Hospital Sustainability Gets Executives' Attention

Joe Cantlupe, for HealthLeaders Media , August 13, 2010
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Case study: Electrical centrifugal water chillers represent the single largest electrical load in most facilities, accounting for 35% to 50% of the building’s annual electrical use. A water chiller is an industrial water refrigeration apparatus that produces cold water to cool the process equipment. To reduce long-term operating costs, Emory University installed two 350-ton

high-efficiency chillers at the Winship Cancer Institute. It realized a 40% to 50% reduction in energy use required for space cooling and 48% savings in cooling tower energy use.


  1. Process-Water Efficiency. Water is an expensive resource. Process water—used to operate building systems including cooling towers and sterilizers—comprises about 75% of hospital water use. Reducing  water use can lower operational costs and should be part of an integrative design process for construction, according to the EPA.

Case study: The total water use at Emory’s Winship Cancer Institute is estimated to be 80% less than a comparable facility because it uses low-flow fixtures and process-water efficiency improvements. The Winship Cancer Institute recovers condensate water from the air-handling units of its cooling system. Condensate water is liquefied vapor. The facility’s actions reduce water needed for cooling towers by about 900,000 gallons per year. The water recovery system cost $45,000, but the hospital expects to recover savings more than the cost over five years.

  1. Indoor Air Quality—Materials Selection. Careful selection of materials along with proper ventilation, operations, and maintenance can improve air quality. Building materials can have a major impact on air quality. Many healthcare construction projects include those that have interior finishes and products characterized as non-toxic, low-VOC, or PVC-free.

Case study: Discovery Health Center specified and installed low-VOC materials, which have significant vapor pressure and environmental impact, and low-toxicity finishes, including paints, stains, cabinetwork, sealers, and adhesives. The EPA cited the Discovery Health Center for the environmental improvement, but no costs were noted.

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Dealing with Waste
The Sustainable Hospitals Program provides technical support to the healthcare industry in an effort to eliminate or reduce environmental hazards and maintain quality patient care. It is a program of the Lowell Center for Sustainable Production and is affiliated with the University of Massachusetts Lowell. The SHP emphasizes two key areas for healthcare facilities in dealing with waste:

1. Procurement: Proper procurement practices can help to reduce the amount of packaging and disposable items, and find non-toxic products as alternatives to mercury and PVC, for example.

 2. Waste Management: Waste segregation can drastically reduce the volume and toxicity of the waste stream. It is a necessary component of recycling, and requires some training and education. Waste segregation will reduce the amount of materials incinerated, since only pathological wastes must be disposed of by incineration, according to Centers for Disease Control and Prevention guidelines.

Medical products that are made of PVC plastic should especially be segregated and not incinerated because they can produce dioxinlike substances, which are endocrine disruptors and carcinogens.

The SHP suggests forming a hazardous waste management committee to conduct a survey of hospital practices. Discuss how employees will be informed about the activities of the committee, whether advanced notice of inspection will be given, how you can gain support and cooperation for your efforts from staff, and to whom the results of the survey will be reported, the SHP states.

 Check with your state Department of Environmental Protection, or similar agency, for regulations concerning disposal of medical wastes. You may need to check with state and federal Occupational Safety and Health Administration representatives as well, who deal with regulations for worker safety issues, according to the SHP.

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Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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