Air Date: Week of November 21, 2008

Critics say hospital buildings and food are enough to make you sick. Today there's a growing movement in health care to get hospitals to green their facilities and, as host Bruce Gellerman reports, it's transforming the medical community.

Transcript

GELLERMAN: About a dozen years ago, the U. S. Environmental Protection Agency reported that medical waste incinerators in hospitals were the largest source of deadly dioxins in the country. The disclosure shook the medical community and led to the creation of an organization that takes its name from the doctor’s Hippocratic Oath. Gary Cohen is the executive director of Health Care Without Harm.

COHEN: And we thought how ironic that is that hospitals whose mission is to heal people are contributing to environmentally related disease in this society and we said we need to redefine what that “first, do no harm” ethic means and it means clean up your act.

GELLERMAN: The hospitals quickly cleaned up their act. The number of medical waste incinerators went from 5600 to fewer than 70 still operating today and Health Care Without Harm has become a worldwide coalition of nearly 500 organizations in more than 50 countries. The mission: hospitals, heal thyself, go green. The group led the effort to safely rid medical facilities of toxic mercury found in thermometers and blood pressure devices. But Cohen says there are still things in hospitals that can make you sick:

COHEN: And in the case of patients, if you’re getting your IV drip with a PVC medical device it is dripping a reproductive toxin into your veins. Nobody’s telling you that but that’s the facts, and so our challenge to the hospitals has been look, can’t we build cancer centers without carcinogens? Can’t we build pediatric units without chemicals linked to birth defects and asthma? This is what health care needs to do. They haven’t looked at, except for the last number of years they haven’t looked at their environmental health impacts of their operations and their buildings and the stuff they buy.

GELLERMA: From bedpans and surgical gloves to operating rooms and MRI machines, hospitals are enormously expensive to build, equip and operate. And when it comes to making life saving decisions, administrators aren’t about to worry about buying energy-saving devices. Still, medicine is starting to use the power of the purse to go green. Architect Robin Guenther is co-author of the book “Sustainable Health Care Architecture.”

GUENTHER: Health care is 17 percent of the gross domestic product so health care purchasing represents a huge market leverage around any goods and services a hospital may buy.

LEVY: This is not brain surgery to save energy and water in a hospital. This is common sense kind of stuff.

GELLERMAN: Paul Levy is CEO and president of Beth Israel Deaconess Medical Center. It’s a teaching hospital - one of three in Boston’s Longwood Medical area. It has three million square feet of space, seven thousand employees, and a 1.2 billion dollar budget. Levy’s first priority is patient care; his second is green - as in money, not green as in the environment.

LEVY: Much of the energy work and environmental work in hospitals is driven more by cost issues than by a desire to make the world cleaner and reduce carbon emissions and the like, but that’s okay because they end up being the same program anyway.

GELLERMAN: Cutting costs and emissions in hospitals requires a healthy dose of technology. The prescription calls for using automated devices that control lights and temperature, the flow of air and water. Most of these devices are hidden in walls and out of sight.

[WALKING DOWN HALLWAY]

GELLERMAN: But at Beth Israel Deaconess some sensors can see you.

LEVY: It’s your traditional vending machine, it’s got a picture on the front that’s brightly light. It has a refrigerator built to keep things cool, and on top of the machine is a little sensor to keep…

GELLERMAN: Oh, look at that. I wouldn’t have noticed it…

LEVY: …to track of how many people walking by it, and when it detects that the traffic has dropped, it powers down the machine the same way your computer would go into rest mode.

[SOUND OF MAKING A PURCHASE AT A VENDING MACHINE]

GELLERMAN: Vending machines are energy vampires, so hospital utility manager Mark Lukitsch has installed automatic detection devices to curb their appetite. He says small change can add up.

LUKITSCH: We’re able to save probably, with the 26 units we installed over the next 10 years, somewhere in the 70, 000 dollar range, just for a simple device that has a payback of less than a year.

GELLERMAN: Again, hospital CEO Paul Levy.

LEVY: The thing is about hospital buildings, because they’re so big, and because they’re so energy intensive, you can make a minor modification in the operation of building and actually result in a fairly substantial savings.

[WALKING DOWN HALLWAY]

GELLERMAN: Down the street from Boston’s Beth Israel is Brigham and Women’s Hospital. It has nearly twice as many employees, 13,000.

MOMBOURQUETTE: It’s a big business, it’s a big business. About 9,000 babies are born here every year. It’s the biggest in New England, and one of the biggest in the country actually.

GELLERMAN: Art Mombourquette is vice president of support services at Brigham and Woman’s. The hospital is a city unto itself. A hallway a quarter of a mile long - called the pike - connects buildings.

MOMBOURQUETTE: We’re walking on one of our green initiatives – this corridor is in the process of being replaced. It’s an old vinyl composition tile that we’re ripping out and replacing it with a renewable product, it’s a rubber product. Not only is it a renewable product, it also doesn’t require any floor finishes, which means it doesn’t need any harsh chemicals to clean it off when it yellows. So it’s much better for the people who need to clean it. It’s also softer, to walk on, it’s a nice product.

GELLERMAN: It’s quiet.

MOMBOURQUETTE: It’s very quiet.

GELLERMAN: The long hallway leads to Brigham’s newest building, the Shapiro Cardiovascular Center, 300,000 square feet of highly specialized space. It’s certified silver LEED – it was designed green from the get go. No new parking spaces were added. Instead, employees were given mass transit passes. Houses that once stood on the property were moved - recycled, in a sense - to preserve the community. And inside the building’s soaring atrium, special glazing was used on glass to reduce heating and cooling needs. And every patient’s room has floor-to-ceiling windows.

MOMBOURQUETTE: The patient rooms actually slope up at the window, so literally funneling light into the room.

GELLERMAN: This is a hospital. Can the things that you’ve changed, letting in more light, using environmentally sound cleaning materials, can that help save people’s lives or improve their health?

MOMBOURQUETTE: I think there’s beginning to be evidence that that’s a true statement, and so while it’s a little difficult to quantify, there is beginning to be evidence that natural light helps healing.

GELLERMAN: Studies show hospital patients with an outside view suffer fewer complications, need less pain medication and are discharged sooner. Similar benefits have been found in hospitals where family members can stay overnight. And many hospitals are starting to build green roofs to bring nature closer to patients. And they’re improving the food they serve, buying organic and locally grown.

It’s all part of what’s called “evidence based design.” It’s a concept that architect Robin Guenther says expands the definition of what constitutes health care.

GUENTHER: Buildings ultimately are the clothing that we put on our institutions. Buildings embody all our values, so when you inhabit a green building, it changes how you think about who you are and what you’re doing.

GELLERMAN: At Boston’s Beth Israel Deaconess, changes in architecture are changing attitudes. Community director Jane Matlaw founded “Healthy Work/Healthy Home,” a program encouraging employees to bring new green ideas to the hospital.

MATLAW: And now I have people calling me frequently, saying, “Why aren’t we doing this? Could we be doing this? How do we do that? and How do we make it better?” So, it’s really gone from, you’re a lunatic out there doing your thing, to something people really have embraced.

GELLERMAN: The benefits from going green, says Bill Ravanesi, Boston Director of Health Care Without Harm will pay for themselves - in more ways than money.

RAVANESI: There’s a big transformation. We have a green tsunami around us right now, and what we’re seeing is a transformation in thinking in health care, going from a mindset that says “let’s build an institution,” into a different kind of vision, and this vision is a healing environment.

GELLERMAN: The green wave has gone mainstream - and hospitals, their workers, their patients, and communities are the better for it.

Our story about green hospitals was reported with the help of Annie Jia.