Started its sustainability journey in 2012 with the establishment of the Sustainability Programme (SP) Master Plan
This commitment has led to numerous policies and strategic plans that highlight the urgency for action under different industries and economic sectors. One such strategic plan is the Green Technology Master Plan.
The Green Technology Master Plan (GTMP 2017 – 2030) is an outcome of the Eleventh Malaysia Plan (2016-2020), which outlines the sustainability goals and initiatives of six key sectors – Energy, Manufacturing, Transportation, Building, Waste and Water.
One of the key performance indicators is to increase the number of certified green buildings via either local or international green building certification tools under the building sector.
The GTMP has provided the opportunity for numerous government ministries to set annual KPIs towards achieving green building certification for both new and existing building stocks. The Ministry of Health (MoH) has been one of the leaders in ensuring these KPIs are met for the Malaysian healthcare facilities.
MoH started its sustainability journey back in 2012 with the establishment of the Sustainability Programme (SP) Master Plan, which calls for the greening of all existing hospitals. In selecting the correct green building rating tool, the local green building rating system MyCrest by CIDB and the Leadership in Energy and Environmental Design (LEED) by the US Green Building Council (USGBC) was shortlisted.
Priority was given to LEED due to its global recognition. It also set a higher benchmark for the categories under which the hospitals would be assessed.
In 2020, the Prime Minister announced the first LEED Gold certified Healthcare Facility in Malaysia- Hospital Sultanah Maliha, Langkawi. The hospital went through almost four years of retrofits and performance period monitoring before being awarded a LEED Gold Certification under the Existing Buildings (EBOM) Version 4 tool.
Hospital Sultanah Maliha’s (HSM) certification was the first but certainly not the last for MoH. Throughout 2018, the ministry supported its five hospital facility concessionaires in conducting a rigorous nationwide Green Building Gap Analysis exercise and training workshops to set the foundation for not one but all hospitals to undertake.
Sustainability Programme Master Plan
The Sustainability Programme Master Plan targets to achieve LEED or MyCrest certification for 148 hospitals and selected clinics by 2025.
This might make one wonder, is it really possible for our old hospital buildings to be certified at such a high level under a prestigious rating system without a complete overhaul? The answer is a resounding yes.
The LEED for Existing Buildings rating tool assesses buildings under six key indicators – Location & Transportation, Sustainable Sites, Energy Efficiency, Water Efficiency, Material Use, and Indoor Environmental Quality. Under each category, the tool places a high emphasis on operational best management practices.
Figure above shows us how LEED points are spread out through each category and how much of those points are design-specific. Examples include roofing materials designed for the building and its ability to reflect solar radiation or strictly operational such as energy audits or indoor air quality testing as performance indicators.
To illustrate the significance of these credits, consider that it takes:
• 40-49 credits to be Certified
• 50-59 credits to achieve a Silver rating
• 60-79 credits to earn a Gold rating – for which HSM has acquired.
• 80+ credits to reach a Platinum rating
The Malaysian hospital buildings are advantageous when it comes to Energy Efficiency (identified as Energy & Atmosphere by LEED). Hospital Sultanah Maliha was able to achieve 28 out of 38 available points under this category.
The benchmark for assessing buildings energy performance under the LEED EBOM tool is done via a third-party data sharing site – Energy Star Portfolio Manager. Building information, occupancy rates and energy and water data are uploaded. It is then given an Energy Star score of between 1-100, which compares the building to similar buildings in the United States.
A score of 50 represents median energy performance, while a 75-100 would mean the building is a top energy performer. Most Malaysian government hospitals achieve 100, which equals the maximum 20 points on the LEED scoreboard.
This is mainly because Malaysian hospitals such as HSM have been built with an open to nature concept, which allows a high per cent of floor area to be naturally ventilated – in the case of HSM, only 27 per cent of the gross floor area is air-conditioned.
While not ideal for challenging improvements in energy efficiency, the energy star score is a good indicator of the significant impact natural ventilation can have on a building’s energy performance in comparison to countries where the majority of spaces are air-conditioned and heated.
However, MoH has realised that this is not an ideal approach to assessing and improving its existing hospitals’ energy performance, and over the past year, have worked with UiTM and IEN Consultants in developing a localised benchmark to ensure continued improvements for its hospitals.
Speaking of continued improvements in energy efficiency, the MoH Sustainability Master Plan also includes all hospitals’ participation in the Energy Management Gold Standard certification by the ASEAN Energy Management Scheme (AEMAS).
Energy Management Matrix
Participation with AEMAS means that each hospital under MoH has developed, at a very minimum, an Energy Policy and a working Energy Management Committee. As part of the committee, a Certified Energy Manager (CEM) who plays the secretary’s role, is based on-site, conducts monthly reporting of energy consumption and budgeting for energy-related activities and guides the ASHRAE Level I and II Energy Audits for the hospitals.
AEMAS uses an Energy Management Matrix tool in assessing the building’s position in respect to energy management across seven key elements, which are – Policy & Systems, Organisation, Motivation, Information Systems, Training & Awareness, Investment and Corporate Social Responsibility.
Monthly energy reports by the CEM includes a summary of the hospitals’ status/ level on each element.
Energy efficiency is a strong point in the MoH’s Sustainability Programme Master Plan, making complete financial sense. For example, in 2019, HSM saw an average of 26 per cent energy reduction compared to its baseline performance in 2015.
This resulted in an electricity cost saving of approximately RM1.8mil over three years of 2017-2019. Additional energy savings will be achieved this year when the chillers of the hospital are upgraded.
With much focus on energy efficiency, which accounts for the bulk of the LEED credits for Hospital Langkawi, it is essential not to forget the other green retrofit categories.
The chart below shows us the credit weightage under each category scored for HSM.
In assessing the impact that buildings have on greenhouse gas emissions from single-occupancy vehicles, LEED for new buildings usually look at the project’s proximity to public transportation modes. Points are awarded for projects with better connectivity and planning for pedestrian and cycling access and EV charging stations.
However, this scenario would not be so practical in the case of an existing building. LEED tackles this through its standalone category – Location & Transportation, which requires building operators to conduct a transportation survey amongst all its occupants.
Doing this allows the project to develop strategies and promote alternative transportation and have a quantitative analysis of its effectiveness as well as gauge its occupant’s behaviour towards alternative transportation and formulate sustainable incentives in the long run.
By having workers quarters located nearby, with good walkability and bicycle access, HSM achieved a decent score – eight out of 15 under this category. Some hospitals located in rural areas could benefit by providing shuttle service or vanpool for their staff.
Indoor Environmental Quality
Indoor Environmental Quality is a critical element of healthcare services. As such, by attaining the LEED EBOM certification, mandatory ventilation requirements and indoor air quality for air-conditioned and naturally ventilated spaces are set per ASHRAE Standard 62.1: Ventilation for Acceptable Indoor Air Quality and the IAQ Building Education and Assessment Model (I-BEAM) by the United States Environmental Protection Agency (EPA).
As an existing building, this calls for a building-wide fresh air measurement exercise at all outdoor air intakes for AHUs and FCUs and a measurement of openings for naturally ventilated spaces and an audit of indoor spaces and systems conditions concerning the presence of contaminants.
While most hospitals like HSM have already been designed with sufficient ventilation and enhanced filtration such as High-Efficiency Particulate Absorbing (HEPA) filters and filters with Minimum Efficiency Reporting Value (MERV) of at least 13, change to space usage over the years or lack of system audits could result in non-compliance.
Where a supply of quality fresh air into the indoor spaces is inadequate, modifications to the systems will be necessary.
Other than ventilation, the indoor environmental quality category also looks at daylighting elements, interior cleanliness, occupant comfort (via population survey), and a green cleaning policy.
The introduction of crucial building operational policies is another highlight of the LEED for Existing Buildings Rating Tool. These policies are mandatory and need to be fulfilled by all projects targeting certification.
Policies introduced to a certified project include Green Cleaning Policy, Ongoing Purchasing and Waste Policy, Site Management Policy and a Facility Maintenance and Renovation Policy.
What these policies do, in addition to setting in place clear sustainability goals for the project, is that it drives market transformation.
For example, suppose 148 hospitals seek green cleaning products and equipment that are Green Seal or, at a minimum, Sirim Eco Label certified as required by LEED EBOM. In that case, this gives a push to service providers to up their green game and develop their own business approach towards providing the right solutions.
Some hospitals, including HSM, face a little bit of a tricky spot when dealing with water efficiency. This is partly due to older water fittings that have not been selected for their low-flow rates, or Water Efficiency Labelling Scheme (WELS) rated fittings.
However, with slight modification such as installing aerators and replacing older fittings, an on-site measurement exercise for HSM showed an 11.4 per cent savings in indoor potable water use than a LEED baseline.
Outdoor potable water use was also significantly reduced by implementing a rainwater harvesting system that captures sufficient rainwater to compensate 79 per cent of irrigation demands.
Digital water meters are installed at the hospital to ensure continuous monitoring of water consumption and potential leakages through the submetering. This is an effort that will be emulated at all hospitals.
Energy Management System
The Pilot LEED Certification for Hospital Sultanah Maliha, Langkawi has acted as a strong testament that Malaysian Healthcare facilities can indeed be awarded internationally recognised green building certifications.
In fact, HSM can pride itself on being the first hospital in the World to be certified with LEED EBOM v4. With a renewal required every five years, this certification certainly does not mark the end in the sustainability journey for HSM or MoH.
With the government’s support, concessionaire companies continue to provide support in the form of sustainability workshops and training programs to develop a green-conscious facilities management workforce.
Using HSM as a case study, the ROI on the capital cost expenditure is approximately 1.8 years. This estimate includes energy efficiency efforts, on-site renewable energy installation of 80kWp solar PV panels, replacement of lights to LED type, and installation of an Energy Management System (EMS).
The very short ROI can be primarily attributed to zero cost improvements in operations.
Money that has been saved from the cost of electricity can then be channelled to more essential elements of a healthcare facility’s operations.
MoH may be leading the path in the greening of Malaysia’s existing buildings. Still, we are sure to see a surge in green and healthy buildings as we move towards the recovery phase from Covid-19. Businesses look for practical ways to reduce operational costs whilst improving working conditions for employees. — @green
Sheena Moses is from IEN Consultants Sdn Bhd – a pioneering green building consultancy in Malaysia with a specialisation in energy-efficient and healthy buildings.