The Healthcare Market:  Getting Greener Despite Ongoing Challenges

By Rosetta Gervasi, Chicago-based syndicated writer

Rendering of Rush University Medical Center’s new hospital (set to open in 2012). Courtesy of Perkins+Will

While interviewing representatives from the healthcare and building industries and energy management and environmental consultants about the challenges facing them when trying to implement green operations and sustainable design, development and construction for hospitals and other medical facilities, Green Space Today asked the following question:  Why are hospitals incorporating green building and other sustainable practices despite the obvious obstacles?  In separate and unrelated interviews, interviewees replied in a similar way-“Because it’s the right thing to do.”

Donna Jarmusz, Senior Vice President for Business Development and Strategic Initiatives, Alter+Care Courtesy of The Alter Group

A Hospitals’ Mission and Social Responsibility

Indeed, doing the right thing-making a commitment to constructing and operating sustainable medical facilities-is a growing trend in healthcare that ties in inexorably with hospitals’ missions and obligations to the larger community.  Joe DeVoss, AIA, Assistant Vice President for Capital Transformation, Rush University Medical Center, which is building a new $575 million hospital set to open in 2012, told Green Space Today, “We want to be good neighbors.  One reason we are implementing green features is precisely because it fits in very well with the hospital’s healing mission.”  According to DeVoss, “Rush will be proud to be known as Chicago’s first Full Service Green Hospital.”  Donna Jarmusz, Senior Vice President for Business Development and Strategic Initiatives for Alter+Care (The Alter Group’s division specializing in healthcare development), which is developing wellness centers and healthcare villages in Arizona, Florida, Michigan, and North Dakota, maintains that healthcare facilities should be looking to incorporate healthy designs because other considerations notwithstanding, “Sustainability fits in very nicely with the mission of most hospitals.”

DeVoss notes that Rush will be seeking LEED certification for its new hospital and adds that early on in the planning and construction process, the organization adopted 10 guiding principles for the project that were aimed at constructing an environmentally sustainable facility with the most advanced technology available.  Some of the planned green features will be in the areas of engineering, water conservation, energy consumption, and operations. 

Green roofs will be present at Rush University Medical Center’s new hospital. Courtesy of Perkins+Will

Indeed, Rush is mentioned in information related to U.S. News and World Report’s 2008 list of America’s Best Hospitals for its green practices.  Although the magazine did not rate hospitals according to green features, a note on one of its blogs says this about Rush: “Rush University Medical Center in Chicago, ranked No. 10 on our orthopedics list, uses green cleaning products and energy-efficient lighting.  All new buildings being constructed in the medical complex will be LEED certified, with green roofs that collect rainwater, recycled materials used in walkways, and natural lighting and gardens to promote healing—a big focus for green hospital advocates.”  (See side bar at the end of this article for further information.)

Rendering of Rush University Medical Center’s new hospital (set to open in 2012). Courtesy of Perkins+Will

The Ann & Robert H. Lurie Children’s Hospital of Chicago is slated to open in 2012. Courtesy of Children’s Hospital of Chicago

Children’s Memorial Hospital, currently located on Chicago’s North Side, is also constructing an impressive state-of-the-art facility at 225 E. Chicago, adjacent to Northwestern  Memorial’s Prentice Women’s Hospital.  The Ann & Robert H. Lurie Children’s Hospital of Chicago is slated to open in 2012.  Bruce Komiske, MHA, Chief of Hospital Design and Construction for Children’s, told Green Space Today that the hospital will include a number of green features because, “We believe it’s critical that all new healthcare buildings be constructed that way.  It’s just the right thing to do.  We want to be front and center in the city and the state as a determinedly green facility because we see it as our social responsibility.” 
 

In an interview with Green Space Today, John Driscoll, President of Alter+Care, noted that sustainability is becoming more apparent in the healthcare industry.  “There is a growing interest in sustainability and sustainable practices are being implemented by healthcare providers and facilities across the country.”

John Driscoll, President, Alter+Care Courtesy of The Alter Group

Brandi McManus, Global Development Manager & Energy Services Manager, TAC Courtesy of TAC

It’s Not Easy Being Green

The trend toward constructing and operating green healthcare facilities is a considerable challenge for projects in the works and being planned prospectively, but implementing green principals is an even greater task for existing facilities.  Brandi McManus, Global Development Manager & Energy Services Manager, TAC, said that “Hospitals operate on such thin margins that any small fiscal change has a much larger impact in the healthcare sector than it would in another industry.” 

Another issue is that “LEED is not regionally set-up,” according to Mark McDowell, The Alter Group’s LEED AP Certified Vice President, and that “LEED guidelines are not specially set up for healthcare facilities.”  “That will change in 2009 when LEED for Healthcare is expected to be introduced,” according to Mary J. Larsen, Manager of Sustainable Operations for Practice Greenhealth, a non-profit-organization that works with hospitals across the nation to reduce the environmental impact of delivering healthcare.

Mark McDowell, The Alter Group's LEED AP Certified Vice President Courtesy of The Alter Group

Making Sustainability Pay Off

Another obstacle to constructing and operating sustainable facilities is the perception among healthcare administrations that higher upfront costs of including green features will be cost prohibitive.  TAC’s McManus said, “We [TAC] are classically in the construction business and the first step is overcoming the cost issue.  In Australia and the U.K., there is more tolerance for what we do, but the U.S. is coming around.”  McDowell noted that “Healthcare has lagged behind other markets but is on the fast track to catch up. “The greatest challenge in convincing clients to go green is to spend more in the beginning for long-term savings.”

However, Larsen points out that the initial cost of going green is often offset by long-term savings through sustainable operations. “Green doesn’t have to cost more money,” said Larsen.  Michelle Halle Stern, AIA, P.E., LEED AP, Project Manger for Perkins & Will, adds that “Green design is a comprehensive team effort that brings benefits both to the environment and to the bottom line.”

Practically Practicing Sustainability

Stern explains that implementing sustainable initiatives relies on a comprehensive approach.  Rush, she says, has embraced sustainability campus-wide by adopting green cleaning practices, waste reduction programs, and recycling.  According to Stern, “Environmental services switched to microfiber mops, and they estimate that will reduce water use by 500,000 gallons per year.  They also purchased floor scrubbers that don’t require chemicals.  Recycling bins have cropped all over campus, and staff has responded enthusiastically.”

“Abra’s Gardens” at Prentice Women’s Hospital (Chicago) house easy-to-maintain plants that withstand the harsh Chicago winters. Northwestern Memorial Hospital

Susan Haifleigh, Director of Sustainability Solutions, VFA, Inc. VFA, Inc.

Susan Haifleigh, Director of Sustainability Solutions, VFA, Inc., offers other practical, low-cost initiatives hospitals can take to become more sustainable.  “Steam can be used and reused in hospitals at the power plant level; hospitals can and are slowly replacing materials with non-synthetics; switching to greener cleaning products is a huge first step; and good energy management through lighting control is a way hospitals can meter their energy systems and monitor their progress, said Haifleigh.”

Practice Greenhealth’s Larsen adds that using green cleansers is an efficient and effective way any health facility can become more environmentally responsive.  “Not everything has to be cleaned with bleach, which can be toxic to the handlers,” she said.

The Power of Green Healing

There are compelling reasons for going green even if the obstacles seem daunting.  For example, a commitment to green construction and operations can help patients heal more quickly.  Rooftop healing gardens and greater use of vegetation are recognized ways to reduce anxiety, speed healing, and shorten hospital stays.

Komiske points out that the Children’s new hospital’s sky garden will be a healing garden and more.  “It will be a gathering place and a stage; it will have elements of discovery and education and even an energy dashboard that shows visitors-in real time how much energy is being saved and what efficiencies are going on in the facility.

Prentice Women’s Hospital (Chicago) has 9,500 square feet of green roof that reduces the building’s heat island effect. Northwestern Memorial Hospital

The connection between staff retention and how green practices will aid positive retention is another important reason that hospitals and other healthcare organizations should strengthen their commitment to green practices.  Larsen points out that asthma is a serious occupational ailment for nurses due to the toxicity of the chemicals they use on a daily basis.  Stern, referring to Rush’s new hospital, adds that “one of new hospital’s two roofs will be a staff amenity where they can unwind from their stressful days.”

In the final analysis, the healthcare industry, along with every responsible private, public or corporate citizen is going green for the most basic of reasons: It’s just the right thing to do for the benefit of the community, the environment, and patients and medical staffs, and in many situations, the financially sensible thing to do.