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green@work : Magazine : Back Issues : Jan/Feb 2004 : Cover Story

Cover Story

Putting the Healthy Back Into Healthcare

Eighteen Kaiser Permanente facilities were singled out in April 2003 for exemplary accomplishments from Hospitals for a Healthy Environment (H2E), a partnership of the American Hospital Association, the U.S. Environmental Protection Agency, the American Nurses Association and Health Care Without Harm. Kaiser Permanente also received an award from the Healthy Building Network for accelerating the transformation to healthier building materials through purchasing policies
and actions.

“Our mission is and always has been to improve the health of the communities in which we serve, and that includes an emphasis on environmental stewardship,” said George Halvorson, chairman and CEO of Kaiser Foundation Health Plan and Hospitals. “We continually work to improve the environmental friendliness of our existing medical facilities, and the designs for new facilities reflect our commitment to environmentally state-of-the-art construction and materials. What’s good for our environment is going to be good for our members, our staff and the community as a whole.”

“As physicians, we think the Hippocratic Oath says it all: Above all, do no harm,” added Jay Crosson, M.D., executive director of The Permanente Federation. “That
credo applies to the environment as well as to our patients.”

Kaiser Permanente’s environmental initiatives are grouped into three main areas:

1. Green Buildings

Incorporating sustainable design and construction practices through environmentally sound facility templates used in all new construction and re-builds. These practices incorporate:

* Implementing efficient water and energy systems.
* Using the least toxic building materials.
* Recycling demolition debris, diverting thousands of tons of materials from landfills.
* Making use of daylight whenever possible.
* Managing storm water to enhance surrounding habitats.
* Reducing site development area
(e.g., total gross square footage) to concentrate and limit total paving and other site disturbances.
* Installing over 50 acres of reflective roofing.
* Publishing an Eco Toolkit reference book, providing it to Kaiser Permanente capital project team members and more than 50 architects and design alliance partners.

2. Environmentally Responsible Purchasing
Kaiser Permanente incorporates environmental considerations into targeted national contracts. These considerations include:

* Reducing the toxicity and volume of waste.
* Increasing post-consumer recycled content.
* Selecting reusable and durable products.
* Eliminating mercury content.
* Selecting products free from polyvinyl chloride (PVC) and di-2- ethylhexyl phthalate (DEHP).

3. Sustainable Operations
Activities designed to ensure its commitment to sustainable operations include:

* Waste minimization resulting in the recycling of nine million pounds of
solid waste.
* Electronic equipment disposition resulting in the recycling of 36,000 electronic devices containing
10,500 lbs of lead.
* Optimal reuse of products which led to reprocessing 53,851 pounds of medical devices and supplies.
* Capital equipment redistribution.
* Greening janitorial cleaning products.
* Recycling and reuse of 8,300 gallons of solvents.
* Energy conservation resulting in the recycling of 30,000 spent fluorescent lamps.


In the course of its first year, KP’s Environmental Stewardship Council has achieved many impressive accomplishments. It has diverted more than 8,000 tons of material from municipal landfills through reuse or recycling efforts; 97,000 pieces of electronic equipment, collectively weighing approximately one million pounds, were reused within KP, redeployed outside KP or recycled domestically; 20,000 of these units were outdated monitors containing 140,000 pounds of lead. In addition, disposal avoidance savings in excess of $1 million were realized. In 2002, 70 million pounds of air pollutants were prevented by implementation of standard energy conservation measures for lighting, temperature control and physical plant equipment updates.

Mercury pollution has long been a health risk. In 2002, KP removed in excess of 500 pounds of mercury from a local community by holding a public mercury fever thermometer exchange. Over 80 percent of its healthcare operations are more than 90 percent mercury-free (based on third party assessments). It is currently assessing the remaining facilities in anticipation of being virtually mercury-free by 2005. Also
in 2002, KP recycled 270,000 fluorescent lamps preventing approximately 189,000 pounds of mercury-contaminated waste from entering municipal landfills.


Epidemic of Care offers a comprehensive assessment of the factors behind the healthcare cost crisis, how the crisis will escalate and what can be done to improve the situation. A blueprint for getting to a coherent national health policy, this book calls for a collaboration between different parts of the private sector, state and local governments, and, at times, the federal government—with a formula that can succeed no matter who rules Congress. Authors George C. Halvorson and George J. Isham, M.D.—two individuals who have made an impressive impact on the national healthcare scene—
provide some practical, field-tested, sometimes controversial suggestions about how to make healthcare in this country more accountable, more efficient, more valuable and more affordable.


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