## 1 Introduction
### Challenges for Healthcare Buildings in Brazil  
Healthcare is a water- and energy-intensive service, mainly due to the continuous operations that require, among others, light, heat, intensive ventilation, sterilisation, and food preparation. It is responsible for generating significant waste and producing polluting emissions. The built environment accounts for about 40% of all CO\({}_{2}\) emissions, and hospitals alone account for about 4% of the total emissions of the built environment. Therefore, it is necessary that hospitals' stakeholders feel the urgency to undertake actions to reduce these greenhouse gas emissions. CO\({}_{2}\) emissions are prone to cause respiratory diseases and other illnesses. Thus, hospitals are undermining the communities' health [8]. Since hospitals provide patient care for people within a community, they can be characterised as inherent to social responsibility by taking care of patients as their core business. In sharp contrast to this, hospitals are among the most significant contributors to climate change [9].  
Brazil's health sector has undergone many changes in the last few years. Concerns regarding sustainability are becoming more evident, mainly because of society's awareness of the growing environmental issues and how the poor quality of indoor environments affects the health and comfort of patients and employees. Additionally, constant technological changes and the need to incorporate them into hospitals lead to a plurality of design issues that must be considered, such as building flexibility and adaptability.  
The need to apply modern concepts in hospital management influences the development of suitable techniques and tools that can support decision making towards integrating sustainability principles that contribute to economic growth, social satisfaction, and the preservation of the natural environment. The design professional can improve the healthcare environment, from being cold, sober, and intimidating to a humanised, ludic, and secure space, increasing the healing ambience of the patient and reducing the hospitalisation period. In addition, designing rest areas enables a better working environment for the employees, resulting in better performance and safety. Besides this set of concerns, merging all specific technical requirements with sustainable development goals is necessary.  
Healthcare Building Sustainability Assessment Methods and Their Application in the Brazilian Context  
With regard to implementing the sustainable healthcare building concept, several assessment methods define the criteria that can guide professionals to meet the standards and develop high-performance solutions. Nevertheless, some issues still need to be considered for better accuracy. For example, comprehensive databases that gather life cycle information about buildings and materials are required, as are more and better correlations between construction and operational costs. In the construction sector, traditional and outdated processes lead to multiple construction processes and considerable heterogeneity of the final products [10].  
According to [PERSON] [11], comparing existing methods allows for identifying the main advantages and limitations of the different existing evaluation processes. Comparative analysis will enable groups with various objectives to choose the most appropriate method for achieving their goals. Many countries either have or are developing sustainability assessment methods, which makes the need for coordination increasingly relevant. In Brazil, the assessment tool for healthcare buildings is mainly LEED, but there needs to be a prior adaptation to the country's specific context.