Resilient by design: Advancing sustainability in healthcare construction

This shift is also reflected in national outlooks. According to the Associated General Contractors of America (AGC), contractors report that “owners are more frequently asking for lifecycle and sustainability analysis as part of capital planning—not just for certification purposes, but as a way to validate performance and ROI projections.”

Case Studies

The following case studies illustrate how project teams are applying sustainability, resiliency, and wellness strategies in real-world healthcare construction projects.

Quinte Health Prince Edward County
Memorial Hospital
Location: Picton, Ontario, Canada
Firm: HDR
The Quinte Health Prince Edward County Memorial Hospital is the first unencapsulated, all–mass timber acute care hospital in North America, positioning it as a model for low-carbon healthcare construction. Compared to a conventional steel and concrete structure, the facility is projected to eliminate more than two million kilograms of embodied CO2 emissions.

HDR’s integrated approach combines sustainable materials, advanced medical planning, and biophilic design to support both carbon reduction and patient-centered care. Key systems include a high-performance building envelope, geothermal energy exchange, and rooftop photovoltaic arrays. The design also incorporates green roofs, native and Indigenous-inspired landscaping, and composite wood cladding. These strategies help future-proof the facility for electrification and net-zero readiness.

Inside, patient rooms, nursing stations, and corridors feature clean, exposed mass timber ceilings that meet infection control standards while enhancing visual warmth and acoustics. Standardized glazing and zero-edge parapets reveal the timber structure from the exterior, reinforcing the building’s natural aesthetic and promoting occupant connection to nature.

Wellness amenities include a landscaped public garden for patients and visitors and a secluded off-stage garden for staff. Together, these features demonstrate how mass timber and sustainable design strategies can deliver durable, adaptable, and healing-centered environments—even in rural healthcare settings.

UW Health Eastpark Medical Center
Location: Madison, Wis.
Firm: IMEG
UW Health’s Eastpark Medical Center is a 469,000-sf ambulatory care facility that opened in 2024 and is designed with long-term sustainability and operational flexibility in mind. The facility is expected to be one of the first healthcare projects in the U.S. to achieve LEED v4.1 certification, reflecting its high-performance building systems and sustainable engineering strategies.

The center houses the Carbone Cancer Center, home to Wisconsin’s first proton therapy unit—including one of the first upright proton therapy systems in the U.S. A 1MW photovoltaic carport array generates sufficient electricity to support this advanced technology, while heat recovery from the proton system is used for perimeter radiant heating, enabling partial electrification of the facility’s heating systems.

IMEG engineered the building with a strong focus on electrification, resiliency, and decarbonization. Design strategies include heat recovery chillers, radiant in-floor heating, dry coolers to offset winter chilled water load, six high-efficiency hot water boilers, and 13 variable-volume rooftop air handlers delivering 570,000 CFM of air.

Additional infrastructure supports long-term flexibility, including robust process water cooling for proton equipment, radiation-conscious MEP design, and smart systems like electronic power monitoring and nurse call integration. The building is also designed to accommodate integration with three future buildings, supporting growth and modernization.

Emory Executive Park Musculoskeletal Institute
Location: Atlanta
Firm: HKS
The Emory Executive Park Musculoskeletal Institute is a 180,000-sf specialty healthcare facility that delivers integrated musculoskeletal care in a high-performance, patient-centered environment. Designed by HKS in partnership with Emory Healthcare, the facility serves as a national model for outpatient innovation, emphasizing flexibility, sustainability, and wellness.

The project’s sustainability strategy focused on reducing energy demand and enhancing long-term adaptability. Key design measures included optimizing solar orientation and massing, improving envelope performance, and specifying high-performance systems to reduce mechanical loads. Notable features include low-emissivity glazing, exterior sunshades, thermally efficient cladding, and smart lighting systems that reduce reliance on artificial light.

The building also integrates biophilic design elements such as natural materials, public art, and strong visual connections to the outdoors—all aimed at reducing stress and supporting occupant wellness. These strategies reflect HKS’s internal sustainability benchmarks and align with the client’s long-term decarbonization goals.

The project has been showcased at industry conferences as a leading example of performance-based outpatient design, demonstrating how energy-conscious planning and wellness-driven design can be successfully integrated in complex healthcare environments.

Permian Basin Behavioral Health Center
Location: Midland, Texas
Firm: Robins & Morton
Scheduled to open in 2026, the Permian Basin Behavioral Health Center (PBBHC) represents a critical investment in expanding behavioral health services across a historically underserved area of West Texas. Robins & Morton identifies the project as a flagship example of socially resilient infrastructure that extends its impact beyond the built environment.

To address anticipated staffing challenges, project leaders collaborated with local foundations, businesses, and educational institutions to develop behavioral health job training programs. This workforce-focused approach to resiliency helps ensure long-term operational sustainability while creating economic and professional opportunities within the community.

Design strategies emphasize trauma-informed care through calming color palettes, sensory-sensitive lighting, and biophilic elements—including covered porches and outdoor gathering spaces—that promote emotional wellness. According to Bob Wall, Vice President at Robins & Morton, the building “supports healing through thoughtful spatial and sensory planning,” reflecting the contractor’s expanding behavioral health expertise.

Conclusion

Sustainable healthcare construction today goes far beyond energy efficiency or material selection. It demands a broader, integrated approach, one that begins early in the design process and accounts for long-term resiliency, operational performance, and occupant well-being.

By combining performance-based strategies with lifecycle cost analysis, project teams are better equipped to design buildings that support both immediate functional needs and future adaptability. Resiliency planning, whether through climate modeling, elevated infrastructure, or system redundancy, is becoming inseparable from sustainability. At the same time, wellness-centered design strategies, including trauma-responsive approaches, are shaping environments that are not only safer and healthier but also more supportive of the people who use them.

As expectations continue to evolve, healthcare facilities are being redefined as critical infrastructure, places that must withstand disruption, foster healing, and serve their communities long into the future. For architects, engineers, and contractors alike, this shift presents both a challenge and an opportunity: to design with care, plan for uncertainty, and deliver healthcare buildings that are truly resilient by design.

To earn one American Institute of Architects Continuing Education System Learning Unit of Health, Safety, Welfare credit (1 LU HSW), read “Resilient by design: Advancing sustainability in healthcare construction.” Then review the exam below and enter your answers at: BDCnetwork.com/HealthcareCourse2025.