The idea of a "green" hospital is going to give some germaphobes the heebie-jeebies. They're picturing nurses in hemp pants and doctors wearing vests without shirts, and everybody's hair is long and not tucked into a hygienic net or cap. And the X-ray techs are all singing Crosby, Stills and Nash songs. Phlebotomists might wash their hands (or not) -- it depends on whether it's a new moon tonight.
But that wouldn't be fair to either environmentalists or hospitals. As architect John Messervy, chair of the Healthier Hospitals Initiative, said, "If we commit to hospitals being centers of health for the employees, the patients, and the community, then we need to be setting an example." This example does not include hemp pants, but it does include rooftop gardens, low-VOC paints, public transportation and even hospitals powered by beer. Seriously.
Janet Brown, director of outreach at the Healthier Hospitals Initiative, admitted that "it took me a while to realize that a commitment to the environment is a commitment to people. Building a greener hospital has a definite environmental impact, but also a positive impact for the patient experience."
Put it all together, and what you figure out is that building a healthy hospital helps keep the trees, the birds, the squirrels, the patients, the employees and even the hospital's bottom line healthy, too. And if you like what you read here, Brown and Messervy both encourage consumers of healthcare to pester -- or politely ask -- local hospitals about their green practices and encourage them to step up. Power to the people!
Pick the Right Place
Before a single slab of concrete is poured, before one sustainably harvested two-by-four is set into place, somebody has to decide where to put the new hospital. This is true of any building, of course, but we're talking hospitals today.
You want to start with the doctor's creed: First, do no harm. That means don't put your big building in the middle of the wetlands, or on top of an old chemical dump, or even on perfectly good farm land that could be used to grow organic soy beans.
If there are old buildings in the way, like, say, a neighborhood, don't demolish it. That's beyond rude. Brigham and Women's Hospital in Boston moved all the houses in the way of its new construction to a new site -- intact. If you can't do that, have a deconstruction company come in and salvage what they can reuse, like flooring or brickwork.
Ditch the Parking Lot
Don't panic, man. Green hospital architects like Messervy don't mean to say you won't have a place to park. But think about it -- if everybody drove all alone in their cars to park on a vast expanse of hot, black asphalt, what would that do to the average global temperatures? Oh, wait. I think we're finding that out.
We can't turn back time, but we can hand out bus passes. If the hospital is sited appropriately, then the architects probably took into account the local public transport system, like buses, subways, trains, trolleys and bike lanes, whatever. And while you, fingers crossed, only have to drive yourself to the hospital a couple times a year, employees have to show up for work every day.
Getting rid of the employee lot and handing out the monthly passes means no more watching squirrels hot-foot it across the tarmac, but that's a small price to pay to have squirrels to watch at all. Besides, you know they'll do something else funny, like eat a cheese doodle, in a minute anyway.
Let the Sun Shine In
Yet another benefit of paying attention to where you put this big building in the first place: sunshine! There are so many ways to use it! It's like the pashmina scarf of celestial bodies.
First of all, you can design the building to avoid the hot summer southern-exposure type of sun, the sun that makes your car into a greenhouse and a hospital very, very expensive to keep cool.
Second, you can put in giant windows, which serve two shiny, happy purposes: reducing the need for electric lighting during the daytime, and lifting the mood and healing ability of patients. Really.
Third, you can get all creative with your architecture self and get that light deep into the building so that less electricity is used throughout the facility. Make a pretty atrium. Create a courtyard. Use skylights and mirrors to bring daylight to every last nook and cranny.
Raise (Veggies on) the Roof
The roof garden provides another two-fer: happy planet, healthy patients.
Green roofs can be included on almost any structure these days, even dog houses. Most hospitals are big, and if they're built with a roof garden (or three) in mind, they can probably grow enough produce to feed Great Falls, Montana. Well, approximately.
Putting plants on the roof increases the carbon dioxide/oxygen exchange that we oxygen-breathing humans so appreciate. Patients and the people who visit them in the hospital all can use the calming effect of visiting a nicely tended garden during otherwise rotten times. Employees can get their green thumb on and have a lovely little lunch spot that doesn't smell like bodily fluids.
A green roof also isn't a painted-black roof, which like the parking lot just makes everything hotter. If you can't plant some tomatoes on the roof, at least paint it white to reflect the heat and keep the interior of the hospital cool.
Ah, humans. If we can futz with things, we will -- even if it doesn't make it any better. Take the thermostat in any grandparents' home. No one can pass that thing without making an adjustment, and it's still never warm enough or cold enough. Or it's too warm or cold. Or you hear this: "You're lucky we even have a thermostat. When I was growing up, we had a frozen lake or a tire fire. Those were your choices."
For a hospital to maximize its green-ness and its energy efficiency (which saves the other kind of green -- money), everything needs to be automated, from temperature to air flow to lighting to water use. Lights can be timed to come on at sunset, or sensors can be used to turn on lights when someone enters an exam room or it becomes too dim to read the charts. A thermostat that can't be easily futzed with -- maybe by keeping it away from finicky grandparents -- will keep heating and air conditioning in check.
Why bother letting the robots do the work? "It's not only the good thing to do environmentally," Messervy said, "but it saves you money, obviously. You use less power, your utility bill is smaller."
Using renewable materials is, again, good for the planet and the people. Are you sensing a theme here?
Take, for instance, the floor installed at Brigham and Women's in Boston. It's made of rubber, which is very renewable. It doesn't require harsh chemicals to clean it, which saves the lungs of the maintenance staff and the people who have to walk that hallway every day. It's also soft, which is just nice. It is not, however, like a bouncy house, which is disappointing. But I bet one of those little hard rubber crazy balls would go like nuts on it.
There are tons of renewable materials that are pretty easy to find, and as green construction gains a foothold everywhere, these things are getting cheaper, too. "If there was a premium cost associated with a particular green product," John Messervy said, "it's negligible now." These materials include all the usual suspects, like bamboo, wool, linoleum and everybody's favorite, hemp.
Keep the Site Clean
When passing a construction site, there are usually two things that come to mind: That place is so tidy, and those construction workers are so polite!
A green hospital construction site, though, can keep things clean, if not necessarily wolf-whistle-free. For starters, taking care not to trample or drive over or dig up or backhoe or spill paint on existing foliage and squirrels would help. I don't imagine a squirrel painted that particular shade of calming hospital green would find himself particularly soothed.
As the construction project progresses, contractors can recycle or upcycle all the leftover bits of wood, rebar, flooring, drywall -- you name it, if it's in good shape, somebody wants it. There are businesses that specialize in recovering just this kind of non-debris, or there are drop-off sites in many cities where do-it-yourselfers can come buy unused building materials to make their sweet suburban chicken coops.
Ahh, that new car smell. You know it's just the plastics and foam and carpet off-gassing putrid chemicals that make it smell that way, right? You didn't? Oh. Sorry.
Same goes for almost any traditional construction material, which often has formaldehyde or PVC or some other questionable chemical content. So just swap those out for better building materials, right? Good luck. "The problem is," said Messervy, "that not all manufacturers are disclosing what chemicals are contained in the products." The Healthy Hospitals Initiative is working on the problem, but a little push from savvy consumers wouldn't hurt, if you get the drift. Nudge, nudge.
And sometimes, there's no alternative to the bad stuff, like lead. "You're going to need lead-lined walls for certain areas where you're using radiological equipment," Brown pointed out. "But there are lots of opportunities with what's available now. We can get furniture without formaldehyde. We can use low-VOC paints."
Make Doing Good Easy
Say the hospital is built and ready for patients to stream through its doors. It's in the perfect spot, it has a state-of-the-art waste and recycling facility, it has new equipment that uses new tools with fewer chemicals and energy drain. New, new, new! Yay!
Unless you've been a nurse or a doctor or a tech for decades and you've always dropped used swabs in one specific place. Now that place has moved. It might seem silly, but these little changes all day long for the sake of those squirrels can add up.
"We know that healthcare is an extremely complex environment, and people are really busy taking care of other people," Brown said. "So whatever intervention we can implement, whether it's recycling or composting or whatever it may be, it has to be easy, it has to be efficient and it has to respect the worker and how busy they are."
In order for a green hospital to stay green, everyone has to see their part in the plan. And if they get stressed out about that whole used swab thing, maybe they can take a break on the rooftop garden.
Power it with beer!
Saving the best for last, courtesy of Messervy: "One of my favorite ways of using alternative energy is a hospital in Wisconsin that's using the biogas from a brewery down the road. It's far enough away I guess that they don't smell the brewery, but not so far that it's uneconomical. They built a pipeline from the brewery and they get the biogas from the brewery, which otherwise is a waste product from the brewery, and they're able to generate electricity."
There are tons of other ways to lessen the load on the grid, like geothermal energy or solar voltaic panels on the roof, or steam heat like they use at Swedish Issaquah hospital in Washington state.
For the record, Messervy says they are not serving beer in the cafeteria of that Wisconsin hospital, which seems like a waste of a perfectly good pipeline. They must have other priorities.
Green Roofs And White Roofs: Low Tech Ways To Save Tons Of Energy. Keep reading to learn about Low Tech Ways To Save Tons Of Energy.
Author's Note: 10 Ways Hospital Construction Can Go Green
I knew very little (all right, exactly zero) about building green hospitals when I started this assignment. I figured not using endangered trees for wall studs would be a good start. And maybe recycle some paper.
But after reading up on the subject, and especially after interviewing two of the major players in the movement to reduce the environmental impact of hospitals in the community, I feel like an expert. I could probably build you an environmentally friendly hospital right now, if you need one.
- A Green Hospital Initiative. "A Global Approach." Hospital 2020. (May 15, 2012) http://hospital2020.org/Agreenhospital.html
- Brown, Janet. Director of Facility Engagement at Practice Greenhealth and Director of Content and Outreach for the Healthier Hospitals Initiative. Telephone interview conducted on May 23, 2012.
- Center for American Progress. "It's Easy Being Green: Environmentally Friendly Hospitals." AmericanProgress.org. March 31, 2010. (May 15, 2012) http://www.americanprogress.org/issues/2010/03/ebg_033110.html
- Children's Memorial Hospital. "Healthy by design: Building a 'green' hospital." ChildrensMemorial.org. 2011. (May 15, 2012) http://www.childrensmemorial.org/newsroom/feature.aspx?pid=3606&sid=6336
- Collier Cool, Lisa. "Hospitals Go Green to Heal the Planet." Healthymagination.com. July 22, 2010. (May 15, 2012) http://www.healthymagination.com/blog/hospitals-go-green-to-heal-the-planet/
- Gellerman, Bruce. "Green Hospitals." Living on Earth broadcast. Nov. 21, 2008. (May 15, 2012) http://www.loe.org/shows/segments.html?programID=08-P13-00047&segmentID=7
- Hiskes, Jonathan. "A green hospital is a comfortable hospital." Sustainable Industries. June 29, 2011. (May 15, 2012) http://sustainableindustries.com/articles/2011/06/swedish-issaquah-tries-show-green-hospital-comfortable-hospital
- Messervy, John. AIA. Chair of the Healthier Hospitals Initiative and Director of Capital and Facilities Planning for Partners HealthCare. Telephone interview conducted on May 23, 2012.
- US Green Building Council. "LEED for Healthcare." USGBC.org. (May 15, 2012) http://www.usgbc.org/DisplayPage.aspx?CMSPageID=1765