#greenHC Part 7 (last one): Why am I interested?

From my LEAN training, I’ve learned to always ask “Why?” and this topic is no different for me. I did not train at a place where sustainability was emphasized, so I asked why it’s emphasized where I work now, Kaiser Permanente.

Answer: this is in our DNA, too

The first images are from the Sidney Garfield, MD, designed Walnut Creek hospital, which opened in 1953. Family could access patient rooms from an outside walkway, leaving the central corridor of the nursing wing free for nurses. There’s a video reel on the Kaiser Permanente History blog that shows just how ahead of its time this hospital was, and yet, the benefits of mother nature were well respected.

Sidney Garfield’s industrialist partner, Henry J. Kaiser, was similarly genotyped:

In 1942, Kaiser built the first steel mill west of the Rocky Mountains, and insisted that his engineers make it the cleanest in the United States and Kaiser Steel installed the most sophisticated smokestack and furnace emission screening devices available. (See: Kaiser Permanente and Earth Day 2010: It’s in Our DNA)

Flash forward to 2008 and 2012: The image on the left is of Kaiser Permanente Modesto, one of the greenest health care facilities in the United States:

  • Vinyl flooring has been replaced with rubber
  • Carpeting is PVC free
  • Partially energized by solar power
  • All cleaning and maintenance materials have a lower toxic footprint
  • 80% of the materials used in the building process were recycled

The image on the right is a depiction of a parking structure covered with solar panels. Kaiser Permanente agreed in 2010 to install solar power systems at 15 California facilities, a total of 15 megawatts of solar energy, which would power 15,000 homes in one year.

Kaiser Permanente’s San Diego Hospital went live on January 25, 2012 with 4,958 solar panels, which will provide 25 % of its energy. Kaiser Permanente’s La Mesa Medical Office Building went live with 4,926 solar panels over its parking structure, providing 75 % of its power.

The next two slides quote the Kaiser Permanente Vision for Environmental Stewardship & Guideline for Climate Change. A vision doesn’t make people do things, it describes what they are like and where they want to be. The first image is of the 2009 Environmental Protection Agency Award for….

Green Health Care and Social Determinants go hand in hand

The image on the last slide is a personal story, which I wrote about previously on this blog. I am not an environmental activist. I am not sure I ever will be. What I am is a patient activist, a diversity, activist, and a health activist. On this particular day, I was at “work” encouraging colleagues attending a conference to not ride in the gas guzzling hotel shuttle, almost standing in front of the boarding doors. Was it easy to do this? No. Was it fun to do? Not particularly (the walk was awesome, however). Did anyone try and stop me? No. Did my colleagues take myself and my co-conspirator on the offer? Yes.

And then we happened on the gentleman in the middle of the photograph. He, along with others around Washington, DC, that day were mourning the 1 year anniversary of the worst man-made environmental disaster in history (guess which one…). None of us realized what day this was, I realized that we were fully supported in thinking of health broadly. Because of that support, we would find ourselves in the company of people who think of health broadly, too, and we would support them as well.

Some of those people don’t have the kind of voice that physicians have.

The Royal College of Physicians has written a wonderful white paper (See: How doctors can close the gap: Tackling the social determinants of health through culture change, advocacy and education) that speaks to the issue of social determinants of health and what physicians can and should do to reduce inequalities. Becoming active in green health care and sustainability is one of the key places they recommend action, because people at the lower end of the social gradient are disproportionally affected by environmental threats.

Reducing health and social inequalities, giving people a voice when they don’t have one, thinking of health more broadly than health care, that’s why I went into health care :).

By the time this post is published, I will have presented all of these slides at ACPM2012.  I am on a roll, though, because tomorrow I’ll be on a panel at the Bipartisan Policy Commission talking about healthy institutions. Prevention is the new HIT….

Ted Eytan, MD