Environment for Change Hospitals Embrace the Numerous Benefits of Going Green

Baystate Medical Center’s Hospital of the Future promises to be many things: a modern facility providing cutting-edge medical care. A driver of short-term construction jobs and long-term careers in health care. Green.

Yes, green. The $251 million expansion is being built in accordance with the Green Guide for Healthcare, a nationally recognized standard for environmentally friendly construction of medical facilities. To wit:

• Interior skylights will bring daylight to interior spaces, reducing energy requirements. Energy-efficient lighting will be used. Light sensors will allow the use of daylight wherever possible, and lower lighting levels at night. Patient rooms and family areas will be located along exterior walls to maximize access to natural light.
• High-quality window systems will assist with insulation, and building infrastructure, including cooling and air-handling systems, will be energy-efficient. A green, vegetative roof will reduce water runoff and cool the building, adding insulation and reducing heat to the roof.
• Meanwhile, landscaping will emphasize native plants and green maintenance techniques, including a rainwater-collection system and water-efficient landscaping for irrigation.

“We found many ways to incorporate green aspects into the building, from the layout of the building to site design,” Stanley Hunter, project executive, told the Healthcare News earlier this year. “We’ve found ways to work with the existing site landscaping, using native plants, and we’re working in a previously developed area, compared to taking undeveloped land.”

The building will adopt Baystate’s campus-wide recycling program, which, in 2009 alone, saved the hospital $101,892 on cardboard and paper recycling, not to mention 3.94 tons of batteries. From 2008 to 2009, Baystate used 338,500 fewer Styrofoam cups, and 71{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} fewer Styrofoam trays. But the new building also embraces recycling in other ways: using a high percentage of recycled concrete, steel, and other construction materials, and recycling an impressive 94{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of materials and furniture in the building it demolished to make room for the addition. Much of that equipment, fixtures, and other items will be reused in developing countries.

“When we started the Hospital of the Future, we wanted to find ways to enhance the green aspects of the building itself,” Hunter said.

These efforts, as significant as they may be, are actually only a small part of the ongoing ‘greening’ of hospitals across Massachusetts and nationwide. As administrators embrace not only the health and environmental benefits of such efforts, but also the long-term cost savings, we can expect one of the past decade’s most important trends in health care to remain a major story in the next 10 years, and beyond.

Chipping Away at Costs

Located in ecologically conscious Hampshire County, Cooley Dickinson Hospital has long considered environmental impacts and sustainable-building techniques, and its recent $50 million expansion, including a new patient building and the Kittredge Surgery Center, was no exception. For one thing, the addition features double-paned, reflective windows and insulation techniques that ensure greater energy efficiency than hospitals of the past.

But long before that, CDH long boasted perhaps the most notable energy-efficiency project in the region’s health care establishment, a woodchip-burning plant that went online in 1985 and typically cuts energy costs by two-thirds.

But when the hospital opened the new, four-story building, administrators knew the woodchip plant’s output would not be sufficient to service it. So, with engineering help from Tighe & Bond in Westfield, the hospital erected a second biomass boiler.

The system uses de-barked virgin woodchips, which keep sulfur dioxide emissions low. Other emissions are minimized through combustion control and recirculation of flue gases, and a new ‘baghouse’ removes 99.5{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of all particulates from the air.

“The nice part about the woodchips is that you don’t have the gases that come from petroleum products,” Norm Welch, former facilities manager for CDH, told the Healthcare News in 2008. “So I think it is quite environmentally friendly.”

Budget-friendly, too. The wood chips provide about $300,000 in savings per year versus fuel oil, said Welch, with the planned addition of a steam turbine to generate electricity in-house possibly leading to another $150,000 to $200,000 in savings. The system also boasts an element of supporting the local economy, since Cooley Dickinson purchases most of the woodchips locally, diverting the material from landfill disposal, and donates the ash byproducts to local farms as an organic soil additive.

Speaking of recycling, Holyoke Medical Center has made a growing habit of it.

“In this 10-year period, we’ve been recycling our bulbs, our batteries, our ballasts, and our computers,” said Neil Demers, manager of Environmental Services. “Those are taken by a vendor and stripped of all usable parts and metal, and we get a rebate for them. These are items that don’t end up in landfills.”

In addition, “we’ve been recycling our cardboard. As far back at 2007, we were recycling 40 tons per year. That’s cardboard that’s not out in landfills, and I would certainly estimate that the number is slightly greater now.”

The hospital also switched from disposable sharps containers to reusable containers, a move that kept 14,051 pounds of plastic out of dump sites last year.

Meanwhile, Baystate employs a massive contraption called a Rotoclave. The machine is fed a steady diet of medical waste each week — more than a ton per day — and chews it into a fine confetti. In doing so, it eliminates the need to incinerate infectious waste, and processes more than 1 million pounds of trash per year.

“It’s a cool concept,” Tim Culhane, director of Environmental Services for Baystate Health, told the Healthcare News recently. “We used to burn needles and gauze and other waste, which was, of course, bad for the atmosphere. This sterilizes the waste and grinds it down, so it has less of an impact on traditional landfills.”

According to the Sustainable Hospital Project, a program based at UMass Lowell that provides guidance for hospitals looking to lessen their environmental impact, reduce infection, and improve energy efficiency, a growing number of hospitals have taken steps to reduce their use of potentially toxic materials and decrease the total volume of incinerator waste.

For instance, it notes that a waste-reduction program at the Fletcher-Allen Health Care System in Vermont reduced the volume of regulated medical waste at one campus by 75{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} in a few months. And Beth Israel Medical Center in New York City saves $600,000 per year through improved waste-management systems.

Better Business

Yet, Demers said cost savings from creating cleaner, more energy-efficient policies is a positive ancillary benefit, but not the main one. “It’s just a better way of doing business.”

No change is too minor to consider, he said, from switching from multifold towels to small-roll towels near sinks to buying trash liners that are the proper size, reducing waste.

Cross-contamination is another issue hospitals have been aggressively targeting in recent years; Holyoke does so with efforts ranging from hand-sanitizing stations in patient rooms and hallways to a microfiber mop system that uses less water and virtually eliminates the practice of pushing germs from one room to another, as the old loop mops did.

“It’s a simple change, but it carries over into many areas of the hospital. We’re trying to do it one program at a time,” Demers said. “We get help from everybody, whether staff members from different departments or Infection Control. We start looking at possible changes and pursue them.”

Other institutions are catching on, he added. “We’ve read that other hospitals are having the same success with the mops that we’re having. It’s a home run; it’s really made a difference. We measure the cleanliness of rooms through frequent inspections, and we check the bottom of the mops. It really does work.”

That, in turn, creates a better environment … for patients. “They see how well you’re cleaning, and that it’s good for them as well,” he said.

And if the facility saves money in the process, well, there’s more than one way to go green. And these days, hospitals can use every dollar they save while saving the planet.