The healthcare industry significantly impacts the environment due to its high usage of energy and natural resources and the associated waste generation. This study applied a cradle-to-grave Life Cycle Sustainability Assessment (LCSA) approach to assess the environmental and social life cycles of public hospitals. One hundred twenty-four public hospitals were selected for the current study; their sustainability performance was compared with those certified by Leadership in Energy and Environmental Design (LEED). The comparison revealed several factors contributing to the poor sustainability performance of public hospitals. These include inadequate management, substandard planning, political interference, insufficient staffing and funding, high energy consumption, high expenses, inconsistent healthcare policies, and conventional building designs. System thinking was leveraged, and a causal loop diagram (CLD) was developed to visualize the interdependency of the identified indicators of LCSA. Based on the findings of the study, a policy framework is proposed to guide the development of sustainable healthcare buildings. The framework includes using eco-friendly materials and techniques in construction, harnessing solar energy, improving hospital management practices, promoting public awareness about sustainability, conserving energy and water, and adopting sustainable waste management and transportation. Additionally, it emphasizes addressing social issues such as improving indoor air quality, thermal comfort, lighting, acoustics, patient safety, and security and ensuring that healthcare services are accessible and affordable. This study contributes to the literature on sustainable healthcare buildings by providing a practical policy framework for achieving sustainability in the healthcare sector.

Healthcare buildings are energy and water intensive, which remarkably impacts their sustainability. They also share a larger portion of hazardous and non-hazardous wastes. Leadership in Energy and Environmental Design (LEED) has been rating healthcare buildings under a separate category of Building Design and Construction (BD + C): Healthcare to acknowledge their role and importance. This research investigates the credit points achieved by these buildings using all versions and rating systems of LEED BD + C: Healthcare. The results report a very small number of Platinum-certified buildings as compared to other certification levels. Further, Technique for Order of Preference by Similarity to Ideal Solution is applied on credit points and certification levels according to their rating system, climate and location to reveal that buildings require a lot more effort to raise their certification level from Gold to Platinum as compared to the effort required between Gold, Silver and Certified. Based on this, a new certification level is proposed. Furthermore, buildings located in dry weather and South region of the USA have been shown to achieve better credit points. The findings can help designers in scoring better LEED points, which could help promote the culture of rating systems.

The hydraulic performance of stilling basins is affected by their size and geometry, which can be predicted by local scour. In 2008, based on a rigid bed study, the stilling basin of Taunsa barrage was remodeled, in which the old friction and baffle blocks were replaced with chute blocks and end sills. However, the study did not consider the effects of the remodeled basin on the erodible bed and only investigated hydraulic jumps. Therefore, this study developed FLOW-3D scour models for a designed flow of 24.28 m³/s/m to investigate the flow field and local scouring downstream of old and remodeled basins. The results showed that as compared to Large Eddy Simulation (LES) and Standard K-ε models, the Renormalization Group (RNG-K-ε) model predicted the scour profiles with better accuracy, for which the coefficient of determination (R²) reached 0.736, 0.823, and 0.747 for bays 33, 34, and 55, respectively. Downstream of the remodeled basin, the net change in sediment bed was 88%, 91%, and 95% in the LES, Standard, and RNG-K-ε models, respectively. However, downstream of the old basin, the net change in sediment bed reached 51%. Conclusively, based on the results, the study suggests investigating scour downstream of Taunsa Barrage using other discharges and sediment transport rate equations.