ASHRAE/ASHE Decarbonizing Hospital Buildings Guide
Overview
Hospitals are among the most energy-intensive and hardest-to-decarbonize buildings. They run around the clock, are heavily regulated, and must protect patients and the indoor environment without fail. Healthcare accounts for close to 10% of U.S. carbon emissions, and hospitals needed a practical, sector-specific roadmap for cutting that footprint without compromising care or resilience.
ASHRAE selected Mazzetti through a competitive RFP to lead development of the first edition of its Decarbonizing Hospital Buildings Guide. Mazzetti CEO Walt Vernon served as Principal Investigator, and Principal Jim Crabb was a principal author. They worked alongside co-authors Heather Burpee (University of Washington Integrated Design Lab) and Mara Baum (DIALOG), with guidance from a working group of hospital owners, engineers, and national lab experts chaired by Tim Peglow of MD Anderson Cancer Center.
The Guide
The guide is written for everyone who shapes a hospital: facility leaders, planners, architects, engineers, builders, and sustainability teams. It focuses on new construction and major renovations and gives a full-spectrum approach to cutting emissions across all three scopes:
- Scope 1: Get rid of on-site combustion by reducing heating loads, recovering and storing heat, and electrifying what’s left with heat pumps. The guide also covers hard-to-electrify uses like sterilization, humidification, and food service.
- Scope 2: Clean up purchased electricity through load reduction, utility green tariffs, virtual PPAs, and on-site renewables.
- Scope 3: Address embodied carbon, whole-life carbon, water, refrigerants, and anesthetic gases, the largest and most often overlooked share of hospital emissions.
- Design to operation: Metering, commissioning, staff training, and analytics that keep performance on track after move-in.
- Decarb-ready pathways: Bridging strategies for projects where full decarbonization isn’t yet feasible, so owners don’t lock in fossil fuel dependence.
Throughout, the guide treats resilience and decarbonization as goals to solve together. Case studies from Kaiser Permanente, Valley Children’s Hospital, and Ascension show that microgrids, storage, and smarter controls can deliver both. Forewords are by Victor J. Dzau, President of the National Academy of Medicine, and Kristie L. Ebi of the University of Washington.
Mazzetti’s Role
Mazzetti led the whole effort, from outline and literature review through the 60%, 90%, and final drafts, coordinating with ASHRAE’s monitoring committee along the way. Walt Vernon provided executive leadership and electrical engineering expertise. Jim Crabb led mechanical engineering content. Troy Savage managed the project to completion.
The guide builds on decades of Mazzetti leadership in healthcare sustainability, including co-authoring ASHRAE’s Advanced Energy Design Guides for Large and Small Hospitals, the ASHRAE-REHVA guidebook on zero-energy hospitals, and contributions to the Green Guide for Health Care and ASHE’s Sustainability Roadmap.
