What is Green Hospital?

A trip to the Hospital is not exactly on every one's To Do List. With harsh Chemicals and bad air quality, Hospitals are sometimes the unhealthiest place to visit. From limiting their toxic waste to reducing their energy and water usage are not only things that are green, however. Hospitals are using green cleaning products. 

Today, Leading edge healthcare organizations are striving to create environment that are more conducive to healing, while also working to eliminate barriers to the patient safety and environmental risks. 

The Goal is to ensure that inpatient and outpatient setting have a positive, rather than a negative impact on patient's health.

Hospitals are also realizing that it is time to shift their focus from stylistic demands to the more sensible and intelligent forms of architecture.  The genre of sensible and intelligence based on architecture involves effective utilization of natural resources, effective disposal and recycling of waste management, efficient use of energy, low operational cost, positive patient and staff outcomes and utilization of building materials with minimal content of toxic and volatile organic compounds (VOCs) Green Architecture can perhaps be the answer for this pressing energy saving, environmental friendly and sustainable development.   


Green Hospitals Defined:

A Green Hospital Building can be defined as one which enhances patient well being, aids the curative process, which utilizing natural resources in an efficient environment friendly manner.

Can a building help cure you? 

Research shows that a well designed hospital building can actually accelerate the curing process. Increasingly therefore, designers are focusing on green strategies to enhance the positive impacts on patients and staff in hospitals. Design professionals need to know how their building will enhance the cure - through spatial and physical ambience.     

Common Problems of the Hospitals related to effective utilisation of resources:

1. Most of the hospitals depend on artificial light and spend 3 to 4 times more energy expenditure signifying the opportunity for cost savings.
2. Lack of implementation of procedures for proper disposal of materials in hospitals is causing environmental pollution problems.
3. Lack of implementation of procedures for proper maintain adequate potable water supply in their hospital.
4.  Lack of implementation of procedures for proper maintain indoor air quality along with passive and active measures. 

Tomorrow’s environmental solutions:

As hospitals typically use significantly more resources and produce more waste than comparably sized commercial buildings, the effective deployment of environmentally driven strategies to improve resource management is of critical importance in the development of sustainable healthcare facilities. A World Health Organization (WHO) report published last year urged hospitals to proactively address the environmental footprint of the healthcare sector by reducing power consumption, utilizing alternative energy generation, and through the recycling and conservation of resources.

A range of energy efficiency measures, which rightly form the starting points for many global green hospital initiatives, are being adopted both in the renovation of existing facilities and the construction of new hospitals. Core measures include the use of energy efficient medical equipment and lighting systems for hospitals to reduce energy expenses, as well as the deployment of technologically advanced energy management systems that leverage onsite renewable energy sources.

These transformational energy solutions, coupled with the implementation of efficient water management and a focus on the reuse of resources, can greatly reduce the overall environmental impact of healthcare facilities, increase efficiency, and reduce cost of operations.

Besides the goal of reducing carbon footprint, hospitals are also looking at how to introduce the increased use of daylight lighting and natural ventilation into the healing environment. To raise the standards of patient care, a sustainable hospital design should also look at improving air quality by exploring ways to reduce the amount of harmful toxins and contaminants used across clinical departments.

Advantages of establishing green hospitals:

• Improves quality of care

• Faster patient recovery time thereby reducing the length of the stay in the hospital

• Employees are motivated and hence improve their quality of work

• Reduction in operation cost by optimum consumption of power and water

• Improvement in the overall hospital performance

Though this concept of green hospitals has significant advantages, yet it is not implemented by many hospitals in India. Lack of awareness, infrastructure, knowledge and proper recycling facilities is a major hindrance for such green initiatives. Thus, hospital planning companies in India should emphasize more on planning and building green hospitals and find out ways in which green hospitals can be best implemented in India as they are linked to a healthy environment and better patient outcomes. 

Focus Areas for Green Hospital Design:

• Lighting 

• Indoor Air Quality - Passive & Active Measures

• Green House Keeping

• Clean & Green Interior Building Materials

• Gardens & Landscape

Lighting: 

A good hospital design should maximise day light and optimise the artificial lighting requirement. Day lighting is the controlled admission of natural light from the sky (Direct & Diffused), into a Hospital building, so as to reduce the use of electrical energy for lighting.

Benefits of Day Lighting in Hospital:

Day lighting has been proven to have positive effects on patients in hospital.

Enhance health & well being of the patients and reduce stress levels of the hospital employees, thus improving quality of care.

Combats seasonal affective disorder, or winter depression, through view connectivity to natural vistas.

Building can save up to 20% of cooling energy load by optimally substituting artificial lighting with day- lighting.

Artificial lighting is required in sensitive areas of the hospital including O.T, Pharmacy, Interior corridors and Passages. However, with rising energy costs and high initial investment, it is imperative to reduce operational cost of lighting in hospitals by combining natural lighting and efficient artificial lighting.

Some of the passive design aspects to enhance natural lighting in hospitals:      

• Design glazing facades so as to have both view & day light.

• Install Translucent Skylights having soothing colours.

• Have transparent & operable opening to green court yards.

• Consider ledge seating at window for engaging nature in the curative process.

 Some of the design aspects to enhance efficiency of artificial lighting in hospitals:

• Use occupancy sensors in passage ways, storage room, labs, etc.  

• Install low energy LED lighting to save on indoor lighting energy cost (up to 40%).

• Use task lighting to provide illumination in task areas like consulting room, labs and wards

Indoor Air Quality by Passive & Active Design:

As restoring and safe guarding health is the main purpose of healthcare facilities, indoor environmental quality is considered critical to green hospitals.

Have in place permanent entryway systems at least 10 feet (3 meters) long in the primary direction of travel to capture dirt and particulates entering the building at regularly used exterior entrances. Acceptable entryway systems include permanently installed grates, grilles, slotted systems that allow for cleaning underneath, roll-out mats, and any other materials manufactured as entryway systems with equal to or better performance. Maintain all on a weekly basis.

Must Do’s for good indoor environment:

• Install permanent entry way systems to capture dust particle like slotted systems, grates or grilles at all primary entrances.

• Use certain species of indoor paints which not only produce oxygen but also reduce indoor pollutants like VOC (Volatile Organic Compound) from air.

• Improve fresh air by providing courtyard spaces with native & adaptive plant species, which are free from any allergic effects.

• Use Zero VOC (Volatile Organic Compound) interior materials.

Green Housekeeping:

Accumulation of dust, soil and microbial contaminants on surfaces is a potential source of hospital acquired infection. Effective & efficient cleaning methods and schedule are therefore necessary to maintain a clean & healthy environment in healthcare buildings.

Today housekeeping policies & procedures increasingly bring in a focus on making a positive environmental impact.

Typical measures include:

• Insist on cleaning products that meet environmental standards
• Provide personnel training for safe handling and disposal of hospital waste
• Consider waste recycling, wherever feasible.

Not just chemicals, it includes various components such as:

• Chemicals
• Parking Space
• Entrance Matting
• Micro Fibber
• Recycling and waste reduction
• Water and Energy conservation
• Liners
• Procedures, Training, Work loading and Scheduling
• Communications
• Recycle Programs/Waste Reduction/Conservation
• Equipment and Custodial Hardware
• Filters
• Paper
• Ice Melter
• Pest Management

 Clean & Green Interior Building Materials:

Hospitals may inadvertently contribute to illness by exposing patients and staff to a host of pathogenic germs & toxins that enter the hospital premises through the medium of a large number of infected patients.

• Ensure that the hospital surfaces have the property of repelling or resisting the growth of pathogenic germs and bacteria. Patented interior surfaces are now available which resists bacterial and fungal growth. These include Countertops, Tiles, Vinyl Flooring, etc.

• Consider using copper based interior materials. Recent research also shows that copper is also a good material for common ‘Touch’ surfaces in hospitals (Door Handles, Light Switches, Faucets, Countertops, etc.) due to its microbial resistant properties.

• Use indoors & flooring which do not emit/ absorb / re- release indoor pollutants such as VOC’s and dust.

Garden & Landscape:

Garden & Landscape are an aesthetic delight and promotes wellness of patients in hospitals. Persons exposed to plants have higher levels of positive feelings (Pleasantness, Calm) as opposed to negative feelings (Anger, Fear).  

Various research studies show that recuperation from stress is faster and complete when patients are exposed to natural settings than any other form of built environment.

In landscaping, the focus has been in using native plants like roheo, chlorophytum, bahunia purpuria, bahunia blackiana, plumeri alba, pisonia alba, polyathia longifolia etc. that require less water for survival.

Written by:

Dr. Praveen Bajpai

Director of Ingenious Healthcare Consultants Pvt. Ltd.
Founder of Skill Sathi

MBA in Hospital administration, PG Diploma in Quality Accreditation, PG Diploma in Medico Legal System, M. Phil in Hospital Mgmt. from BITS Pilani, P.hD in Management, Certified NABH Auditor, Certified NABL Auditor, Certified Auditor for Clinical Audits, Green Belt in Six Sigma, Certified in Hospital Infection Control Practices, Certified trainer for International Patient Safety Goals, Certified Auditor for JCI 7th Edition Standards 

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