Greening Healthcare: 21st Century and Beyond

Abstract

WE ARE INUNDATED with news reports, advertising campaigns, and media blitzes about the need to go green. Going has become the buzz phrase of the new millennium. If manufacturers aren't green, then their product just isn't in. Healthcare hasn't been left out of this trend. We have been steadily making changes to protect the health and safety of patients, as well as provide for a healthier planet. Many hospitals started by making small changes that ultimately led to a big difference. Others, such as the two hospitals profiled in this issue, began greening their hospitals from the very start. By taking a good operational look at how care is delivered, enlisting staff volunteers to serve on green teams, and working with suppliers, Boulder Community Hospital in Colorado and St. Mary's Hospital Medical Center in Green Bay, Wisconsin, are outstanding examples of how more and more hospitals are going green-from design and construction of their buildings to greener operations and more sustainable purchasing. These two hospitals have been at the forefront of the greening healthcare movement and have incorporated an environmental mind-set in their planning and decision-making. As we move ahead in the 21st century, what future steps will other hospitals need to take to protect not only patients and staff, but the planet? GREENING THE SUPPLY CHAIN Healthcare providers always face the challenge of providing high-quality care in an ever-changing industry. Many of the key changes these days deal with the environment. For example, research has long linked chemical contaminants in the environment with a high incidence of disease. And now increasing scientific evidence shows that chemical exposure in healthcare products and devices is having an impact on the health of patients and healthcare providers (Healthcare Environmental Resource Center 2008). Consider the number of items in a hospital that contain potentially harmful chemicals: cleaners and disinfectants, medical devices with phthalates, furniture with flame retardants and formaldehyde, solvents in labs, and countless others. Patients and staff are exposed daily to a stew of chemicals. Hospitals purchase thousands of different products each day, and often may not know which products and devices contain toxic components. And product toxicity is only the beginning. Other green purchasing issues include the amount of pollution created and the energy consumed in the manufacture of the product and how recyclable it is. Boulder Community and St. Mary's have implemented environmentally preferable purchasing (EPP) practices to help identify safe and environmentally smart products. Environmentally preferable products are generally: * less toxic; * minimally polluting; * more energy efficient; * safer and healthier for patients, workers, and the environment; * high in recycled content; * packaged more efficiently; and * fragrance-free. Boulder Community's EPP program clearly demonstrated that purchasing green supplies meant selecting items that use less wasteful packaging. The hospital successfully collaborated with manufacturers to modify their process in order to eliminate bulky packaging. In doing so, the hospital achieved its first big cost reduction. The Sterile Processing department switched to hard, reusable containers instead of plastic wrap-reducing expenses in excess of $100,000 per year. From eliminating unnecessary packaging to seeking substitutes for mercury-and polyvinyl chloride (PVC)-containing products, it's clear the hospital purchasing decisions do have a major impact in providing healthcare without harm as well as positively impacting the bottom line. MANAGING THE WASTE STREAM Hospitals on average generate more than 5 million tons of waste each year (Brannan 2006). In the past, many hospitals simply dumped all waste together, from reception area trash to operating room waste, and burned it in incinerators. …