
by Andrew Pinneke, PE, LEED AP
Hospitals, clinics, and other types of medical facilities are striving to create high-performance buildings more conducive to healing, while also reducing energy and water consumption to minimize their environmental footprint.
As the demand for sustainable design and building practices grows, concrete and cementitious-based building materials are making a strong contribution to the construction of new healthcare facilities. Concrete and blended cements can be used to achieve credits under the U.S. Green Building Council (USGBC) Leadership in Energy and Environmental Design (LEED) program in uses ranging from stormwater management to the improvement of indoor air quality (IAQ). They do so while also offering possibilities for versatile design innovations using shape, color, and texture.
With the longest life span of any building material, concrete has all the advantages to respond to the challenges of sustainable healthcare construction. A mixture of natural substances, concrete is locally produced, entirely recyclable, durable, and fire-resistant. It also provides good thermal mass properties and acoustic insulation qualities.
Concrete’s thermal inertia properties enable it to absorb heat during the day, store it, and give it back at night—this makes for substantial heating and air-conditioning savings. As it is a highly resistant and airtight material, concrete can easily be used with other materials to provide optimal insulation, while offering numerous solutions for limiting greenhouse gas (GHG) emissions resulting from the building’s daily use. In high-risk areas, concrete’s resistance properties enable the design of buildings demonstrating superior resiliency performance during natural disasters.
Blended cements (i.e. those under ASTM C595, Standard Specification for Blended Hydraulic Cements, or ASTM C1157, Standard Performance Specification for Hydraulic Cement) contain supplementary cementitious materials (SCMs) as a partial replacement for portland cement. This enhances the material’s strength and versatility. The three most commonly employed SCMs are:
- slag—a reclaimed by-product of the iron- and steel-making process;
- fly ash—a coal-combustion by-product of power plants; and
- silica fume—a by-product of silica metals and ferrosilicon alloys.

Photos courtesy GRT Admixtures
Since they are recycled industrial materials, SCMs enable reuse of by-products that would otherwise be landfilled. Moreover, their use reduces the volume of portland cement required to make concrete, decreasing the amount of energy associated with cement production, lowering GHG emissions, and reducing the virgin material required for making concrete.
How concrete contributes to LEED
Sustainable construction aims to identify building materials and methods that are cleaner and more environmentally responsible while ensuring the highest quality in terms of aesthetics, durability, and strength.
There are several resources to help design professionals tackle sustainability initiatives in the healthcare industry. Though not a rating system, the first guide to enhancing healthcare facilities was the Green Guide for Healthcare (GGHC). Introduced in 2011, the most widely adopted green building rating system in the United States is the LEED for Healthcare (LEED-HC) rating system, which provides sustainable construction standards for inpatient and outpatient facilities and licensed long-term care facilities. The rating system may also be used for medical offices, assisted living facilities, and medical education and research centers.