Evidence-Based Design and Stewardship of Our Limited Resources

Abstract

I am on record as believing that projects are designs clearly founded on a research-informed method (Hamilton & Watkins, 2009). It seems to me that crucial decisions in any sustainable, energy-conscious, environmentally friendly design should be based in part on research findings. This a special issue of HERD that addresses the subject of evidence-based design for healthcare organizations committed to sustainable practices.Few topics are as timely as discussions of our shared sustainable future, and there are few settings more difficult to design for sustainability than hospitals with their critical functions, continuous operation, constant energy consumption, huge demand for water, and enormous generation of waste. (Hamilton, 2008, p. 33)I wrote the preceding last year as part of a commentary for an issue of Frontiers of Health Services Management that focused on Hospitals: Improving the Workplace, Saving Money, and Healing the Earth. Although the focus of this issue somewhat different, there are notable elements of the Frontiers papers that bear reviewing here.Coller and Grunseth (2008) describe the situation at St. Mary's Hospital Medical Center in Green Bay, Wisconsin. They have an environmental success story that springs from the stewardship obligations of the Hospital Sisters Health System and the teachings of Jesus Christ, St. Francis, and St. Clare, who believed in for the and all living creatures. The Hospital Sisters required every hospital in their system to integrate environmental standards into their facilities and communities. With the support of the local board, an Environmental Statement for St. Mary's Hospital Medical Center declared its reverence for the earth and recognition that protecting the environment is critical to our community's long-term health (Coller & Grunseth, 2008, p.12).Coller and Grunseth share a litany of successful results. I am impressed by the report of an overall recycling rate of 31.5% by 2006, which had grown to 40% in 2007, sending 40% less trash to the landfills. The authors contend that a typical hospital doing well to recycle 25% of its waste streams, according to Hospitals for a Healthy Environment. They explain that in 2007 St. Mary's recycled more than 163 tons of waste material. Its innovative programs-such as recycling medical waste suction canisters, to name only one example- are superb models for emulation, and St. Mary's openly shares the lessons learned.The mandate model of stewardship demonstrated in the Hospital Sisters example-or similar mandates that originate from a system, board, trustees, or executive leadership-is an important one. Every healthcare organization plays a role in its community (or communities) and has an obligation to make wise use of limited resources. The pursuit of evidence-based design one way for these organizations to demonstrate their commitment to stewardship, and when leaders set the course, good things can happen.Gehant (2008) tells the story of grassroots activity by environmentally conscientious employees that spurred a hospital's involvement and commitment to environmental principles. Boulder Community Foothills Hospital in Colorado in a progressive college community with an activist history. A volunteer green team was formed and the actions that followed aligned the goals of the organization with the goals of the employees. A full-time sustainability coordinator was hired to develop and maintain environmental initiatives. The board subsequently approved a Statement of Principles of the Environment, which deals with waste reduction, waste disposal, recycling, nonrenewable resources, toxic emissions, alternative transportation, the purchase of recycled and reusable products, water conservation, and a commitment to full disclosure of incidents that harm the environment. It obvious that attention to energy use was important and that significant results were garnered in that area. …