The Architecture of Healing

Stacy Malkan, for HealthLeaders News , June 5, 2007
From rooftop healing gardens, to patient rooms with views, to less-toxic building materials, hospitals across the US are raising the bar for a health-based approach to green building.

"In hospitals, there's a natural alignment with green issues," David Hanitchak, director of planning and construction at Massachusetts General Hospital, told the Boston Globe in a recent front page story about the major green construction projects underway in the state’s healthcare sector.

MGH, Dana-Farber Cancer Institute, Children's Hospital Boston, Spaulding Rehabilitation Hospital and Brigham and Women's Hospital are among those incorporating environmentally sensitive building, construction and operation strategies.

Brigham’s new $352 million, 136-bed cardiac care center--the first of the new green facilities slated to open in Boston next spring--will feature large windows that allow more natural light; less toxic building materials, including non-fuming glue, paints, and sealants in interior construction; and rubber flooring instead of traditional vinyl sheet tile, eliminating the need to strip wax with toxic solvents.

"Patients recover more quickly in this environment," Arthur Mombourquette, Brigham and Women's vice president of support services and a key project planner, told the Globe.

The Boston projects are part of a nationwide trend to build hospitals that are healthier for patients, workers and the environment. As one indicator of the trend, more than 115 projects are registered as pilots with the Green Guide for Health Care (, a voluntary, self-certifying system for designing and building high-performance healing environments.

“As the first quantifiable sustainable design tool for hospitals, the Green Guide provides the framework for the healthcare industry to fulfill its commitment to ‘first do no harm,’” said Gail Vittori, co-director of the Center for Maximum Potential Building Systems and co-coordinator of the Green Guide Steering Committee. Vittori was recently named as an Innovator by Time magazine for her work on the Green Guide.

The Green Guide for Health Care is modeled with permission on the U.S. Green Building Council’s Leadership in Energy and Environmental Design Green Building Rating System. To date, more than 10,500 people have downloaded the free toolkit and some of the largest healthcare construction projects in the country are using it to design and construct some 30 million square feet of construction over the next decade.

Best practices in the Green Guide include:
  • Incorporating healing design elements such as daylighting and views. Studies show that patients with views of nature go home sooner, use fewer heavy medications and exhibit better emotional well being.

  • Using innovative technologies to reduce energy and water use. Hospitals can save significant amounts of money and greatly reduce their carbon footprints by incorporating energy and design efficiencies. More efficient waste management and smaller building footprints are other cost-saving strategies outlined in the Green Guide.
  • Reducing hazardous chemicals such as mercury, lead, dioxin, cadmium, phthalate plasticizers and halogenated flame retardants. By choosing safer materials, hospitals can enhance indoor and outdoor air quality, curtail building-related illnesses, and protect workers and the community at large from chronic diseases.
  • Implementing green operations, ranging from organic food, to green housekeeping and landscaping protocols.

Such innovations in the healthcare industry can benefit the bottom line, enhance patient and worker satisfaction, and also help shift the market toward safer non-toxic materials, Vittori notes. “The healthcare industry represents $16 billion and more than 100 million square feet of construction per year. Shifting healthcare’s building efforts toward environmentally friendly materials can be an enormous force for market transformation,” she said.

As one example, when Kaiser Permanente, the largest non-profit healthcare system in the United States, decided to purchase PVC-free materials for new construction, a carpet manufacturer agreed to develop a new PVC-free product made with non-toxic, recycled plastic at no extra cost. In exchange, the vendor won an exclusive contract with the healthcare system to supply carpet for millions of square feet in new construction. “In an era of rising construction costs, you don’t have to pay extra money and use precious healthcare dollars just to be green,” Christine Malcolm, a vice-president at Kaiser Permanente, told The Wall Street Journal.

With the industry’s purchasing power, “we can force suppliers to generate environmentally sensitive products,” Malcolm said.

For more information about the greening of the health care industry see:
Designing the 21st Century Hospital White Papers
Health Care Without Harm
Hospitals for a Healthy Environment
Green Guide for Health Care free downloadable green building toolkit

Stacy Malkan is communications director of Health Care Without Harm, an international coalition of 450 groups in 55 countries working to transform the healthcare industry so it is ecologically sustainable and no longer a source of harm to people or the planet.




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