The Need for reforming green rating systems for hospitals in Sri Lanka

Abstract

The healthcare sector combines a significant environmental footprint with strict operational and safety requirements. Although green building rating systems such as LEED, and GREENSL promote sustainability, they typically assess hospitals using the same criteria as other building types. However, hospitals require specialized considerations such as infection control, biomedical waste management, specialized ventilation and continuous operations, which are insufficiently addressed in general GBRS. This creates a research gap, as general GBRS may not adequately address the unique requirements of healthcare facilities in developing countries like Sri Lanka. Therefore, this study evaluates the appropriateness of general GBRS for hospital buildings. A qualitative single case study approach was adopted focusing on Sri Lanka’s only green-certified private hospital, which achieved Gold certification under the GREENSL rating. Data were collected through semi-structured interviews with three key stakeholders and on-site observations. A comparative assessment was conducted by applying the IGBC Green Healthcare Rating to the same hospital to evaluate whether it could retain its Gold certification under a healthcare-specific framework. The findings identified that strategic leadership, financial benefits, and green technology implementation supported sustainability adoption, while retrofitting aging infrastructure, operational constraints due to 24-hour healthcare services and limited government support created challenges. The comparative analysis revealed a performance gap, with the hospital scoring 68% (Gold) under GREENSL but only 60% (Silver) under IGBC criteria. Deficiencies were observed in areas such as infection control, medical waste management, specialized ventilation, acoustic design, and healing architecture. The study highlights the need for healthcare-specific green building assessment frameworks for Sri Lanka.