Is the New Red, White and Blue is the title of chapter in Thomas L. Friedman's book entitled Hot, Flat and Crowded. This thought-provoking book analyzes how the world has arrived at the Energy-Climate Era, in which there are significant energy supply and demand imbalances, dependence on fossil fuels, and other environmentally unfriendly practices that threaten our climate and result in substantial challenges to our future health and well-being (Friedman, 2008). Although the challenge of determining how we can halt the accelerating pace of energy consumption and stop polluting our world with toxic wastes seems daunting, Friedman (2008) describes the problem of changing the direction of the entire world to more sustainable future as a series of great opportunities disguised as insoluble problems (p. 170). His optimistic view is based on the belief that we simply have no alternative but to transform our thinking and actions, because the human race cannot continue to power its growth and evolution with the same thinking that drove the Industrial Revolution: tremendous use of fossil-based fuels, destruction of the earth's natural resources, the dumping of toxic wastes into the ecosystem, and exploitation of the land.This issue of HERD features articles on the sustainable design of healthcare facilities, and poignant editorial by our guest editor, Robin Guenther, provides insight into the critical nature of this initiative. Sustainability in design is crucial issue, because what we are doing about resource utilization, environmental pollution, and energy consumption is becoming visible and measurable in our communities. We have many opportunities to make difference in energy conservation and the protection of the environment by adopting culture and philosophy of sustainability that meets current needs without compromising the ability of future generations to meet their needs. A number of healthcare executives have spoken out about the responsibility of the healthcare industry to assume leading role in ensuring healthy environment rather than contribute toxic insults to fragile ecosystems. Embracing culture of sustainability will guide design decisions and influence the selection of materials, finishes, and building methods that ensure that completed project demonstrates eco-accountability.There are many opportunities for innovative practices in with sustainable design and carbon neutral, toxin free, water balanced and zero waste construction (Guenther, 2008, p. 31); we simply need to educate and avail ourselves of the increasing number of products and vendors that also value the concept of going green. Designs for the future must develop energy-efficient systems, reduce greenhouse gas emissions, and develop and use such sources of renewable energy as solar, wind, and geothermal whenever possible.Sources of information about sustainable design can be found on the Federal Center Web site (Federal Center on Energy, 2008); in the U.S. Green Building Council Leadership in Energy and Environmental Design (LEED) program (U.S. Green Building Council, 2008); in Practice Greenhealth (Practice Greenhealth, 2008); in the Green Guide to Health Care (Green Guide to Health Care, 2008); in the Toxic Use Reduction Institute (2008); and in Energy Star (Energy Star, 2007). To ensure the joint optimization (a process described by Hamilton, Orr, and Raboin, 2008) of the sustainability culture and design, it is necessary to articulate clearly the philosophy and value of going green, identify champions of the culture, establish team, identify designers and contractors who can embrace and partner with you in this belief, and contract with green suppliers in the purchase of environmentally safe and energy-efficient products and materials. …