The design of healthy and sustainable health-care environments

“Environmental responsibility makes good sense. Energy efficiency saves money and reduces greenhouse emissions. Reduced paper use saves trees and costs less. Hospital recycling programs reduce garbage and save landfill fees. And when going green costs a little more, it makes a statement that health care needs to manage its environmental footprint, too,” says Chris Mazurkewich, Chief Operating Officer, Interior Health Strategic and Corporate Services.

The design, operations, and maintenance of health-care facilities can be a challenging task. When trying to create healthy and healing environments for those requiring care, as well as workplaces where individuals often perform under stressful conditions, the design principles and choice of materials, equipment and products used within the facility must be carefully considered. To meet many of these requirements, the Interior Health Authority is focused on energy conservation, green and sustainable health-care facility design, sustainable maintenance and purchasing practices, and a healthy work environment.

The Interior Health Authority is one of the six provincial Health Authorities in the province of British Columbia (BC), Canada. It provides health-care services at 35 acute care facilities and 40 residential care facilities to a population of approximately 718,000 across 216,000 square kilometres.

In 2002, the Interior Health Green Committee was formed to implement sustainable, energy efficient choices for each facility across the health authority. Comprised of representation from Plant Services, Facilities Management, Workplace Health and Safety, Material Services, and others, this committee established green policies and principles and examined how Interior Health could be an environmentally sustainable organization. Using a collaborative, multi-faceted approach to sustainability and healthy design, the committee has been able to help Interior Health reduce building energy usage, decrease the amount of waste from facilities, design health-care facilities that are healthier for the staff and patients, and have a smaller environmental impact with ongoing operations. The implementation of sustainable and healthy principles, combined with the purchase of “green” products, means less energy consumption, less heat generated by equipment, and less emissions from harmful products _ all of which result in a decreased impact on the environment.

To meet the Province of British Columbia’s mandate for all government- owned buildings to become carbon neutral by the year 2010, Interior Health has created a Department of Environmental Sustainability. This department, which formalizes Interior Health’s commitment to sustainability, is comprised of a manager and an Environmental Sustainability Steering Committee. The Steering Committee includes representatives from Housekeeping, Acute Care, Public Health, Material Services, Facilities Management, and Workplace Health and Safety. Their mandate is to coordinate the efforts of regionalized “Green” teams; maintain and oversee various sustainability- focused initiatives such as enhanced green product procurement for all departments, green building design and operations, and hospital and health-care facility energy reduction; and prioritize initiatives to align with the provincial government priorities. The collaboration of this diverse steering committee will allow Interior Health to integrate environmental sustainability principles in every aspect of health-care delivery and all associated processes.

Sustainable and healthy health-care facilities The link between the environment and health is clear. To improve the “health” of its facilities, Interior Health has taken a two-step approach.

To reduce ongoing operational and maintenance costs of each of its buildings, the organization is currently completing an Energy Conservation Project at eight separate facilities. This involves upgrading and retrofitting various building features such as lighting and mechanical systems to make them more efficient and less harmful to the environment. When the project is complete in 2008, it will have reduced CO2 emissions by the equivalent of taking 380 cars off of the road.

The second step is a commitment to meeting Leadership in Energy and Environmental Design (LEED) Silver standards for the design and renovation of all existing Interior Health facilities, and meeting Gold standards for all new construction. This means creating environmentally-friendly buildings that are more efficient to operate and are healthier for the occupants. As a result of this commitment, Hillside Acute Psychiatric Facility, a 44-bed inpatient psychiatric facility located in Kamloops, BC was awarded LEED Gold in late 2006, the first for a Canadian inpatient health-care facility. This facility provides a new benchmark for sustainability within Interior Health and is setting the standard for the design of any new health-care facility within the province. Interior Health’s first acute care facility designed to meet LEED Gold requirements is currently under construction with an anticipated completion of Fall 2008.

Sustainable purchasingInterior Health’s Materials Management Department oversees purchasing of the majority of products for use within each health-care facility. The department is committed to sustainability and is purchasing products that are less harmful to the environment. One of the original policies implemented in this area was to only purchase Energy Star products; a first step in the right direction in terms of reducing energy use.

To ensure more effective cleaning products, a Housekeeping Purchasing Committee was created to incorporate front line staff input into purchasing decisions. This committee now reviews all cleaning products and the Requests for Proposals from suppliers, specifying green alternatives for each product.

As part of the housekeeping environmental initiatives, Interior Health also introduced microfibre mops. These mops significantly reduce water and chemical requirements through the power of static electricity attracting dust. As a result, the cleaning process is improved, less water is used, and there is a reduction in risk factors for musculoskeletal injuries when mopping.

In addition, the Pharmacy Department has centralized purchasing for all pharmacy sites across Interior Health. With the implementation of unit-dose dispensing and centralized purchasing, Interior Health has significantly reduced both cardboard and plastic packaging. This innovative purchasing, supply, and distribution of pharmacy products won the “Award for Excellence in Pharmaceutical Supply Chain” at the 2006 National Healthcare Leadership Conference.

The focus on a “healthy” health-care environment has allowed Interior Health to provide safer and more environmentally friendly facilities for the staff that work in them, and the patients who require care. Its multi-faceted approach to sustainability is improving relationships internally and externally – with the community and with governing and funding bodies such as the regional hospital districts and the Ministry of Health. These sustainability efforts were rewarded this spring when Interior Health received the 2007 Champions for Change Award from the Hospitals for a Healthy Environment (H2E) in the United States.

Each step Interior Health takes toward more sustainable and healthy buildings leads to the creation of health-care environments that are healing for patients the moment they walk through the doors, while also meeting the needs of staff. These buildings are becoming centrepieces in many communities showing how sustainability and health go beyond front-line medical care.