"First, do no harm," has been the mantra of healthcare professionals for centuries. It's a perfectly good one, that serves as a reminder that bad things can happen even with the best of intentions.
Ironically, while hospitals are dedicated to healing, they can also have a negative impact on the patients and communities they serve. Healthcare is a highly energy-intensive business – hospitals are third only to food service and food sales in terms of consumption of energy per square foot in the U.S. [source: Energy Information Administration]. Hospitals and medical centers also consume massive quantities of water and generate extraordinary quantities of waste. The environmental implications are staggering.
One response to these challenges is for hospitals to commit to "going green." There's already momentum toward more sustainable use of resources in homes and buildings around the globe, and medical facilities are an important part of that trend. There are so many ways a hospital can go green, ranging from the elimination of Styrofoam in their food service operations to the construction of new buildings with the latest sustainable features. Each hospital will likely be a bit different in their approach due to their specific priorities and challenges.
In the next section, we'll look at some of the hospital-specific strategies for going green, as well as what certain hospitals are doing.
Green Strategies in Hospitals
Considering that healthcare facilities are among the top water consumers in any community, water conservation is a great way to reduce the environmental impact of a hospital while saving money at the same time [source: Energy Star]. For example, low-flow faucets in hospital sinks can reduce consumption by one gallon (3.8 liters) per person per day, while low-flow shower heads can save four times that much. One hospital in Portland, Ore. estimated they'd save $17,000 per year making just these two adjustments [source: Energy Star].
Waste management is another very important strategy for any hospital's greening process. After labor costs, it is the second largest expense for most healthcare facilities. Medical centers in the U.S. produce more than 5.9 million tons of solid waste annually, which amounts to about $10 billion annually in costs across the healthcare industry [sources: Practice Greenhealth and Sustainability Roadmap for Hospitals]. It's estimated that 85 percent of hospital waste is non-regulated waste – the same kind of waste as any other large facility. Eliminating unnecessary purchases and properly sorting and recycling can go a long way to curbing waste.
Another area of concern is paper files. Making the switch to electronic medical records (EMRs) not only saves enormous amounts of paper, but has the added benefit of reducing labor hours and improving quality of care since EMRs reduce redundancies and allow for quick access to information across entire healthcare teams [source: Centers for Medicare and Medicaid Services]. The U.S. government is currently offering financial incentives for healthcare providers who adopt EMRs [source: McGee].
The University of Virginia Health System (UVA Health) is one hospital that's made strides toward reducing its carbon footprint by using EMRs and adopting other Earth-friendly strategies such as non-toxic and reusable supplies in their cleaning systems.
"It helps that our environmental services department has input into the type of flooring, walls, etc. that are selected when we construct or renovate buildings," says UVA Health's Reba Camp, administrator for environment of care. "We've also swapped our annual plants for perennials and natives in our landscaping projects because they require less water."
While some hospitals take small steps to continually "green" their facilities, others choose to pursue one of the four U.S. Green Building Council (USGBC) certification levels for Leadership in Energy and Environmental Design (LEED), which include Certified, Silver, Gold, and Platinum. In the next section, we look at a couple of LEED certified medical centers, including one that has achieved the highly coveted Platinum prize.
Hospitals of the Future
Hospitals are increasingly aware of their environmental impact on patients as well as the surrounding community. According to the 2011 Hospital Management Survey, nearly one in five healthcare facilities are using LEED requirements in new construction and many more are following LEED guidelines without pursuing certification [source: Health Facilities Management]. One example is San Francisco's LEED Silver-rated Laguna Honda Hospital and Rehabilitation Center, which features an energy efficient HVAC system, auto-on water facets, and materials with low quantities of volatile organic compounds (VOCs). The hospital estimates it will cut its energy consumption by 30 percent and save $7 million over 10 years [source: Laguna Honda].
Another example is Dell Children's Medical Center of Central Texas in Austin, which was the first hospital in the world to achieve LEED Platinum status, the highest level of certification offered by USGBC [source: Dell Children's]. Designed from the ground up with the environment in mind, Dell Children's has high-efficiency mechanical and plumbing systems as well as a three-acre garden and six interior courtyards that represent the six distinct biomes found in the 46-county region that the hospital serves [source: Weisel]. The hospital achieved LEED Platinum certification by earning 52 LEED points as a result of these and many other innovations both during the construction and operations phases of the project.
Taking green initiatives to the level of LEED Platinum Certification may be beyond the reach of many hospitals, but these efforts very often pay for themselves over time. According to Alan Bell, director of design and construction for the Dell Children's facility, hospital-based green initiatives can help with fundraising.
"LEED Platinum certification was a big contributor in terms of philanthropy for Dell Children's," says Bell. "We had a goal of $75 million to support the project, and we raised $87 million."
Healthcare facilitates that want to pursue LEED certification can now do so with the help of LEED for Healthcare, which provides guidance on achieving LEED certification for hospitals and medical centers [source: USGBC].
In keeping with the mantra, "First, do no harm," hospitals have a special responsibility to provide a health-promoting environment to the patients and communities they serve. Going green is an important step in that direction.
I don't imagine that anyone actually enjoys a hospital stay, but some people have an almost visceral aversion to hospitals. I'm one of those people. My feelings are based on one particularly bad experience, which luckily for me, turned out OK. But it left me feeling suspicious of hospitals in general. The move toward "going green" in healthcare settings may be helping to change that suspicion. That's because these trends are not only ecologically sound, they make sense on a lot of other levels. Generally speaking, green initiatives save time and money and I'd be willing to bet they foster a deeper sense of connectedness to patients among the hospital staff. It seems logical that this could lead to better patient outcomes. Any institution that is dedicated to healing has a responsibility to maintain a healthy environment that supports patients and is well integrated with its community.
- Bell, A. Seton Network Facilities. Personal interview. (April 14, 2012)
- Camp, R. University of Virginia Health System. Personal correspondence. (April 14, 2012)
- Centers for Disease Control and Prevention. "Public Health and Aging – United States and Worldwide." (April 14, 2012) http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5206a2.htm
- Centers for Medicare and Medicaid Services. "Electronic Health Records." (April 14, 2012) http://www.cms.hhs.gov/Medicare/E-Health/EHealthRecords/index.html
- Dell Children's Medical Center of Central Texas. "Dell Children's is Green." (April 14, 2012) http://www.dellchildrens.net/about_us/about_our_green_building/leeds_interactive_slideshow/#slide_1
- Energy Star. "Saving Water Counts in Energy Efficiency." (April 14, 2012) http://www.energystar.gov/index.cfm?c=healthcare.ashe_sept_oct_2005
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- McGee, Marianne Kolbasuk. "IT Decisions Hang On Supreme Court Healthcare Ruling." InformationWeek. (April 14, 2012). http://www.informationweek.com/news/healthcare/policy/232700400
- Practice Greenhealth. "Waste." (April 14, 2012) http://practicegreenhealth.org/topics/waste
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- US Energy Information Administration. "Consumption and efficiency." (April 14, 2012) http://www.eia.gov/emeu/efficiency/cbecstrends/cbi_html/cbecs_trends_6b.html
- US Green Building Council. "LEED for Healthcare." (April 14, 2012). http://www.usgbc.org/DisplayPage.aspx?CMSPageID=1765
- Weisel, Sonja. "Texas Hospital Turns Green." Children's Hospital Today. (April 14, 2012) http://www.childrenshospitals.net/AM/Template.cfm?Section=Homepage&CONTENTID=35963&TEMPLATE=/CM/ContentDisplay.cfm