but it is typically not to the level done by an independent agent and not with an emphasis on energy efficiency required by the PSE program. The extra benefit is a building that works better from day one.
  • Windows. The hospital is oriented to get full sun on three sides and will have a daylight basement, which is a huge benefit for staff and patients. Without the super-energy-efficient windows, exterior/interior shading devices, and insulation Swedish specified, this ‘day lighting’ could have actually increased energy consumption.
  • Swedish incorporated fairly extensive electrical sub-metering throughout the campus. A controls engineer on staff will set all the monitoring points and then can easily evaluate real-time usage data.
  • ENERGY STAR® Equipment and other miscellaneous efficiency measures. On the non-medical side, Swedish specified high-efficiency lights, appliances, fixtures and motion/occupancy sensors where appropriate – along with energy-performance monitoring systems.
  • User Training. A final component is educating all Swedish Issaquah staff on the easy things everyone can do to conserve energy, including turning off lights and equipment when not in use. “In a brand-new facility, we get to use some brand-new thinking,” says Gillespie. “When our physicians and other employees all understand how we designed this campus, we know they’ll help us operate it at peak efficiency.”

Design and Construction Team     

For More Information

For more information about the Swedish/Issaquah hospital project, including the latest updates, detailed project information, renderings, animation, construction progress photos, etc., visit


Swedish plans to apply for an ENERGY STAR rating for the new Issaquah buildings. Lee Brei expects the structures will get a rating in the high 80s or low 90s. For comparison’s sake, Swedish Ballard is currently ENERGY STAR-rated in the high 70s.

ENERGY STAR is a joint program of the U.S. Environmental Protection Agency and the U.S. Department of Energy designed to help protect the environment and save money through use of energy-efficient products and practices. Commercial buildings that achieve a rating of 75 or higher are eligible to earn the ENERGY STAR label and a bronze plaque is awarded to the owner.        

Certain types of buildings that perform in the top 25 percent compared to their peers nationwide consume, on average, about 35 percent less energy than typical buildings. EPA believes that energy efficiency is the first step to green building, and that all green buildings should be energy efficient. This voluntary program provides businesses and organizations with free, easy-to-use online tools and resources to help establish energy benchmarks and compare the energy use of buildings.


About Swedish

Established in 1910, Swedish has grown over the last 100 years to become the largest, most comprehensive non-profit health provider in the Greater Seattle area. It is comprised of four hospital campuses – First Hill, Cherry Hill, Ballard and Edmonds – a freestanding emergency department and ambulatory care center in Issaquah, Swedish Visiting Nurse Services, and the Swedish Physician Division – a network of more than 40 primary-care and specialty clinics located throughout the Puget Sound area. In fall 2009, Swedish broke ground on a new medical office building and hospital in the Issaquah Highlands, as well as an emergency department and medical office building in Ballard. More recently, Swedish announced plans to open freestanding emergency department and ambulatory care center facilities in Mill Creek and Redmond. In addition to general medical and surgical care, Swedish is known as a regional referral center, providing specialized treatment in areas such as cardiovascular care, cancer care, neuroscience, orthopedics, high-risk obstetrics, pediatric specialties, organ transplantation and clinical research. For more information, visit and

About Hammes Company

Hammes Company is a single source of market-based and financially sound healthcare facilities solutions. Headquartered in Brookfield Wis., with 17 regional offices, Hammes Company is at the forefront of providing strategic planning, facility development, project management and implementation, and real estate acquisition and advisory services to their clients. Ranked as one of the nation's top developers of healthcare facilities for ten consecutive years by Modern Healthcare magazine, Hammes Company serves major hospitals, healthcare systems and physician groups across the country. For more information, visit

About Puget Sound Energy

Washington state’s oldest local energy utility, Puget Sound Energy serves more than 1 million electric customers and nearly 750,000 natural gas customers in 11 counties. A subsidiary of Puget Energy, PSE meets the energy needs of its growing customer base through incremental, cost-effective energy conservation, procurement of sustainable energy resources, and far-sighted investment in the energy-delivery infrastructure. PSE employees are dedicated to providing great customer service and delivering energy that is safe, reliable, reasonably priced, and environmentally responsible. For more information, visit

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