With new CSA standards, healthcare systems will need a decarbonization roadmap

Canadian governments use these standards as a basis for their building codes. The CSA standard for hospitals and other healthcare facilities is directly cited in the National Building Code. It guides designers and owners of healthcare facilities when they build new or renovate hospitals.

What’s new in CSA-Z217.2?

The new 2025 version of CSA-Z317.2 standard has been shared in draft format for public review. The feedback has been overwhelming, so the CSA is revising again. The final version will be released later this year. It will have a major impact on the design and operation of HVAC systems in Canadian healthcare.

For example, adiabatic humidification uses much less energy than traditional steam humidification. In the past, regulators have excluded it from health facilities due to concerns about infection control. Recently, this technology has advanced and become safer to use. The new CSA-Z317.2 standard will allow hospitals to adopt this more efficient process.

The biggest news for us, however, is how the new CSA-Z317.2 will take on carbon emissions, bringing our Canadian health buildings closer to net zero by 2050. For existing buildings, the new version of the standard as currently drafted includes a new decarbonization mandate for owners to contend with. One-for-one replacement of their existing systems is no longer adequate. The CSA has raised the bar. And it requires most hospitals to chart their path to zero carbon.

For new building projects, it’s a big change. It means designers must now account for climate risk and take approaches that drive emissions toward zero in HVAC systems for all new healthcare buildings.

Who needs to know?

Canadian healthcare institutions need to be aware of the new CSA standard and its implications. They may need guidance to navigate the code changes and create a decarbonization roadmap that is realistic, feasible, economically sustainable, and cost-effective. Our team has charted carbon neutrality roadmaps for a half-dozen healthcare projects. And we have a deep understanding of the nuances and challenges of healthcare HVAC design and decarbonization strategy. 

New needs: A decarbonization roadmap

When they go into effect, the standard requires those institutions with buildings that can’t meet net zero to create a decarbonization roadmap to show how they will get to net zero emissions and keep it on file. Many healthcare institutions are not ready for the new CSA standards. They may be older facilities that haven’t had the opportunity to update or the budget to decarbonize. They shouldn’t panic, but they do need a plan.

Every hospital needs a decarbonization roadmap. It will give them a wider perspective on the possibilities for integrated transition. Using a longer-term plan, allows them to allocate budgets and find synergies with other larger planned projects, such as renovations of clinical spaces.

The roadmap is a living document for the client to maintain. It grows as the marketplace changes. It evolves with the wider plans for the facility to help a healthcare institution make sure all its buildings are carbon neutral by a target date. The roadmap shows what the client needs to do to meet local/regional climate/emissions targets. For example, a commitment to a clean electrical grid by 2035. The roadmap tells them what they will need in terms of space, systems, retrofitting, and replacement to meet future goals. The roadmap should acknowledge the institution’s master plan and its long-term goals within a realistic budget framework.

What should healthcare institutions look for in a high-quality decarbonization roadmap?

Not all carbon neutrality roadmaps are equal. They require a complex understanding of healthcare buildings, decarbonization strategy, and the nuances of code. Here’s a good place to start.

1. The roadmap should be informed by a holistic understanding of the specialized demands of a healthcare facility. It should account for a hospital’s resiliency and operations, shutdown procedures, infection control, and energy loads. For example, hospitals must be able to operate when the grid goes down. So, hospital backup systems are often going to include generators that have their own emissions. They require fossil fuels. And these systems need to be tested regularly.
2. It requires an awareness of the new standards and how they will result in new regulations and code and require upgrades or retrofitting. As health facilities renovate existing spaces for new uses, we need to bring them up to current code requirements for air change rates and pressurizations. This often triggers the need for upstream system upgrades to air handlers and thermal energy systems and offers opportunities like turning toasty exhaust air into usable heat. This allows us to decarbonize holistically.
3. An understanding of building and system lifecycle and asset renewal as it relates to the master plan should inform the roadmap. For example, it makes little sense to invest in larger cost and lifecycle updates to systems in a building that is scheduled for replacement within 10 years. Changing the control sequences to improve efficiency would be a viable decarbonization measure. But it probably wouldn’t be wise to convert the entire HVAC system to a lower carbon design. It would be better to divert capital costs to systems that will remain in place beyond 10 years and make provisions so the existing system can continue to operate.
4. The decarbonization plan should account for grid quality as it relates to electrification and emissions. For example, in regions where the grid is still highly dependent on fossil fuels, it may make more sense to design for a mix of efficient fuel sources for the near future. Save the more comprehensive electrification until the grid has switched to renewable sources.

Getting to net zero by 2050

The new CSA standard will support Canada’s transition to net zero emissions by 2050. This transition will require us to extensively retrofit many of Canada’s buildings.

To make progress toward our decarbonization goals, we need to develop RFPs for decarbonization roadmaps and create clear goals and a delivery plan. Hospitals need to develop decarbonization roadmaps. The roadmaps will help them feasibly implement large-scale retrofits on a realistic timeline. Just think of the new CSA standards as another very good reason for healthcare institutions to develop a robust decarbonization plan.