The newest revision to the Green Guide for Health Care's (GGHC) Operation Section was recently released amid a handful of studies from various sources declaring that green building will be a bright spot in these hard economic times and might even be an integral part of an economic recovery. For example, according to Turner Construction Company's Green Building Barometer, 75% of commercial real estate executives say the credit crunch will not discourage them from building green. Another study, by Greener World Media, says LEED projects are directly tied to more than $10 billion of green materials, and that could reach $100 billion by 2020, helping to drive an economic recovery.

Across the green movement it is apparent that understanding the operations going on within and around a structure is essential for a successful sustainable built environment. Design that is informed by what's going on operationally with regards to sustainability can only increase the effectiveness of such strategies, says Janet Brown, director of sustainable operations at Practice Greenhealth, the main implementation vehicle behind the Green Guide. The Green Guide organizes both sides of this equation, hospital construction and operations, into a self-certifying rating system to achieve greener healthcare facilities.

In the following interview, Online Editor John Oberlin speaks with Brown about the new updates and the effect design has on green operations. Updates and alterations to the section include strategies grouped by facility department, up-to-date standards, alignment with LEED, expanded scope, and emphasis of continuous improvement and integrated operations and education.

John Oberlin: What is the overall goal of the Operations Section?

Janet Brown: The goal of Practice Greenhealth, which is the organization responsible for getting it into the sector, is to integrate the GGHC Operations Section into the hospitals that we work with. A lot of green activity is going on out there but we want them to frame it within this document to give the work structure and organization. It is a way to both identify what has already been done and take credit for it and help plot future activities.

A lot of times, hospitals say, “Ok, we've done this, what should we do now?” We think the Green Guide is a good way to look at the landscape of greening by breaking it down into pieces. It can be very overwhelming, and it's hard for hospitals to prioritize or know what will give them the biggest bang for their buck.

Oberlin: The Green Guide has a Construction Section and an Operations Section. What is the link between operations and construction and design?

Brown: In order to create healing environments we really do need to integrate both the construction side of things and then what's taking place inside the building. Sometimes people don't understand what we mean by “greening operations,” but what we are talking about is taking control of what we buy, how we use it, and what we do with it when we're done with it. So you build the space, but then, in comes the activity, the people, the supplies, the materials, and the waste. The processes are often inefficient or the space was built without taking into consideration everything that's happening operationally-including the garbage. A lot of times the materials that we use are sort of an afterthought, and so it's important to integrate those operational activities when designing the space.

We talk a lot about culture and a “culture of excellence.” I was just reading Improving Healthcare with Better Building Design, edited by Sara Marberry, and it makes a nice case that instituting a culture change goes hand in hand with the designing of a new space. The more crossover we get, the more success we'll have in culture change. That includes bringing the environmental health and safety, environmental services, and sustainability officer types to the design team, as well as educating the whole design/construction team on what's going on operationally.

Practice Greenhealth hosts Webinars, one on construction one month and one on operations the next, in which we are starting to see crossover, where the architects and design team are on our greener operations calls learning about food waste prevention and composting for example. The more they have an understanding of the materials that flow through the facility, the better they will be able to address them when they are designing spaces. And likewise, we want to bring operations people to the construction side.
Janet Brown, Director of Sustainable Operations at Practice Greenhealth, the main implementation vehicle behind the Green Guide for Health Care

Janet Brown, Director of Sustainable Operations at Practice Greenhealth, the main implementation vehicle behind the Green Guide for Health Care


Oberlin: What's new in the revised Operations Section?

Brown: Well, we didn't have a food services section before, so it's pretty exciting now that healthy food in healthcare has really exploded. A lot of hospitals that are doing sustainability are also doing food work, and it's nice to tie that together, recognizing that sustainable food work is part of an overall environmental commitment. If a food services department wants to focus on these activities, it's all framed for them in the Green Guide. It includes everything from food sourcing to reusables, to less-toxic cleaning chemicals, to composting, and food donation. It's all in one place to make it easier for the food services department to address their activities.

The other new section is Facilities Management. Whereas credits related to this section had been broken down by energy and water, we now placed it all in Facilities Management, using a more departmental approach. We also added Sustainable Sites Management. Integrated Operations section was expanded to be called Integrated Operations and Education, and that's the section that really crosses departmental lines. It's about training, new employee orientation, and saturating the message of sustainability to staffers and the community. We fleshed out the Environmental Services section, recognizing the numerous opportunities within that department. And pharmaceutical waste management is now addressed in the Chemical Management section. All of the subsections, such as Sustainable Sites Management, now include credits modified with permission from USGBC's LEED for Existing Buildings: Operations and Maintenance and the LEED for Healthcare public comment draft.

We have infused everything we have been working on at Hospitals for a Healthy Environment (H2E) and Practice Greenhealth into the Operations Section, so it's really focused on implementing environmental culture. It has a lot of resources, tools, and examples of hospitals that have achieved some of these credits. We are also building our Web site to reflect this structure and gathering real life examples from our members. For example, let's say you go to Integrated Operations and Education, you will find a PowerPoint on new employee orientation, a sample educational poster, and a brochure that goes out into the community.

Oberlin: Why would it be important for a designer to know about the content covered in the Operations Section, for example concerning aspects of food services such as composting or the movement of materials through a kitchen?

Brown: Take a complex place like surgical services, the OR, or even the kitchen-getting educated on the activities going in there can only help with efficiency. Listening to the workers about the operations and learning about where the food waste is generated, and which prep areas generate the most or least amount of waste, helps with design features like space for a composting receptacle or a recycling bin. I recently visited a kitchen that had a little satellite room next to it with its own baler so the workers could very easily prepare their corrugated plastics and metal cans for recycling. Having it compacted close to home reduced the number of trips to the storage area. When the designer has the knowledge that food services generates a tremendous amount of waste and that there is an opportunity to make it more efficient, they will be able to design a better space that aids green operations. HD

For more information, listen to an archived Practice Greenhealth Webinar about the Operations Section:

Healthcare Design 2009 March;9(3):10-14