Smaller pumps, smaller fans
Architects and engineers for an undergraduate life sciences building look to achieve enormous gains with such strategies. Construction on the $92-million office, classroom, and lab building, adjacent to DMS's Hanover campus, is slated to begin later this year. A rigorous set of energy-performance metrics has informed every decision about the facility —from the kind of glass in each window to the mechanical systems that will provide heat, cooling, and ventilation. In the process, preliminary designs have been optimized to drastically reduce peak demand for both steam and chilled water. "That means all the systems in the building get smaller—smaller pumps, smaller fans," says architect Stephen Campbell, who heads the College's planning, design, and construction office. "Each of those reductions saves capital costs."

But that doesn't make designing a high-performance facility any easier than getting a building's occupants to remember to turn down the thermostats at night or to shut off the lights when they leave a room. "It takes a lot of knowledge, more consultants at the front end to supplement the architect," says Campbell, who admits to having been skeptical of green-building claims until he came to Dartmouth two years ago. "What I'm seeing . . . is that we're able to save money not only through the life of the building, but in terms of initial cost of construction. It's not costing more to go green; it's costing less." It turns out the highest savings come from an integrated approach to design and engineering that persists from preliminary design through construction and operation. "The green design isn't a tack-on to the normal building process—it's a cradle-to-cradle philosophy," says Campbell, echoing a phrase that is the title of a best-selling book on sustainability.

DHMC now has almost two decades of experience at optimizing facilities' performance while mitigating their environmental impact, at implementing low-toxicity purchasing agreements, and at cultivating a climate where every employee takes personal responsibility for minimizing waste. At Mt. Ascutney and APD, Diane Riley assumed she'd be starting from scratch. But at the Mt.

"Everyone thinks energy efficiency is important, because you can save money doing [it]," says Charles Mannix, Dartmouth Medical School's associate dean and chief operating officer. "We're going one step further and saying, if we're an educational institution, let's use our buildings as a learning opportunity."

Ascutney medical staff meeting where she first proposed forming a sustainability committee, a group she now chairs, the idea garnered unanimous support. She found similar enthusiasm on the hospital's board of trustees, on which she also serves. Riley attributes the early support to two key factors: a CEO predisposed to sustainability and her own institutional clout as a surgeon. It took a little longer to get APD on the green bandwagon, she adds, but soon the wheels were in motion there, too.

Along the way, Riley turned to staff in Dartmouth- Hitchcock's recycling and operations arenas, gleaning a host of insights and best practices. DHMC even shared a copy of its environmental policy, which Riley rewrote and adapted "in a way that makes sense for a community hospital."

2002

Year DHMC banned ethylene oxide (a chemical often used in sterilizers but associated with an increased risk of liver cancer and miscarriage)

2006

Year DHMC switched to intravenous bags that contain no polyvinyl chloride

5,000

Number of medical waste incinerators nationwide shut down since 1996