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Weekly UpdatesThe decision to improve environmental performance is daunting for many healthcare organizations. After all, so much work needs to be done, and so many environmental policies, standards, recommendations, point-based systems, and benchmarking tools need to be sorted through and understood. The good news is that an organization ready to undertake an environmental project can turn to a number of groups that can help in prioritizing options and then developing and implementing its plans. This column describes some of the leading resources, both nationally and internationally, in the healthcare sustainability movement.
U.S. GREEN BUILDING COUNCIL
A nonprofit association, the U.S. Green Building Council (USGBC) offers green-building certification, administers the LEED rating system, provides courses and workshops, publishes reference guides, and disseminates information. Soon, USGBC will implement LEED for Healthcare, a third-party certification system aimed at the unique needs of healthcare buildings. Joining USGBC as a member organization requires a fee, and registering a green-building project with the USGBC has a fee as well. For more information, see www.usgbc.org.
GREEN GUIDE FOR HEALTH CARE
The Green Guide for Healthcare (GGHC) is created by volunteers who loosely organized before the USGBC was able to develop a LEED system relevant to the healthcare industry. The GGHC is a point-based rating system similar to LEED for Healthcare. In fact, GGHC has a memorandum of understanding with the USGBC. This agreement gives permission to USGBC to base its LEED for Healthcare system on the existing GGHC toolkit. Also, the two groups work together to provide education about and improvements to the LEED system.
In contrast to LEED products, however, the GGHC tool does not feature third-party certification, so it may lack the rigor in rating the reliability of outcome. On the other hand, the toolkit is free and contains both a new buildings tool (equally relevant to expansions and renovations) and the recently launched Green Healthcare Operations tool. GGHC's website allows healthcare organizations to register a project, which in turn enables access to a forum that is a community of those interested in green healthcare. On this forum, registrants can post questions, discuss their projects, and ask for help from other registrants. A range of resources--from case studies to technology briefs--is also available on the website to help facilities implement environmental strategies.
GGHC is currently developing a new generation of a tool that is not based on the points system, but it will aid the continuous improvement in various dimensions and at various scales. This tool is intended to connect planning, design, construction, and operations of the organization. For more information, see www.gghc.org.
PRACTICE GREENHEALTH
The U.S. Environmental Protection Agency (EPA), American Hospital Association, Health Care Without Harm, and the American Nurses Association founded Hospitals for a Healthy Environment or H2E. Originally formed to help healthcare organizations eliminate mercury from their operations, H2E gradually expanded its role to work with facility operations, housekeeping, food service, engineering, and materials management staffs to improve the performance of the facility. Renamed as Practice Greenhealth, H2E is now a membership organization that offers educational tools, including e-newsletters, webinars, online performance measurement tools, and links to other resources. For more information, see http://cms.h2e-online.org/about.
AMERICAN SOCIETY FOR HEALTHCARE ENGINEERING
To its members, the American Society for Healthcare Engineering (ASHE) has long been an informational and educational resource and has long been an advocate for performance improvement, particularly in the area of energy consumption. ASHE partners with many organizations to extend its reach, including the EPA's Energy Star program, U.S. Department of Energy's Hospital Energy Alliance, International Facility Management Association, and Center for Health Design. Recently, ASHE established a Sustainability Task Force, chaired by a former ASHE president, to develop new tools that will support its members in emerging green performance imperatives. In addition, ASHE's newly launched electronic newsletter--Building Health--shares reports and case studies relevant to its members' initiatives. For more information, see www.ashe.org.
GLOBAL HEALTH AND SAFETY INITIATIVE
The Global Health and Safety Initiative (GHSI) was formed in recognition of the fact that many healthcare organizations in the country and the world are willing to make sustainable facility and environmental changes but are hampered by limited available guidelines, instruments, models, and other strategies. By pooling resources from partners and other organizations, GHSI aims to provide tools and information for achieving breakthrough outcomes, which typically can only be obtained through large capital investments. Recognizing the various imperatives faced by healthcare organizations, CHSI focuses not only on green solutions but also on maximization of patient, staff, and facility safety. For more information, see www.globalhealthsafety.org.
HEALTH CARE WITHOUT HARM
One of the first leaders in the healthcare sustainability movement, Health Care Without Harm (HCWH) is a nonprofit, international network of healthcare organizations, clinicians, environmental groups, and other advocates. HCWH's mission is "to transform the health care sector worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment." Solutions and approaches are developed by HCWH work groups. These tools and resources are available at no cost on the organization's and its constituents' websites. For more information, see www.noharm.org.
U.S. ENVIRONMENTAL PROTECTION AGENCY
One of the EPA's hallmark initiatives is the Energy Star program aimed at conserving energy and reducing the environmental impact of energy consumption. The Energy Star label on electrical equipment and appliances brings this message home to both consumers and businesses. In addition, the Energy Star website offers a free energy performance benchmarking system. With this tool, a healthcare organization can enter basic information about its facilities and its energy use. The system then returns a rating that shows how the facility's energy performance compares with that of other similar buildings in the area. Case studies, news, tips, guidelines, award opportunities, and other recommendations are posted on Energy Star's website. For more information, see www.energystar.gov.
U.S. DEPARTMENT OF ENERGY
The Department of Energy (DOE) is another newcomer to the green movement in healthcare. Despite of this, the DOE is aggressively working to help the healthcare sector make dramatic improvements in energy efficiency. In addition to supporting its national laboratories--National Renewable Energy Laboratory and Lawrence Berkeley National Laboratory--in conducting various healthcare energy-related studies, DOE is collaborating with the American Society of Heating, Refrigerating, and Air-Conditioning Engineers to produce a series of documents called Advanced Energy Design Guide for small hospitals. This project will be available in September 2009, and a guide for large hospitals will follow in 2010. As part of a sector-focused, industry-led energy partnership, DOE formed the Hospital Energy Alliance, which is made up of representatives from leading healthcare organizations and national associations. This group tackles common energy-related challenges and provides various educational resources to healthcare organizations. For more information, see www.energy.gov.
FINANCING OPPORTUNITIES
"If only we had the money" is a common statement among healthcare leaders who want to make their facilities more efficient and sustainable. Funding opportunities do exist, and they include the following:
* Incentives offered by local utility companies
* Tax deductions or credits (accessible through partnerships with for-profit third parties in the form of power purchase agreements and the like)
* Stimulus money
The pathways for the stimulus money vary and are complex. Many of the organizations listed in this column can direct hospitals in accessing this funding, and they have also been instrumental in pushing for these financial incentives. HCWH, for example, has worked with Congressional representatives to insert financial support provisions in various climate change bills circulating on Capitol Hill. For more information on financing and funding assistance, see www.fundinggreenbuildings.com.
CONCLUSION
This is indeed a perilous time for the healthcare industry. The fiscal and safety (both for patients and staff) challenges are tremendous. Healthcare leaders could take the safe path by dealing with only one issue at a time, but the need for improvement is just too great for that approach. When both the national and international communities have formed coalitions to signal their growing concerns, healthcare leaders must take the opportunity to participate in the solution.
We need not embrace mindless and expensive approaches to sustainability. What we can do is support carefully thought-out, evidence-based environmental systems and plans. What we can do is show the world we can be the leaders the public expects us to be.
For more information on the concepts in this column, contact Mr. Vernon at walterv@mazzetti.com.
Walter N. Vernon, Principal, Mazzetti Nash Lipsey Butch, San Francisco
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