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Green principles in hospital design integrates patient comfort and sustainable utilities management

Netcare Pholoso Hospital looks to the future with sustainability initiatives

Thursday, November 19 2015

Designing a new healthcare facility presents an ideal opportunity to make a positive difference for future generations. The new Netcare Pholoso Hospital, which opened in Polokwane last month, is a model of how patient comfort and principles of sustainability can work in harmony in the healthcare sector.

In planning the hospital, we prioritised water and power savings while incorporating design elements that would create a pleasant, tranquil atmosphere to promote healing,” says managing director of Netcare’s hospital division Jacques du Plessis.

Godfrey Phakoago, founder and chairman of Pholoso Hospital Group, which partnered with Netcare to develop the hospital, explains that some aspects of the design elegantly combine utility and aesthetics.

“The hospital design makes the most of natural light, which not only saves on power consumption but also maximises daylight and makes for a more inviting environment. The hospital also includes atriums with gardens to create a peaceful oasis for staff, patients and visitors to enjoy. The atriums also enhance natural ventilation by allowing warmer air to move to higher zones, and then out of the building, thereby reducing the need for air-conditioning,” says Phakoago.

General manager of Netcare Pholoso Hospital, Sydney Masalla, notes that natural lighting plays an important role in maintaining people’s circadian rhythm, which controls the cycle of sleeping and wakefulness. Several studies have indicated that being deprived of natural light can reduce the quality of rest, which is vital to healing.

“At Netcare Pholoso Hospital, we are all about healing and promoting health from all perspectives. The wards are north-facing so as to make the most of daylight. Larger windows forge a relationship between the clinical environment and the outside world. Where possible, natural products and soothing colours have been incorporated into the design to enhance the tranquillity,” Masalla explains.

Du Plessis observes that green principles have been incorporated in the hospital design, using state-of-the-art sustainability technology. Provision has also been made for refinements to be implemented in future.

“The latest design, engineering and operational practices have been harnessed to minimise waste through recycling protocols as well as to achieve water and energy conservation. The indoor air quality is being elevated by eliminating toxic materials and minimising harsh cleaning agents. Furthermore, the structural, spatial and systems planning that went into Netcare Pholoso Hospital will reduce the impact of future expansions.”

The hospital’s concrete roof is insulated and coated with reflective paint to reduce the amount of heat lost or gained in the building.

Furthermore, the insulation material used throughout the building was carefully chosen not only for optimal thermal performance, but also to absorb noise, thereby contributing to a more serene environment. The building has glazing throughout, which further serves to reduce energy consumption.

The hospital furthermore has its heating, ventilation and air conditioning (HVAC) integrated with the domestic hot water generation plant, whereby waste heat is recovered from the air conditioning plant and utilised for heating water. All hot water storage vessels are, however, fitted with electrical heating elements for backup.

In addition, the HVAC system is designed in such a way that each department within the hospital produces and stores its own domestic hot water locally, thus minimising the amount of heat lost in the hot water reticulation system. The air-cooled HVAC system, as opposed to a water-cooled system, also saves on water consumption. 


Theatre air handling units are also integrated into the HVAC system, so that the maximum amount of waste heat is recycled for the production of domestic hot water. Theatre units indirectly produce hot water for the theatres, kitchen, central sterile services department and other areas that consume large amounts of hot water daily.

The use of the HVAC system in conjunction with the insulation will result in an estimated saving of 600 000kWh in electricity per annum, and 600 tonnes of CO2 emissions.

“Several rooftop units, fitted with inverter type compressors, are provided for areas in the hospital that require relatively small amounts of hot water. 
The special heat recovery allows for the exchange of heat between indoor units so that when one area requires cooling and another area heating, heat will flow from the one area to the other with minimal electrical input,” Du Plessis explains.

All air-handling units are equipped with economy cycle systems, which monitor the outside conditions and, if favourable, the systems will opt to use more fresh air, filtered directly from outside, to maintain ideal conditions inside the building, thereby saving additional energy that would otherwise have been expended through use of compressors.

Water is also conserved through a variety of measures including water efficient plumbing fixtures, which reduce consumption by approximately 25%, a grey water drainage system in the hospital’s laundry. In addition, the autoclave plant room is equipped for future water harvesting and water-wise indigenous plants have been incorporated in the landscaping design.  

In terms of lighting, highly energy efficient LED (light-emitting diode) lighting constitutes 62% of all internal light fittings installed and 95% of all external and parking area lighting. The balance of the fittings are fluorescent lights, which are also extremely energy efficient and reliable.

LED lights are mainly 15 Watt, 12W or 9W units that have been used to replace both compact fluorescent lighting, as well as low voltage down lighting.

Occupancy sensors, which switch lights off automatically, are used in some areas including storerooms and utility rooms, for further energy savings. The emergency staircase escape route lighting is also fitted with occupancy sensors to dim lights down to 15% of normal output when no one is there, but when the sensors are activated they will return to full output. 


The total installed Wattage for lighting is 117kW, which translates to 7.2W per square meter. “This is extremely energy efficient. However, it is important to note that not all lights will burn at the same time and so, on average, normal usage should be roughly, 4,3W per square meter, or 70kW for lighting usage at any given time.

Happily for the environment, no incandescent or halogen lights have been used in the design of this hospital. The hospital will save approximately 500 000 kWh of electricity per annum through energy efficient lighting, compared with what it would be had conventional lighting been used, and around 500 tonnes in CO2 emissions.

“The overall annual power consumption for Netcare Pholoso Hospital is not expected to exceed 185kWH/sq.m and design load should not exceed about 42 Volt Ampere per square meter (VA/sq.m), although it may be as low as 34VA/sq.m. Maximum demand should not exceed 50 VA/sq.m, mostly due to the extremely energy efficient building, energy efficient air-conditioning plant and laundry equipment,” Du Plessis says. Provision has been made for future power factor correction equipment if required, although the current power factor is very close to unity. The design of the hospital also allows for a photo-voltaic system to be installed in the future.

“Thanks to these environmentally sound design features, Netcare Pholoso Hospital’s carbon footprint will be reduced by as much as 1 245 tonnes of CO2 each year, relative to what it would have been if not for such measures. This emphasises the point that cumulatively these measures can make an appreciable difference to our environment,” Du Plessis concludes.

Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Pholoso Hospital
Contact: Martina Nicholson, Graeme Swinney, Meggan Saville, Thomas Hartleb or Devereaux Morkel
Telephone:011) 469 3016

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