These days many hospitals are buying into the seemingly self-evident concept that their environments should be among the cleanest and safest—in a word, the “green-est”—available to society, but such was not always the case. As recently as seven years ago, when a young woman approached Hackensack University Medical Center in Hackensack, New Jersey, and convinced management to use environmentally friendly, “green” cleaning products, it was considered a breakthrough in hospital operations. That woman was Deirdre Imus, a former high school athlete long interested in healthy foods and, more recently, deeply involved in supporting kids with cancer through such charitable activities as the Imus Ranch for Kids with Cancer in New Mexico (cofounded in 1998 with husband and controversial radio personality Don Imus). Visiting various cancer care units, she wondered why kids in such dire straits had to live in environments maintained with chemicals that were demonstrably unhealthy for them. She approached the president of the Hackensack University Medical Center and the rest was history. Ms. Imus reviews that history, how it evolved into a more all-encompassing design orientation and where it's all going from here, in an interview with HEALTHCARE DESIGN Editor-in-Chief Richard L. Peck.

Peck: How did your hospital-based efforts get started?

Imus: My husband had raised millions throughout the years for kids with cancer and sickle cell disease, both for the ranch and for the Hackensack campus. While this was happening, I was asking whether hospitals were in fact true places of healing. I knew that building materials in general had toxins in them but I focused primarily on cleaning products. It was clear that many cleaning products used in hospitals contained carcinogens, neurotoxins, hormone/endocrine disrupters, and teratogens among their ingredients, and I thought it was possible to use alternatives. I showed the data to the president of Hackensack Hospital and he said, “Why aren't we doing this already?” That's when I started investigating and developing a product line for what we call our “Greening the Cleaning” program
Hackensack university medical center in hackensack, new jersey

Hackensack University Medical Center in Hackensack, New Jersey

.

Peck: Were there difficulties in getting this off the ground?

Imus: We knew that the safer products had to be at least as effective and cost-competitive as traditional cleaners. At first, I thought green manufacturers would be readily available for this, but in fact it was difficult to find those whose products were completely nontoxic. So we invested in developing a product line meeting stringent criteria actually going beyond some criteria used by other green certification programs today. For example, we require full disclosure of ingredients, with nothing withheld for “proprietary reasons”; we have third-party certification of our formulations for all products; we use purified, chlorine-free water in the manufacturing process; and we have certification of all raw materials used by our suppliers.

Peck: Is the use of these products economically justifiable?

Imus: Yes, the case can be made on several fronts. For example, starting with the Hackensack facilities, they've gone from using 22 cleaning products to 11. Our approach in general focuses on using eight to ten core products, with the resulting savings ranging from 3 to 75%. We also go to the extent of installing a free dispensing system and free training staff for implementation. I know this approach has boosted housekeeping staff morale at Hackensack, the fourth largest independent healthcare campus in the United States, with all 200 of them recognizing that their employer is looking out not only for their patients, but for their own best interests. Not only does this help with recruitment and retention of staff, it has reduced workers compensation costs and reduced physical symptoms among staff, such as burns, rashes, headaches, respiratory problems, even depression, associated with standard cleaning chemicals. Needless to say, this campus and other participating facilities—there are more than 200 now, including hospitals, schools, and airports—enjoy advertising this fact to prospective employees.

Peck: Now you've moved from cleaning products to more general design and operational concerns, correct?
Hackensack university medical center in hackensack, new jersey

Hackensack University Medical Center in Hackensack, New Jersey

Imus: Yes, we began to expand into design and operational concerns though our partnership with Health Care Without Harm (HCWH), at first by focusing on its mercury-elimination program. HCWH has been spreading awareness of just how many products and medical instruments used in healthcare contain toxic mercury and has succeeded in developing awareness. We have since expanded to participate in the design and construction of the Sarkis and Siran Gabrellian Women's and Children's Pavilion on the Hackensack campus—perhaps the first extensively green-designed hospital in this country. Consisting of 300,000 square feet and five floors, the building uses insulation made of recycled blue denim; nontoxic paints; forest-certified, fast-growing woods such as eucalyptus, sycamore, and bamboo; wheat- and straw-board instead of particle board for millwork; green cotton layettes; a dedicated water purification system; and five green rooftops. The design added about 10% to the costs, but the facility has been open about a year and it's clear that we'll recover those costs in energy savings alone over the next eight to ten years. Beyond that, we're getting a positive reputation in the community, high satisfaction and return business from patients and families, and much safer patient care.

Peck: What are your plans for the future?

Imus: We want to continue to expand the “Greening the Cleaning” program and provide free design consultation to hospitals wanting to build green. We've also had governors and mayors in several states begin moving toward greening the environments of their hospitals and schools—for example, former Governor George Pataki of New York, Governor Jodi Rell of Connecticut, Governor Richard J. Codey of New Jersey, and Mayor Michael Bloomberg of New York.

We are continuing to urge people to take notice of a serious problem in our country—that the health of our kids is poor in general, with recently growing incidence of asthma, diabetes, obesity, autism, and more. There appear to be several reasons for this—for example, poor diets high in calories and light on nutrition, continuing use of toxic agricultural pesticides, and the prevalence of heavy metals, such as mercury, in vaccinations commonly given these days. Our kids are carrying a heavy burden. I really don't mean to scare anyone, but it's clear to us that we have plenty of reason to keep moving in the direction we've set for ourselves. HD
Hackensack university medical center in hackensack, new jersey

Hackensack University Medical Center in Hackensack, New Jersey

Founder and President, the Deirdre Imus Environmental Center for Pediatric Oncology, Hackensack University Medical Center; Photography Courtesy of Hackensack University Medical Center