Last Updated Aug 18, 2008 8:26 PM EDT
Other than a possible seismic issue here and there, and maybe some other obvious exceptions (we'll just let that surgeon wash those hands and arms with the water running for a full 300 seconds, just in case), healthcare facilities around the nation are jumping on, and occasionally off, the green bandwagon. Green is clean, and nobody likes a dirty hospital. Indeed, it is the fantasy of every soon-to-be hospital patient that he or she is greeted at the door by Florence Nightingale and then whisked away to a private, state-of-the-art patient room complete with satellite television and high speed Internet.
Being a green hospital, however, is not so easy, and many of the suggested green practices may actually compromise patient care. Green cleaning products, mercury, lighting and basic hospital equipment are just four of many examples currently waiting at that crossroads where "green" public policy and generally accepted healthcare practices collide.
The Time Has Come for Hospitals to Clean Up, Seriously
Sometimes less really is more, and reducing toxic ingredients in any space will create more of a healing environment. For a hospital in particular, using less toxic cleaning products will reduce the stress on patients, visitors and employees, improve overall safety and make for a cleaner overall environment.
Traditional cleaning products are toxic and full of VOCs (volatile organic compounds). VOCs, in an estimated 35 percent of traditional cleaning products on the market, can cause blindness and very serious skin irritation. These same toxins can also lead to eutrophication -- defined as "the process by which a body of water becomes rich in dissolved nutrients, thereby encouraging the growth and decomposition of oxygen-depleting plant life and resulting harm to other organisms" -- smog, and may seriously interfere with the hormonal system of everyone and everything in close proximity. Long-term exposure has been linked to cancer, damage to the reproductive organs, kidney failure and neurological damage, among other concerns.
The Stakes Are Up For Hospitals With Sick Patients
In hospitals nationwide, an estimated 88,000 deaths occur each year as a result of hospital-acquired infections. The causes of these infections are just as numerous as the list of green cleaning supplies on the market today. In response to this after-admission epidemic, Medicare announced last fall that it would stop paying hospitals for any medical treatment directed at medical conditions not present at the time of admission. Known as MS-DRG's (medical severity â€" diagnosis related group) in the healthcare industry, the government's response is designed to hold hospitals accountable and make them financially liable for any medical condition acquired after admission and during that patient's hospital stay.
In light of the 88,000 annual deaths, coupled with the hundreds of thousands of post-admission medical conditions that can occur for any number of reasons during a hospital visit, if green means clean, then it better be good. Proper implementation of a "green cleaning program" must involve a multi-disciplinary team for research, implementation and oversight. Too much "disinfection" can cause harm to the patients, visitors and employees. Not enough can lead to nosocomial infections and eventually "free" medical care. Balance and common sense must prevail in any hospital's plan because missing from either side can create a disaster.
Bye Bye Mercury
Most hospitals have made significant progress in eliminating mercury from the facility. Mercury exists in all sorts of clinical devices from thermometers to sphygmomanometers and x-ray tubes to thermostats. And while total replacement of these mercury-containing devices may be expensive, a mercury spill will probably cost more.
Hospitals also need to identify and eliminate mercury-containing laboratory equipment. Many examples have readily available alternatives. Other materials used as staining reagents in histology and cytology (such as B-5 fixative, Harris Hematoxylin, Zenker's Solution, and Schaudinn's fixative) do not have as many readily available alternatives, or none at all. Prudence and patience will ultimately prevail, and once a hospital is mercury free, it must put practices in place to stay mercury free.
Electronic Equipment Enigmas
Computers, televisions, lab analyzers, EKG monitors and other types of biomedical equipment contain hazardous materials. Whether it is the lead in a cathode ray tube (CRT) monitor, the toxic plastics in cable wiring, brominated-flame-retardent-infested circuit boards to, yes, the mercury in LCD displays, healthcare facilities must be vigilant in managing disposal. Absent the appropriate disposal protocol, hospital waste can threaten the environment and public health. Hospitals, however, must be mindful that their disposal practices also comply with federal, state and local laws specific to healthcare.
Don't Turn Off The Lights, Ever
Hospitals are one of the few places where you just might need to keep the lights on all day, every day. The transition from incandescent lamps to fluorescent lamps reduces energy consumption and ensures a longer usage time. But if not disposed of properly, fluorescent lamps may release mercury (yes, mercury again) into the air, water and soil. That would be bad.
Hospitals really want to clean up their act, but competing influences often make the process challenging. Effectively managing the areas above is possible, but perhaps not so easy. The distinctions and sometimes contradictions that local, state and federal laws create place hospitals again at an unpleasant but somewhat familiar crossroads of conflicting policies. Things could always be worse, I suppose, especially if while standing at that crossroads, the earth began to shake.
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