As Mother Nature offered up a wonderful bout of late-summer sunshine this past September, a group of healthcare providers, suppliers, designers, and others convened in Hackensack, New Jersey, to examine the ecological status of our healthcare system. The result was a landmark one-and-a-half day conference, funded by the Robert Wood Johnson Foundation (RJWF), to discuss and create a call to action on the effect our healthcare delivery system has on the ecological health of our planet and its occupants.

Also with funding from RWJF, The Center for Health Design and Health Care Without Harm commissioned six white papers that were presented at the conference. These papers examine where we are today and where we need to go to create an environmentally friendly healthcare delivery system.

Ray Anderson, founder and chairman of Interface Carpets, opened the discussion by describing his own incredible journey, which transformed his industrialist's mindset to one with a strong sense of moral and ethical responsibility to change Interface's manufacturing methodology for the good of Mother Earth. Anderson likened his enlightenment to what will be required to “green” the healthcare delivery system. He warned it would not happen overnight; just as our ethos has eroded one step at a time, so will each action to reverse our self-inflicted damage need to take place one step at a time. He advocates for strong leadership that embraces each community throughout our system of healthcare delivery.

Anderson laid out a tall order.

Each of the six papers presented at the conference addresses the ecological state of our healthcare delivery system and provides a call to action. Highlights from the six papers follow.

In exploring a wellness model, First Do No Harm by Gary Cohen challenges this audience to begin to understand how the environment has added to the burden of illness in our society today. The paper discusses how a conscious effort to innovate within the healthcare setting not only can promote healing from these adverse effects, but also can prevent disease in the general public.

Values-Driven Design and Construction: Enriching Community Benefits through Green Hospitals by Robin Guenther, FAIA, Gail Vittori, and Cynthia Atwood acknowledges the noble leaders in the movement who are building ecologically safe hospital buildings in the midst of a healthcare construction boom and discusses how others who are poised to build can learn and continue to lead in this effort. The audience was asked how best to create a tipping point. Representatives of Kaiser Permanente who participated in this discussion said for their organization, the tipping point is at the intersection of environmental safety, patient safety, and workplace safety. It is at that point where innovative concepts are owned and incorporated into their culture—and hence into their operations.

Creating Safe and Healthy Spaces: Selecting Materials that Support Healing by Mark Rossi, PhD, and Tom Lent explains that there is no clear methodology on how to change common behaviors within an industry as large as healthcare. This paper tackles the sheer volume of materials necessary to provide care, their toxicity, and the power the industry can have over those who manufacture them. Participants at the conference discussed the concept of getting the right strong message to manufacturers through group purchasing organizations, which would allow institutions of all sizes to have an ecological impact.

Common to all of these papers is the concept of behavior modification. Changes in the choice of materials and how and where best to use them are recurring themes. In the case of Preventative Medicine for the Environment: Developing and Implementing Environmental Programs that Work by Laura Brannen, ways to use and dispose of needed materials more efficiently are essential. The economic model presented may be just the argument needed to drive this level of organizational modification home.

We are what we eat, and Redefining Healthy Food: An Ecological Health Approach to Food Production, Distribution, and Procurement by Jamie Harvie, PE, makes one think more profoundly about the effect the healthcare system could have on the food we ingest in the United States. The reality of how food is farmed, harvested, processed, and brought to our tables is different from our perceptions. Can we rebuild a healthy food system? If so, who will lead?

Toward an Ecological View of Health: An Imperative for the Twenty-First Century by Ted Schettler, MD, MPH, questions our model of a health system that is “disease-based” versus “health-based.” This paper leaves us with a paradigm shift, asking, “What would a health facility look like if its primary purpose would be to make unique contributions to the well-being of individuals and their communities?”

Each of these papers (which can be downloaded for free at address a different yet connected view of how to improve the ecological approach to our healthcare system. If we maintain our current delivery system, we will be forced to downgrade the planet's health status and move to an intensive-care model of recovery or balance. The experts who wrote these papers do not see this as a viable option, nor should you.

We welcome the opportunity to facilitate an ecological discussion within your organization. It is particularly timely if you are building or renovating your facilities. Learn to transform your organization's ecological health “one step at a time.” HD

Rosalyn Cama, FASID, is Board Chair, The Center for Health Design, and President of CAMA, Incorporated in New Haven, Connecticut. The Center for Health Design is located in Concord, California.