Green Guide for Health Care, provides framework for healthy building

Imagine a cancer center constructed without materials that contain known human carcinogens, or a hospital that serves organic food and meat without added antibiotics.

These are among the more than 160 strategies that define a new age of “high-performance healing environments,” according to the Green Guide for Health Care™ Version 2.0, released in November 2004 (see http://www.gghc.org for the full guide).

Drawing on sources such as the Green Healthcare Construction Guidance Statement from the American Society for Healthcare Engineering (ASHE), the U.S. Green Building Council's LEED® (Leadership in Energy & Environmental Design) Green Building Rating System, Green Building Council Australia's Green Star rating system, the U.S. Environmental Protection Agency's ENERGY STAR® rating system, The Center for Health Design's research, and the International Organization for Standardization (ISO) 14001 Environmental Performance System, the Green Guide for Health Care has defined a comprehensive, voluntary self-certification system for the design, construction, and operation of high-performance healthcare buildings.

As the first quantifiable sustainable-design tool kit for hospitals, the Green Guide provides the framework, so to speak, for the healthcare industry to fulfill its promise to “first do no harm.” In today's world, this admonition poses a greater challenge—and more significant opportunity—for the healthcare industry than ever before.

The challenge was laid out at the 2004 CleanMed Conference by Kathy Gerwig, former national director of environmental programs at Kaiser Permanente, the nation's largest nonprofit health plan. “In the United States, we are experiencing alarming increases in chronic diseases. Cancer, asthma, birth defects, developmental disabilities, autism, endometriosis, and infertility are becoming increasingly common. Mounting evidence links the incidence and severity of these diseases to environmental toxicants,” Gerwig said.

The situation creates a paradox for the healthcare industry. Gerwig added, “In the course of providing healthcare to individuals, healthcare institutions use chemicals and materials that are hazardous to human health.”

The evidence has convinced Kaiser Permanente and other healthcare institutions to adopt a precautionary approach by eliminating or reducing hazards wherever possible and choosing safer alternatives. For example, hospitals across the United States are working to reduce harm by replacing mercury thermometers with non-mercury devices.

In the process of building new facilities, hospitals have an opportunity to apply the precautionary approach on a grand scale—choosing safer materials that are not associated with chronic health issues, for instance, and incorporating design elements that have the potential to aid the healing process.

Currently, the healthcare sector is experiencing an unprecedented building boom. According to a survey conducted by Hospitals and Health Networks magazine in 2004 (“A Good Old-Fashioned Building Boom” by Dave Carpenter, March 2004, pp. 34-42), 60% of hospitals and 68% of health systems need to replace aging facilities.

At the same time, the green-building movement is burgeoning in the United States. “Sustainable development is the most vibrant and powerful force to impact the building design and construction field in more than a decade,” wrote the editors of Building Design & Construction in an October 2003 progress report on sustainability. A recent update includes survey results showing that interest in the field has risen markedly in just the past year.

Until now, the healthcare industry has been characterized as slow to respond to the rapidly emerging green-building trend. Perceived obstacles include complexity of the building type, constrained capital spending, and regulatory-compliance requirements. Available green-building tools, such as LEED, have targeted the commercial building market, which is markedly different from the 24/7, energy-intensive healthcare sector.