Designing a Water-Wise Hospital at Lucile Packard Children’s Hospital Stanford


* Designing a Water-Wise Hospital at Lucile Packard Children’s Hospital Stanford

* Landscaping, shading, cisterns and more will result in a 38 percent less water usage than in a comparable hospital

* Recycled water sources will save as much as 800,000 gallons of water per year

Preserving natural resources, especially water, is a central aspect of the Lucile Packard Children’s Hospital Stanford expansion and new main building.

While maintaining a safe environment for children and their families requires an abundance of clean water, the hospital is setting an industry-leading example in how it will maintain its complex medical systems and equipment, as well as essential services like heating and cooling, laundry, sterilization, sanitation, and food service.

This approach is more than a nicety: Hospitals today are the third most water-intensive public buildings, behind senior care facilities and hotels, using an average 570 gallons of water per staffed bed per day, according to Healthcare Design magazine. In comparison, the U.S. Environmental Protection Agency estimates that an average person uses about 80 to 100 gallons of water per day.

As construction continues on the hospital project, architects, designers, and planners are changing the numbers on water consumption. The expanded facility, scheduled to open in 2017, will add 521,000 square feet to the approximately 300,000-square-foot existing hospital, expanding and streamlining care for children, expectant mothers, and their families, and adding more private rooms. Once the expansion opens, the hospital will have a total of approximately 330 beds on-site, with later expansion up to 361 on-site. Together with other locations, the hospital will have 397 licensed beds.

“Throughout the design process, we looked at sustainability as a key feature,” said Jill Ann Sullivan, MSN, RN, vice president of hospital transformation and space planning. “Using water wisely makes an impact on the whole community and saves money in the long term. Plus, it’s simply the right thing to do.”


An inherent sense of environmental responsibility is a driving force behind the design, which makes sustainability and “green” systems a top priority. The building integrates nature seamlessly into its layout, with almost four acres of gardens and green space for patients, families, visitors, and staff to enjoy.

The landscaping will feature native and hardy adapted plants that require minimal water, such as drought-tolerant varieties of yarrow, flax lily, mountain lilac, lavender, and sage. A specially designed blend of grasses that requires little or no water will be planted instead of a traditional lawn. Expanses of greenery and permeable paving allow rain to be absorbed into the region’s groundwater rather than running off into the Bay.

A water-sensitive approach to the building was factored in long before California’s current drought made xeriscaping with native plants popular and water usage a major concern. “In 2008, when we started planning, we knew there was not enough rainfall to sustain even the most efficient hospital’s needs,” said Robin Guenther, FAIA, LEED, principal at Perkins+Will and the lead designer of the expansion project. “That presented the option of finding ways to reuse water as much as possible.

The result? No potable water will be used for irrigation. These water-efficient landscapes will be irrigated with rainwater and condensate water—water that is extracted from dehumidifying indoor air—that will be collected in two 55,000-gallon underground cisterns. The distilled water that is used nonstop in dialysis equipment also will be routed to the cisterns, ensuring that water will be available even when there is no rainfall. Recycling these sources will save as much as 800,000 gallons of water per year, said Michele Charles, LEED project engineer for the expansion who acts as the project’s sustainability liaison, adding that the system is adaptable and additional cisterns can be integrated in the future.

“Nature is an important part of the Lucile Packard Children’s Hospital identity,” Guenther said. “We wanted to create a verdant experience for patients and families. We wanted the look and feel of a lush, green landscape, much like the existing building, but one that could be maintained solely with water from the cistern and natural runoff.”

Shading and location

The expansion will also incorporate an extensive external shading system to minimize direct sunlight penetration throughout the year. Limiting direct sunlight helps to reduce solar gain—the increase in temperature caused by the sun—cutting down on the need for air conditioning and its subsequent need for both energy and water. And, in a reversal from traditional locations, the hospital’s data center has been positioned on the roof rather than in the basement, a move that allows it to use outdoor air as a cooling system rather than air conditioning for much of the year. Guenther says that the building’s thermal energy consumption is projected to be close to 60 percent less than average Northern California hospitals.

Equipment systems

Water-conserving dishwashers and sterilizers are projected to use about 80 percent less water than their standard counterparts. Water-cooled pumps and air compressors will be eliminated to reduce water usage. On-demand sinks and low-flow bathroom fixtures—which also are being phased into the current hospital—are expected to save 2.5 million gallons of water per year. Together, these systems in the new building are expected to use 38 percent less water than in a comparable standard hospital, according to Guenther. An electronic dashboard in the main lobby will display the building’s ongoing water and energy usage.

The current hospital

The existing hospital facility also operates in a water-wise manner, especially on its grounds. Designed during a drought in the late 1980s and opened in 1991, most plants are drought-tolerant. “An ongoing program to monitor and replace or repair misaligned or broken sprinkler heads limits runoff, and plantings are mulched to shade the soil and retain moisture,” said Patrick Connor, administrative director of support services. Rather than using artificial turf, lawns are mostly drought-tolerant and have an efficient irrigation system, which invites families and visitors to lounge and play. New weather-based irrigation controllers are also being installed.

“Sustainability is a guiding principle in everything we do,” said Christopher G. Dawes, president and chief executive officer of Lucile Packard Children’s Hospital Stanford and Stanford Medicine Children’s Health. “Everyone on our team shares in this commitment. It’s part of being a good neighbor and a member of the larger community, and ensuring we’re doing the best thing possible when it comes to preserving all of our environmental resources.”


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