There is a new trend in health care: greening hospitals to reduce toxins and provide a healthier, healing environment. The Green Guide sought out the top 10 in the U.S.. By Kim Weller, AIA
Since 2000, when the U.S. Green Building Council (USGBC) started to promote its Leadership in Energy and Environmental Design (LEED) standards, green building has taken off, producing environmentally sound schools and offices. Now the trend is catching on in health care, as hospitals seek to reduce toxins and provide a healthier, healing environment.
By taking up green practices, whether incrementally or from the ground up, many hospitals are managing to lower energy bills, reduce waste and achieve healthier indoor air.
Green hospitals make good sense for the health of the entire community: patients, staff and visitors. To prevent spread of infection in hospitals, it's important to reduce exposures to germs—especially for patients with compromised immune systems—but the use of harsh chemical cleaners can cause respiratory problems. Conventional cleaning products, as well as many paints, adhesives and furnishings, can give off irritating, allergenic fragrances and toxic volatile organic chemicals (VOCs) such as formaldehyde; by choosing low-VOC products, hospitals help those in their care recover and improve conditions for staff. Simple design changes can work wonders, too. Studies have shown that poor indoor lighting increases levels of stress in hospital workers, leading to compromised medical care. "Daylighting" (that is, bringing daylight indoors with enlarged windows, light wells, clerestory windows and reflective surfaces), not only improves work performance but has been shown to improve patient recovery rates, while saving energy.
At the same time, many unique challenges are presented by the complexity of hospital operations. Infection control requires strict cleaning procedures and frequent air changes, which increase the already-high energy costs of the 24/7 operations and sophisticated medical equipment that make hospitals among the greatest energy consumers of any institution. "Hospitals are the
The Top Ten Green Hospitals
Below are The Green Guide's picks for the greenest hospitals in the U.S. We did not rank the hospitals in any particular order; they are listed alphabetically.
1. Boulder Community Hospital Foothills Campus in Boulder, Colorado, completed in 2003. Boulder was the first healthcare project in the nation to achieve a LEED Silver certification, the second level of certification in the LEED system.
2. The Green Team Award Bronson Methodist Hospital in Kalamazoo, Michigan, which received the H2E Environmental Leadership Award two years in a row, has a long history of environmental stewardship. "It started in 1997 when the incinerator was shut down. We realized we would have to get serious about segregating waste and recycling," says Mike Way, vice president for materials management and facilities.
Enthusiasm about Bronson's environmental programs runs so high that when the hospital could not find a vendor to collect waste Styrofoam on an on-going basis, staff volunteered to take it to the local recycling center themselves.
3. Green Gadfly Award Regarded by many as the West Coast industry leader in environmental innovation, Kaiser Permanente has established its own guidelines for green and ethical operations. "These are our top concerns as we look at purchasing: workplace safety, patient safety and environmental issues," says Jan Stensland, in strategic sourcing and technology for strategy, planning and design at Kaiser Permanente.
4. Urban Oasis Award- Laguna Honda Replacement Hospital and Rehabilitation Center in San Francisco, California, is a public hospital, funded by San Francisco city taxes, replacing the former hospital building on the site. Part of a pilot program for benchmarking the green design of all future City of San Francisco development, its performance will be monitored by the city's Department of Environment. Architects Anshen + Allen and Gordon H Chong Partners designed the 850,000 square foot acute- and long-term care hospital to be Basic LEED NC-certified, with a focus on indoor air quality to create a healthy environment for patients and staff. Started in July 2005, the project is scheduled for completion in 2008 and is the only uncompleted hospital on the top 10 list.
5. Against All Odds Award Everything on the densely populated island of Manhattan costs more, including healthcare construction, from labor to materials, logistics to transportation. At the same time, healthcare reimbursement rates in New York are some of the lowest in the country. Yet the greening of Mount Sinai Medical Center's Lauder Center for Maternity Care stands out as an impressive example of what can be accomplished in a city where hospitals struggle to keep their doors open. Designed by Guenther 5 Architects and completed in 2003, the Center is a renovation of a 20-bed unit occupying a single floor in the Klingenstein Pavillion.
6. A Star for Sunlight...Legacy Health System Salmon Creek Hospital has just opened its new, 220-bed facility in the rapidly growing Vancouver, Washington area. Basic LEED certification has been applied for. "The hospital was designed with a focus on views and the ability to control daylight," says Johanna Brickman, associate partner and director of sustainability for Zimmer Gunsul Frasca Partnership, the architects for the project. The firm is working with the University of Oregon on a daylighting study for hospitals. Daylight modeling was performed for the exterior of the hospital to establish efficient energy levels. They are now studying patient control of daylight, window glazing, optimizing patient window views, reducing glare and how the shape of the room and other factors affect lighting.
7. Sustenance and Shelter Award --The Patrick H. Dollard Discovery Health Center in Harris, New York, reflects the belief "that there's an intrinsic link between environment and health, and they put it into action through their own organic farm and their healthcare clinic," says Peter Syrett, principal of Guenther 5 Architects, the firm which designed the center. The center serves children and adults with profound neurological and developmental impairments at its residential school in rural New York. Syrett says, "The farm and the clinic building act as a gateway to the broader community, inviting outsiders to purchase produce or to receive health care."
8. Do It for Free Award...Providence Newberg Hospital's groundbreaking in 2003 was quite the event: "Over 2,400 community members showed up with shovels to turn a spadeful of earth, breaking a Guinness World Record," claims Mark May, executive director of the new hospital. It was also the start of construction of one of the first hospital buildings in the country to seek LEED certification. The hospital is officially registered as seeking a LEED Silver certification and has just received an award from H2E for waste management. While construction has been completed, the hospital will begin seeing patients in June.
10. Green Ideals Award... Emory University's LEED NC-certified Winship Cancer Institute located in Atlanta, Georgia, is a comprehensive cancer institute dedicated both to improving treatments and applying those findings as quickly as possible to the center's patients. The seven story, 280,000-square-foot pavilion gathers patients, doctors, nurses and cancer researchers in one facility to improve cross-pollination of research and treatment. Each floor carries an ideal embedded in its stairwell's landings: Compassion, Caring, Courage, Hope, Imagination, Translation (i.e. taking research findings and applying them to patients) and Discovery.
Completed in July 2003, the building saves 19 million gallons of water per year by collecting condensed water for cooling towers, employing drip irrigation for plants and using electronic sensors on taps and toilets. The high energy demands of the laboratory have been reduced with an "enthalpy wheel" heat transfer system, the effect of which is to bring incoming air closer to the temperature and humidity of outgoing air, saving energy for the HVAC system.
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Runners Up
Hospitals across the country are making the connection between healthy buildings and operations and healthy staff and patients. We'd like to highlight some other existing and planned facilities that are standouts in a number of ways:
Garbage and Mercury Out
Dartmouth-Hitchcock Medical Center, Lebanon, NH, 2005 H2E Environmental Leadership Award winner, for its thorough staff education program on waste management. The center trains its staff in safe mercury handling, is replacing mercury devices and has set standards for low-mercury fluorescent bulbs.
Sparrow Health System, Lansing, MI, 2005 H2E Environmental Leadership Award winner, for its admirable reduction of biological waste, from 12.7 lbs/occupied bed/day to less than 3lbs/occupied bed/day. Sparrow also received the 2005 H2E Making Medicine Mercury Free for eliminating mercury in all patient areas.
University of Michigan Hospitals & Health Centers, Ann Arbor, MI, 2002 and 2005 H2E Environmental Leadership Award winner, for using the H2E awards program to propel advances in waste reduction, re-use and recycling. The hospitals and health centers have also replaced mercury-containing devices such as thermometers and sphygmomanometers, as well as mercury switches and gauges. Batteries and fluorescent tubes (which also contain mercury) are recycled.
Green Buildings
Concord Hospital, Concord, NH, for seeking Basic LEED Certification for a major addition and renovation, featuring wheelchair accessible rooftop gardens and daylighting
Children's Hospital of Pittsburgh, Pittsburgh, PA, on track for achieving Basic LEED Certification for less than five percent of total construction costs
Mercy Suburban Hospital, Norristown, PA, for living by the guiding principle that "All places are sacred—especially the earth we live on. Excessive consumption of resources degrades the earth, impoverishes others and debilitates our spirit;" and for seeking LEED Gold certification for its new expansion and renovation project
Fresh, Local and Organic Food
St. Luke's Hospital, Duluth, MN, for serving organic fruits, produce and dairy products at its cafeteria
Good Shepherd Health Care System, Hermiston, OR, for replacing canned and processed foods with organic produce and hormone-free/antibiotic-free meat cooked and prepared on site
Fletcher Allen Medical Center, Burlington, VT, for its new patient menu focusing on fresh, local food to improve patient health and support local commerce
Duke University Medical Center, Durham, NC, for its farmers' markets and farm stands
Allen Memorial Hospital, Waterloo, IA, for its farmers' markets and farm stands
Conclusion
Recognizing that the health of the individual, the community and the earth are inextricably linked, hospitals are rising to the challenge of creating truly healthy environments. And though healthcare facilities have made great strides in adopting green practices, building and purchasing, there is always room for improvement. "The medical industry needs to look at the direct link between the quality of the environment and the quality of health," says Kai Abelkis of Boulder Community Hospital. "We need to be better stewards of our communities, and by communities, I mean my daughter, your