Hospitals are a significant cornerstone of any community, not just because of the services they provide but also as a significant source of employment and as a source of leadership through their education, activities and by supporting other organizations.
Healthcare used to be a service you only used when sick or something was wrong. In recent years however, healthcare has changed focus to prevention and the promotion of healthy lifestyle choices. Another change that is starting to occur is the growing interest healthcare organizations are showing in being green. Choosing to be green can be mission driven or motivated by economics, but it also directly and indirectly impacts the health and well being of patients.
There are many ways healthcare facilities can become green while enhancing patient health. Design and construction of a new building or remodeling of an existing space can have a major impact. Daily operations such as cleaning, maintenance and many clinical functions all have an impact. Purchasing, Food and Transportation also have an impact. Becoming green in each of these areas directly and indirectly affect patient health.
Green Design
The connection between facility design and patient health may seem unclear initially but it has an important role. Visiting the doctor or receiving treatment at a hospital can be a stressful experience. Alleviating stress in the design phase is an effective way to improve the experience. Use of the natural environment with creeks and natural landscaping help reduce the stress when arriving at the facility, and placement of the building can support the use of day-lighting. Day-lighting uses natural light inside the facility which both reduces patient and staff stress as well as lowering energy needs, which saves money and reduces pollution.
Facility design using the Green Guide for Healthcare and/or LEED, (Leadership in Energy and Design) promote “green” decisions during building and remodeling in a way that enhances patient care. Visible choices such as sustainable flooring , low or zero VOC paint and sustainable easy to clean furniture all play an important role as do choices about materials that are not as visible such as energy and water efficiency.
Another opportunity to green healthcare is to design and enhance the patient and guest experience by the use of gardens. Whether the garden is clinically focused such as healing gardens or simply for aesthetic purposes, they provide both a better experience for all involved, as well as tons of environmental benefits. A variation of applied landscaping is the green roof, which enhances the appearance of the roof top and provides both rain management and energy efficiency benefits. Often a green roof is placed not on top of the building, but on a lower roof where patient rooms have a view. Nature views from patient rooms are another way landscaping can enhance patient recovery.
Green Purchasing
The most effective way to reduce negative health impacts of daily activity in a hospital is to prevent the situation in the first place. Purchasing staff and suppliers can work together to be more green and facilitate better patient health results.
Most patients are unaware of the amount and types of hazardous chemicals used in healthcare. Mercury was once present throughout healthcare, in thermometers, blood pressure devices, even esophageal dilators. Significant effort has been applied towards eliminating mercury wherever possible with much success.
Formalin, a formaldehyde-based solution is common in most hospitals as are other solvents. Formaldehyde is a known carcinogen and the use of formalin can be substantially reduced with only a modest effort.
Recently, the public has become much more aware of chemicals classified as Persistent Bioaccumlative Toxins, (PBT’s). Many plastic products contain PBT’s as do brominated flame retardants. Two such chemicals drawing increased scrutiny are DEHP (diethyl phthalate), a material that increases the flexibility of plastics such as with IV bags and bisphenol-A, a common additive to plastic containers such as water bottles. Both have been shown to have negative health effects, especially on infants and children.
Green Operations
One of the top priorities in healthcare is cleanliness. Regular cleaning is mandatory and the types of cleaners are not necessarily the kind you find at the corner grocery store. For many years, fear of contamination meant using the harshest cleaning chemicals one could buy, but an Earth-friendly new generation of green cleaners has proven effective at reducing transmission of contaminants and reducing the detrimental effects on employee and patient health.
Waste Management is another area where patient health is affected invisibly. A typical medium-sized hospital can produce 3-4 tons of waste a day. Managing that waste effectively lessens the impact on the overall health of the community and saves the hospital substantial expense, expense that takes away from the bottom line, thus reducing the amount of money available for direct patient care.
In addition to cleanliness, such as room cleaning and hand-washing, elimination of pests is another important function. Often products used to eliminate insects and other vectors of disease can be toxic, so implementing a green pest management plan is an effective way to prevent unnecessary exposure to staff and patients to chemicals.
Green Food
There have been plenty of jokes about hospital food but a revolution has been taking place. Many hospitals are on the leading edge of serving fresh, locally produced and sustainably grown food. There are several reasons to look closely at making green changes to how food is provided in healthcare. How and where food is purchased from can have a significant impact on the greater environment. The way food is prepared and presented can have an impact on patient recovery time.
Healthcare spends billions of dollars on food. Healthcare can use this purchasing clout to promote and support food choices that enhance our environment. One example of this is a reduction in meat served. A recent study showed that reducing meat in the diet also reduces greenhouse gas generation.
Buying local sustainably grown and harvested foods is another way to have a positive impact. This ensures high quality fresh foods which is good for patient health and supports local farmers and the local economy. Healthy food can have a bottom line impact as well. One study showed that patients receiving early nutrition intervention had a shorter length of stay (by 2.1 days on average), leading to a direct saving of $697 per bed, per day.
Green Transportation
There are many ways green transportation can indirectly improve patient health. Respiratory health issues are directly affected by pollution from automobiles. Providing easy access to the facility for transit services for patients, their guests and employees can help lessen the air pollution in the local community as well as specifically around the hospital. Supporting bike use with safe covered parking is also effective at reducing pollution.
One of the major sources of poor air quality around hospitals is the delivery of supplies. A large hospital is like a small city with deliveries throughout the day and often at night as well. A coordinated planning effort can offer significant reductions by lowering the number of deliveries each day. Hospitals can also work with suppliers to encourage the use of clean diesel technology or alternative bio-based fuels.
Working with drivers to prevent unnecessary vehicle idling is also important. In some cases vehicles operate in an area where building air intake exists and idling vehicles can create significant indoor air quality issues. Emergency helicopter service can also influence indoor air quality.
Facilities can look closely at employee work schedules. If a department can operate with a 4-day work schedule instead of the standard 5-day schedule, you can reduce employee commuting trips by up 20%. In addition, many of the functions supporting hospital operations can be performed anywhere so work-from-home is a valid option, which saves on fuel and reduces air pollution.
Green Environment
It is commonly accepted that patient recovery is positively affected by the support and contact with family and friends. If a facility is an unpleasant place to visit a sick family member or friend, it is far less likely they will visit or stay long, thus greatly impacting recovery. Many of the features mentioned in this article make for a more pleasant environment for family and friends.
Patient recovery is affected by the attitude of hospital staff. Staff under stress is known to have a deleterious impact on patient recovery time as well as patient satisfaction. Hospitals implementing green programs often utilize green teams, an effective way to include employees in decision making. A facility that has chosen to pursue green as part of the core mission is more likely to provide a better work environment for their staff. Employees that feel involved and supported in performing their jobs are happier and more productive, thus leading to better patient care.
Healthcare facilities can enhance patient health by striving to be greener. Changes to design and construction and daily activities such as cleaning, maintenance and clinical practices all have an impact. Purchasing, Food and Transportation also have an impact. Becoming green in each of these areas directly and indirectly affect patient health and can have a positive impact on patient satisfaction and revenue.
About the Author
Tom Badrick is President of Badrick Consulting specializing in healthcare sustainability program design and implementation. Tom is a thought leader and recognized speaker in the healthcare sustainability field. Tom successfully crafted and directed the nationally recognized and award winning sustainability program for a large health system and has guided and assisted many other organizations to create or expand successful programs as well as partnering with suppliers.
Tom has a background in Environmental, Health and Safety management in biotech/chemical manufacturing and the electronics industry. Badrick Consulting offers a wide range of services from program creation/development to partnering in management of specific components of a sustainability program ranging from waste management to climate change initiatives. The Badrick Consulting web page is www.badricksustainability.com and Tom can be reached via email at tbadrick@aol.com.
