Photo: The high-performance building envelope will minimize heat loss and contribute to an estimated 30% reduction in energy demand compared to the existing hospital building. | Photo Credit (all): Cicada Designs Inc., 95degrees Inc.
By Lindsey Coulter
The new 204-bed Cowichan District Hospital in Duncan, British Columbia, won’t come online for nearly two years but is already a blueprint for sustainable healthcare infrastructure. As the country’s first hospital to achieve Zero Carbon Building – Design™ certification from the Canada Green Building Council—and the first fully electric hospital in the province—the project reflects a groundbreaking shift in how hospitals can be designed and built.
The seven-story, patient-centric Cowichan District Hospital Replacement Project is being led by the Nuts’a’maat Alliance—a partnership between owner/operator Island Health, general contractor EllisDon Corporation, interior designer Parkin Architects, sustainability consultant ZGF Architects, and BC Infrastructure Benefits, and Infrastructure BC. Together, the team will deliver a healthcare facility that offers high-performance design and long-term resilience.
Hospitals are among the most energy-intensive building types, required to maintain strict indoor air quality standards, operate life-saving equipment, and ensure patient and staff comfort. The new Cowichan District Hospital tackles these challenges head-on through an integrated design approach that reimagines energy use, carbon emissions and resource efficiency.
“We are exceedingly proud to be part of the Alliance building the state-of-the-art Cowichan District Hospital, which will serve the diverse communities of Cowichan Valley while also setting unprecedented sustainability standards,” said Sean Dekoning, senior vice president and area manager, EllisDon, in a statement. “Being the first hospital in Canada to receive the Zero Carbon Building design certification is a testament to the hard work, meticulous planning, and commitment to sustainability that our team has exemplified from the project’s inception.”
Key Design and Construction Features
Upon completion, the new Cowichan District Hospital—which will also include spaces such as a community hall, inclusive indoor and outdoor areas, and dedicated areas for art programming—will be the province’s first fully electric operation. By eliminating the use of fossil fuels entirely, the facility significantly reduces its greenhouse gas emissions.
The high-performance building envelope will minimize heat loss and contribute to an estimated 30% reduction in energy demand compared to the existing hospital building. Advanced ventilation and filtration systems will ensure superior indoor air quality—critical in a region that is increasingly impacted by wildfire smoke and respiratory illnesses.
The hospital will also incorporate on-site renewable energy. A rooftop solar array is expected to supply 2.5% of the facility’s total annual energy demand, helping reduce dependency on the power grid and reducing operational costs. Meanwhile, various water conservation strategies will make it 60% more water-efficient than the existing facility.
Sustainable material choices—such as low-carbon concrete, mass timber and low-global-warming-potential refrigerants—minimize embodied carbon and environmental impact. LED lighting throughout the facility reduces lighting energy consumption by 75% compared to traditional systems.
“We are proud to be part of the team delivering the new Cowichan District Hospital—the first hospital in Canada to achieve Zero Carbon Building – Design Standard certification,” said Shane Czypyha, principal at Parkin Architects Limited, in a statement. “This landmark achievement reflects our commitment to innovative, sustainable design that supports both environmental responsibility and community well-being.”
Collaborative Innovation
Delivering a project of this complexity required early and continuous collaboration between the architecture, engineering and construction teams. Using integrated project delivery and advanced modeling, the design team was able to optimize energy performance, reduce waste and ensure long-term adaptability.
“Healthcare buildings are inherently carbon intensive,” said Jan Willemse, partner at ZGF Architects, in a statement. “As Canada’s first zero carbon hospital, the Cowichan District Replacement Hospital proves that significant reductions to embodied and operational carbon in complex buildings are possible.”
The project is targeting multiple certifications, including LEED Gold, the CaGBC Zero Carbon Building Standard and Salmon Safe—further reflecting the team’s focus on environmental stewardship throughout the design and construction lifecycle.
Cultural and environmental contexts also played a vital role in design decisions. Cowichan Tribes, the largest First Nation in British Columbia, was actively involved in the project’s planning to ensure Indigenous values were respected and reflected.
“Our teachings remind us to steward the well-being of both our smus-timuhw (body) and our tumuhw (environment) and that everything in nature is part of our family,” said As Chief Cindy Daniels in a statement. “Ensuring both the health of the land and the health of people are prioritized will provide better long-term outcomes for the facility and its users.”
Building for the Future
Slated for completion in 2027, the new 607,601-square-foot hospital sets a national precedent for the integration of sustainable design principles into essential public infrastructure.
By future-proofing the building against climate-related events and optimizing its energy systems, the Cowichan District Hospital Replacement Project is positioning itself as a model for other regions. It is not only a response to immediate healthcare needs but a long-term investment in environmental resilience, public health, and responsible stewardship.