## 1 Introduction  
The building industry is one of the largest sectors involving people (services) and materials. It significantly impacts the environment, economy, and society because it consumes large amounts of natural resources [1]. As reported by the World Business Council for Sustainable Development, the building sector accounts for about 40% of total energy use, 30% of greenhouse gas (GHG) emissions, 17% of freshwater consumption, and 25% of harvested wood and is responsible for the production of 45% to 65% of disposed waste in landfills [2].  
Consequently, mitigating the environmental impacts of the building sector has become a significant issue, and projections for the future global population and economic growth predict a steady increase in the worldwide energy demand [2]. Energy use in the built environment is the main factor causing climate change. Therefore, promoting energy-efficient buildings is crucial to ensure a more sustainable future [3].  
According to [PERSON] and [PERSON] [4], numerous building sustainability assessment (BSA) methods have been developed over the last decades to evaluate building performance and to analyse the buildings' life cycle impacts on the environment, economy, public health, and well-being in cities. These methods are based on a list of indicators organised in different sustainability dimensions.  
BSA methods are tools for evaluating building performance and supporting sustainable design. Therefore, they are essential to support decision making towards implementing sustainable principles in existing and new buildings. It allows us to obtain a sustainability rate after a detailed report [5] and serves as a management tool or guideline to address sustainability targets during the design, construction, and operation phases. Considering the effect these methods can have in fostering the implementation of sustainable buildings, some governments offer tax incentives for buildings that fulfil certain sustainability rating thresholds [6].  
Globally, there are different BSA methods developed by private and public institutions. The approaches share the general aim of promoting sustainable buildings and are based on a similar list of core sustainability indicators. Still, they differ in adjusting to the specific territory's environmental, economic, and sociocultural contexts [6].  
Healthcare buildings are very complex due to the different types of users, the dynamic demand of spaces, the integration of constantly evolving technologies and systems and their social contribution to the community. Incorporating sustainable development criteria in the design strategy is considered the main factor for the success of sustainable hospital projects. Other essential factors are promoting sustainable initiatives, measuring risks and impacts (goals, metrics, monitoring, and evaluation), management programs (water and energy efficiency), low-impact maintenance products, actions towards transparency, educational programs, communication, and response teams.  
In Brazil, the healthcare sector is starting to look at sustainability as an opportunity, and efforts are being made to define the sustainability indicators for different healthcare buildings and locations. One of the limitations of developing a method to support the practical implementation of sustainability goals in the Brazilian healthcare sector is the need for comprehensive information about its performance. In addition, the Brazilian territory is very vast. Therefore, diverse economic, environmental, and social goals make it challenging to develop an effective method to be applied nationwide [7]. The analysis and interpretation of the current situation in Brazil are crucial in developing a sustainability assessment framework that fits the market needs and stakeholders' expectations.