The Sustainable Side of O&P

As the O&P profession looks to the future, it is plain to see that green is the new hot color.

In 2002, the U.S. Green Building Council (USGBC) hosted little more than 4,000 attendees at its first Green Building Conference. By 2006, 13,500 attendees visited the Greenbuild International Conference and Expo, and the 2007 event in Chicago welcomed more than 23,000 attendees. As of press time, USGBC had not released numbers from Greenbuild 2008, but early estimates from attendees place the turnout near 30,000.

Even in this time of recession, people are considering the larger picture. Now, more than ever, people want to lessen their impact on the environment and make the world a healthier place for themselves and for other living things.

Starting small

Cheryl Kelly, office manager at Grace Prosthetic Fabrication in New Port Richey, Fla., takes it one step at a time. In the year-plus she has spent at Grace Prosthetic, Kelly has revved up the company’s green efforts from accidental to purposeful.

“Even back before being green was the thing to do, everywhere I have worked, I have tried to reduce the paper, save a tree,” she said. “So when I came here, there were already some things they were doing, they just didn’t realize they were doing them.”

For example, Ed Grace, president of Grace Prosthetic Fabrication, and his staff members use a recycling bin for their aluminum cans and another container for plastic bottles. To further cut down on the amount of bottles going into the recycling bin, Kelly is looking into getting a water filtration system for the building. This system will connect to Grace Prosthetic’s water supply and significantly reduce the amount of plastic bottles that are generated by its staff members.

In addition, Grace Prosthetic takes advantage of the local climate to lessen its environmental footprint. Aside from the summer months, the company uses ceiling fans instead of air conditioning units.

“We just open up the doors and we’re right off the Gulf so we have a nice Gulf breeze that blows through,” Kelly said.

Also under the umbrella of recycling, Kelly collects used shipping supplies to reuse on future orders, like boxes, packing peanuts and bubble wrap.

More about Grace Prosthetic Fabrication’s conservation efforts — including its customer outreach program, Help Grace Go Green — will follow in an upcoming issue.

Thinking big

Hands holding plant
© 2008 iStock International Inc. /Viorika Prikhodko

Many companies with larger budgets are able to make much larger efforts. One such company is Subaru.

Entering the green game fairly early on, Subaru of Indiana Automotive Inc. was the first auto assembly plant in the United States to be ISO 14001 Certified. Determined by the International Organization for Standardization (ISO), ISO 14001 is a generic management system standard for grading the effect of an organization or company on the environment. According to ISO’s Web site, it had issued at least 154,572 ISO 14001 certificates in 148 countries and economies up to the end of December 2007. Figures from 2008 were unreleased as of press time.

In May 2004, Subaru’s Indiana plant also became zero landfill — by reusing or recycling 99.8% of waste and having the remaining 0.2% destroyed in an environmentally safe manner — the first auto assembly plant in the United States to achieve this distinction.

Overall, the plant reported that its 2007 recycling saved 29,900 mature trees; conserved 53,116,000 kilowatt-hours of electricity; left 26,377 cubic meters of landfill space free; cut gasoline consumption by 131,354 liters; and conserved 38,368,933 liters of water.

Since 2004, several others have followed Subaru’s lead. General Motors recently announced that 43 of its global manufacturing operations have reached landfill-free status. And it’s not just car companies getting involved: All of Xerox’s major manufacturing sites were ISO 14001 Certified in 1997, and Fetzer Vineyards, of Mendocino County, Calif., was the first in California to purchase 100% green energy for all its winery operations, according to the companies’ Web sites.

Taking care

Though the health care sector was slow to join the push for sustainable business practices, it continues to pick up pace quickly. With help from the Center for Maximum Potential Building Systems in Austin, Texas, green building for health care is well on its way to catching up with other specific market segments.

The Center, established in 1975, is a nonprofit organization “engaged in the intersection of the built and natural environments, and understanding the human contribution to that in an ecosystem construct,” Gail Vittori, LEED AP, co-director of the Center, told O&P Business News. “Buildings have a big part of defining ecosystems, and we work in the realms of policy, education, research and demonstration to advance thinking and action around a more compatible relationship between the built and natural environments.”

Working side-by-side with the USGBC’s Leadership in Energy and Environmental Design (LEED) Green Building Rating System, Vittori and the Center have been instrumental in establishing both the Green Guide for Health Care and LEED for Healthcare. While the Green Guide serves as a self-certifying best practices toolkit for people to determine necessary steps in their projects, LEED for Healthcare will provide third-party certification to distinguish those projects.

Although both tools designate general strategies, they also touch on the specific needs of health care.

“In health care, there’s significant interest in the health and healing part of green building, in terms of patient and staff well-being. There’s also a significant cognizance of the footprint that health care has on natural resources used, whether it’s energy use and climate implications of that, water use, land use, how it fits into an urban or a non-urban context,” she said. “I think, overall, [there is] this growing sense that health care can emerge as a leadership voice in specifically understanding the human health dimensions to their built environment activities.”

Building health care

Vittori and the Center convened the Green Guide in 2002 with funds provided by the Merck Family Fund. A volunteer steering committee was formed, including representation from the USGBC. With USGBC’s permission, the Green Guide took advantage of the LEED framework as its foundational structure. Individual credits were shaped to give the guidelines relevance to the health care community. Specifically, emphasis was placed on the human health dimension of each aspect.

LEED for Healthcare was initiated in 2004 with the formation of a core committee, of which Vittori is the founding chair. Now 4 years in development, LEED for Healthcare is finalizing the first public comment draft phase. The second public comment draft, due for release this year, will include revisions made in response to the first public comments, and will be aligned with LEED 2009.

Vittori explained some of the credits featured in LEED for Healthcare.

Health care facilities — like acute care hospitals — are encouraged to have places of respite for staff members, patients and visitors. Also addressed is a credit addressing the significant use of process water in hospitals, estimated to represent about 70% of total water use versus domestic water use. In this respect, the draft LEED for Healthcare significantly differs from LEED for New Construction, where process water does not represent a significant percentage of water use.

Additionally, the LEED for Healthcare draft includes a credit regarding furniture and medical furnishings, also not specifically addressed elsewhere in LEED rating systems targeting new construction projects. Health care indeed is a distinct sector.

“Right now, health care projects are a relatively small percentage of total LEED registered and certified projects, but as these tools come out that are targeting specific market sectors, they’re likely to then initiate a much higher percentage of involvement,” Vittori said.

In addition, she pointed out that several states and municipalities have started requiring that building projects use the Green Guide for Health Care, now a project of the Center or Maximum Potential Building Systems and Health Care Without Harm, or the USGBC’s LEED rating system. These requirements also will raise the number of participants in LEED projects.

“It is viewed today, not just as a best practice, but really as a 21st century imperative as we better understand the relationship of the built environment to what’s happening to the natural environment, and the relationship of the built environment on people,” Vittori said.

LEED Credit Categories

The U.S. Green Building Council’s Leadership in Energy and Environmental Design (LEED) Green Building Rating System breaks down into six credit categories. They are:

Sustainable Sites
This category addresses the location of the building, and the ways in which the site location contributes to the sustainability of the project, including issues dealing with erosion, urban redevelopment, availability of alternative transportation and landscaping.

Water Efficiency
This category serves to determine the best use of water for the project. Factors consist of the use of water-efficient landscaping, innovative technology for wastewater, and overall water use reduction.

Energy and Atmosphere
This category includes optimizing energy performance, using renewable energy, eliminating harmful factors and switching to green power when possible.

Materials and Resources
This category focuses on reducing, reusing and recycling all kinds of building waste.

Environmental Quality
This category addresses the issues of air quality in the project, such as ventilation effectiveness and low-emitting materials, as well as issues of comfort and ability proximity to daylight and views.

Innovation and Design Process
This category promotes innovation in green design.

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Making changes

For O&P businesses that are just starting up, the world of sustainable building is wide open. Business owners can follow the LEED for Healthcare guidelines when it is launched to build a green facility worthy of ISO 14001 status.

For those with existing O&P facilities who still want to make a difference, there are some measures business owners can take to create a greener practice.

Kelly suggests plenty of research — online and otherwise.

“Sometimes, if you contact your local utility department, they can give you advice on what is available,” she said. “Or [the utility company can] come out and take a look at what you have and they can give you advice on what improvements you can do to green up the place.”

Another matter for practitioners to consider when going green is their bottom line. Overall, the benefits far outweigh the costs.

At this point, green construction is no longer the new fad, and has become mainstream enough for the cost to come down significantly. Furthermore, additional cost business owners do incur can be nominal and often quickly paid back, Vittori said.

“Beginning early and having integrated design embedded in decision making where you have many different disciplines involved, that seems to be a hallmark for putting people on a development track that helps to prevent unnecessary high first costs,” she said. “It also means that you’re thinking more systemically about your project, which usually also translates into not adding costs but integrating function, and by doing that you don’t layer on additional costs.”

The LEED rating systems continue to improve with each passing public comment period, and the structure allows for individual credits to be updated as necessary, so the systems never lag behind.

For LEED 2009, Vittori said, there is a specific emphasis placed on climate change and human health, allowing the entire rating system the ability to be fine-tuned based on those criteria that are so integral to all aspects of the health care sector.

The future of all green building addresses people’s health. It is only natural that health care steps up to the green challenge.— by Stephanie Z. Pavlou

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