Green Hospital: not only ecological, but holistic sustainability
Green Hospital: not only ecological, but holistic sustainability
Interview with Anja Schönheit-Müller, Director of Nursing, REGIOMED Klinikum Lichtenfels
The REGIOMED Klinikum Lichtenfels is the lighthouse project of the "Green Hospital Initiative Bayern" (Bavarian Green Hospital Initiative), which launched in 2014 and aims to increase energy efficiency and promote sustainability in Bavarian hospitals. Lichtenfels took things one step further by constructing an optimized new building where sustainability is an integral part of all hospital units and departments.
In this MEDICA-tradefair.com interview, Anja Schönheit-Müller talks about the sustainable use of resources in hospitals and explains why this encompasses more than just energy and water.
Ms. Schönheit-Müller, what is the level of interest in "Green Hospitals"? Is the Green Hospital Lichtenfels a role model for other hospitals in terms of implementation?
Anja Schönheit-Müller: We received several inquiries from international and regional parties, which expressed interest in our endeavor. Unfortunately, the "Green Hospital" concept is not as widespread as it could be, which is why it is crucial to educate and inform hospitals on a deeper scale. A new building is not what is important in this case. There are many individual measures that can generally be applied to all healthcare settings. The hospital location dictates the respective components, but even small changes can have a big impact.
Which measures promote greater energy efficiency in your new building?
Schönheit-Müller: We have optimized our building envelope with a triple-glazed window system, and the use of heat recovery, geothermal energy, solar heat, biogas, green electricity, and photovoltaics integration. The Green Hospital should be sustainable wherever there is a use of resources. It emphasizes ecological, economic, and social sustainability.
Where do hospitals use an especially large amount of resources?
Schönheit-Müller: Commodities and energy are the key components on the ecological side. It is assumed that hospitals on average generate 6 kilograms of waste and consume 500 liters of water per day and patient. Some of this waste pertains to harmful cytotoxic drugs or cytostatics. Hospitals annually spend an average of € 3,300 in energy and heating costs per bed.
On the economic level, there are capital, processes and structures to consider, while the social component includes values, culture, employee motivation, and the trust of patients and referring physicians. The Green Hospital navigates through this so-called sustainability triangle.
How can employees contribute to sustainability?
Schönheit-Müller: Needless to say, everyone is encouraged to save energy and resources in the workplace. For example, waste sorting and separation is part of all of our wards and departments. Right from the start, we have involved our employees in change management and the design and construction of the new building. Workplace health promotion and annual health campaigns are also part of our commitment to employees, which also fosters involvement on their part.
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The new building of the REGIOMED Klinikum Lichtenfels features an open room concept with large windows. Moreover, lighting is adapted to the time of day and supports both the recovery of patients and positively affects staff this way
What has changed for patients?
Schönheit-Müller: Our integrated admission system boosts hospital workflow, improves the admission process, and optimizes bed occupancy rates and length of stay. We have a central patient admission office to manage all unplanned, urgent patients and emergencies. All other patients are subject to elective hospital admissions where they receive the required documents, admission testing, information and physician instructions. Patients subsequently go home and return on the day of their scheduled procedure. Patients ready to be discharged can wait in our discharge lounge to await pickup or discharge papers.
Apart from the wards, we have also created interdisciplinary care centers whose teams specialize in organs or organ systems. The Center for Neuromedicine for example integrates pain management, neurosurgery and parts of trauma surgery and cardiology. Primary care nurses, wound care experts and nutritionists provide patient-centered care in this setting. Besides high-tech medicine, we also want to facilitate high-touch medicine and create a close patient/provider relationship that is shaped by empathy.
Does the concept pay off?
Schönheit-Müller: Green Hospital concepts leverage economic savings and environmental benefits, which many hospital operators still do not recognize as fundamental factors. Rising healthcare costs threaten to decrease health services, especially in rural areas.
In my view, the staff members, their knowledge and motivation continue to be the most valuable assets as their commitment drives health care quality. As with all other valuable resources, Green Hospital helps to relieve staff members and attracts, nurtures, and retains top talent.
How do you manage to achieve that?
Schönheit-Müller: We established multiple measures aimed at rebalancing and reducing the workload. This includes a novel pneumatic transport system that is designed to send and receive documents between wards and departments via tubes. In the future, we also plan to fully digitize all medical and billing records. We have optimized our logistics processes and procurement structure thanks to a modular shelving system with barcodes. Our hospital supply assistants know immediately what needs to be ordered from the central warehouse and supplied to the respective wards and departments and can quickly identify items that must be reordered. Added to this is the already outlined bed management and hospital length of stay component.
Do you still see any room for improvement?
Schönheit-Müller: A culture of continuous improvement is necessary to make the concept work. The material perspective puts us on the road to a digital, paperless hospital with as many automated healthcare processes as possible. I also see potential in other services such as health promotion and counseling for patients, enabling them to leave the hospital in a much healthier state and prevent future diseases or health risks.
If we look beyond the hospital setting, it is clear that the entire healthcare system could use an overarching patient care delivery model that manages the complexity of all interfaces between facilities and optimizes the framework and health care structures. That is the path to true sustainability.
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