Energy Use at Karolinska

Six overarching goals constitute the foundations for the New Karolinska Solna project:

• Healthcare, research and education must be so integrated that they effectively support the development and dissemination of new knowledge for the care of seriously ill and injured patients.
• The project must create attractive, caring environments with high architectural values, both within and adjacent to the hospital.
• The care processes must be rationalized and the utilization of resources optimized.
• As far as possible, the project must employ general solutions that permit the continual development of activities.
• The hospital and its activities must be given a clear, prioritized role in the city.
• The project must work on the basis of a sustainability perspective at all levels

The final goal, “the project must work on the basis of a sustainability perspective at all levels” contains three sub-categories:

• Minimizing supplied energy
• Creating environmentally adapted support systems
• Optimization of cost on the basis of life cycle perspective

In a report submitted to The Stockholm City Council in November 2007 they outlined these goals in terms of the “hospital as part of a long-term, sustainable society.” This includes environmental control within the project, transportation, the physical landscape, sustainable solutions for building materials and the building as a whole, as well as minimizing emissions.

Here, I am going to look at the aspect of minimizing emissions. This is where there is a great level of interest in understanding how to implement systems and infrastructure that will allow for hospitals that significantly decrease energy demand compared to their predecessors. It was my understanding, before I began the research for this Valle, that the projections for the new Karolinska Solna showed that it would use 5x less energy than the typical Pacific Northwest hospital — an astounding difference. How are they able to achieve such low energy use? Are there practices that perhaps we could learn from, and potentially adopt in our future hospitals?

I met with the mechanical engineers on the project, from ÅF to try to understand the energy use projections for the New Karolinska Solna University Hospital project a little more in depth.

The first major outcome of this meeting was a confirmation of the difference in energy use. Their projections are, in-fact, very low. They have achieved this in a variety of ways, which I describe below. Two overarching goals drove the decisions for the systems of this project. First, the systems should be robust and secure. Second, the systems should be flexible and adaptable. That is, a change in one area should not disrupt another area of the hospital.  Notably, ÅF is designing all of the systems: mechanical, electrical, plumbing. Therefore, integration of systems is happening from the initial design phase.

[Their presentation included specific information about specific strategies that aimed to achieve these outcomes. After analyzing these strategies, I will post another entry summarizing my comments from that discussion.]

I also presented the work that I have been doing with Mike Hatten at Solarc in Eugene Oregon.  We have been looking at different strategies for reducing energy consumption in Pacific Northwest hospitals. Recently, Mike put together some data that showed accumulative strategies that met today’s 2030 challenge goal of reducing the energy consumption by 50% of current “average” energy use — a very admirable achievement and difficult goal to attain.  It is, however, really interesting to show this data to these Swedish mechanical engineers.  Their new hospital project projects to use 2.5x less energy than the most progressive model that we have simulated in our research project.

I think that this really opens a point of conversation.  Why is our most progressive strategy 2.5x more energy consumptive than a project that is being proposed here in Stockholm? It seems like this is either a difference in calculation method or a difference in regulations.  Whatever is causing this discrepancy, it is significant. And it may open a window into understanding the difference between energy use in Scandinavia and the US. Why are these numbers so vastly different?

This difference is so significant that even our most “progressive” hospital model uses more energy than the current Karolinska hospital, which ÅF is using as their benchmark for comparison. ÅF’s point of view is that the existing hospital uses a lot of energy, and they are hoping to significantly change that in the new facility. That comparison is demonstrated in this graphic:

I would really like to understand where the differences are coming from — especially if they are coming purely from the design of the architecture and systems. This is especially important because I am looking to Sweden as a model of energy efficient design, so I really want to understand this issue at its core.  I will continue to work with ÅF to look into this topic, so I will hopefully uncover some answers to these questions.

Meeting with White Arkitekter

I met with Bengt Svensson and Linda Mattsson at White Arkitekter today. Bengt is the principal in charge of the Karolinska Solna hospital project and Linda is an architect who is also very involved in the project.

They were also the lead designers of the office building that they occupy. It is on the southern edge of Södermalm adjacent to a very busy multi-level arterial bridge on one edge, and a seaway on another edge. They have published a small book illustrating the different strategies that were implemented in the project to conserve building cost and energy. Graphically convincing. Systematically convincing. There are several things that they are doing to reduce their loads. One: external shading devices are used with automatic sensors used for deployment. Two: Thermal mass of the building is increased by using the water from the seaway to cool the building in the summer. Conversely, that same water is used to slightly heat the building during the winter so that the temperature differential is not quite as great. Ulitmately, they designed a building that is beautiful, comfortable, and energy efficient. The hard numbers: It uses 85 kWh/M²/year, equivalent to 27 kBtu/ft²/year.

Now they are applying similar strategies to the Karolinska Solna Hospital project. They took me through their presentation of the project from the urban level to the detailed level. One thing that I had not understood until this meeting is that this is actually going to be a NEW organization. A totally new hospital. It will bring together two existing organizations melding them together with a new idea for care, but this new facility will not replace either of these existing facilities.

Another very interesting aspect to this project is that they are planning in ultimate flexibility for the building. That is, every floor, every room, can be used for any function. That has extensive implications. They have calculated the maximum load requirements, the maximum height requirements, and the maximum ventilation requirements, etc. for the most difficult spaces (notably the Operating Suites and Diagnostic and Treatment facilities) and are designing to those specifications throughout the building. Therefore, when the hospital functions change, which they inevitably will, the building can accommodate that shift. Surgery can be located anywhere, imaging can be located anywhere because the height, structure and ducting have all been sized appropriately from the initial design.

At the end of their presentation they showed this slide, which has really stuck with me as the center of why I am studying here in Scandinavia.

Now, this seems like a funny thing to say probably, based on this image. But, I think this shows a lot, really. This is an industrial kitchen, in the basement of a hospital. What is present is natural light, a view, the ability for the kitchen workers to go sit outside and take a break. It looks like a really nice place to work! It is not buried in a basement where the time of day, weather, and any connection to what is happening in the natural world has been cut off. I asked Bengt and Linda when I saw this image if there was some kind of regulation in Sweden that required that workers must have some kind of proximity to a window or daylight. They said no, but that it was the right thing to provide. In order to have a work place that people will agree to work and a place where people will work productively, this is what must be designed. This seems like a cultural shift. Their point of view was “we do it because it is right, and to not do it would be taking something away from those who work there.”

This discussion led to another important topic: the size and cost of Karolinska Solna and framing that “cost.” This will be a 350,000M² = 3.77 million ft² project costing 14.1 Billion Swedish SEK = $2.32 Billion in today’s dollars. That is $614 per ft². Bare in mind that the exchange rate right now is not in favor of the dollar, which effects this figure. Linda and Bengt brought forward a new way of framing the cost of the building, however. If we think of the building in the scope of the total cost of healthcare — the building really does not cost very much comparatively. If we can make the healthcare component even 10% more effective through the architecture of the building, then we have essentially made the building free to the organization. I like that as a business case.

White Arkitekter

Why study in Stockholm?

That is a question that I get a lot when I am talking about my research and travel fellowship.

There are two big reasons. One is the IVL, link here for more information on them and their role in my studies. The other big reason is White Arkitekter. They are currently working on a very big hospital project, Karolinska Solna.

White describes this project as, “…one of Sweden’s most comprehensive hospital projects ever, and a decisive venture in the realisation of the vision of Stockholm and the Mälardalen area as the world’s premier life science region.”

Six project goals constitute the foundations for the New Karolinska Solna project:

• Healthcare, research and education must be so integrated that they effectively support the development and dissemination of new knowledge for the care of seriously ill and injured patients.
• The project must create attractive, caring environments with high architectural values, both within and adjacent to the hospital.
• The care processes must be rationalised and the utilisation of resources optimised.
• As far as possible, the project must employ general solutions that permit the continual development of activities.
• The hospital and its activities must be given a clear, prioritised role in the city.
• The project must work on the basis of a sustainability perspective at all levels.

These project goals align with the goals that I hoped to realize in my design thesis. Here, I hope to understand how a project of this magnitude is undertaking such goals and implementing them in a real project. Perhaps some of the lessons learned from this project can help positively influence the course of healthcare architecture in the Pacific Northwest.

IVL — The Swedish Environmental Research Institute

I am studying in Stockholm, Sweden with the IVL, The Swedish Environmental Research Institute. They have been generous to host my Valle here, providing me a desk, computer and supportive work environment. They are also providing expertise in sustainable building practices, techniques and measurements. To learn more about what the IVL does, click here. Their offices hold a very prominent location at the entry courtyard to Kungl Tekniska Högskolan (KTH), the Royal Institute of Technology in Stockholm. The building was formerly the library, design in 1930 by Erik Lallerstedt, and it has now been re-adapted into offices and laboratory spaces for the IVL

Read more about the IVL by clicking here.