Book Review: Greening Health Care: How hospitals can heal the planet:

Healthcare in America is undergoing many changes. From the Affordable Care Act (ACA), to electronic records, to an increasing awareness on the impact of facility design and management on patient and staff outcomes, the role of healthcare is being transformed both in clinical and in community settings. Although there has been increased awareness of the potential for healthcare to green their facilities and operations as part of these changes--particularly with the release of Leadership in Energy and Environmental Design (LEED) for Health Care in 2011--making the case for why this is good for hospitals' mission and bottom line has been less coherent. Kathy Gerwig's Greening Health Care: How Hospitals Can Heal the Planet provides both an historical overview and a practical guide for the healthcare industry on how and why hospitals can green their operations, programs, and facilities.As Kaiser Permanente's Environmental Stewardship Officer and Vice President of Employee Safety, Health, and Wellness, Gerwig is an industry leader with over 20 years' experience in pioneering the greening of healthcare. This experience is reflected in the books' two objectives. First, it gives an historical overview of the origins of the green movement for healthcare, its key players, and the evolution of initiatives like the Healthy Hospitals Initiative and Practice Greenhealth, with special focus on the pioneering role of Kaiser Permanente. Second, the book aims to provide examples specific to healthcare on how hospitals have greened their operations and facilities, ranging from healthy food procurement, to hospital waste, to measuring and reporting. Each chapter begins with a personal example of Gerwig's experience in the topic to be discussed, followed by a justification of why the issue affects both environmental and human health, and finishes with examples and case studies of how Kaiser Permanente and others have addressed the topic.[Image omitted: See PDF.]The book begins with a compelling story of Gerwig's realization of the chemical hazards contained in the medical equipment in Kaiser's neonatal intensive care unit (NICU) units in 2001, and the resulting realization of the need to address environmental concerns as part of Kaiser's healthcare mission. The rest of Chapter 1 gives an overview of the green healthcare movement, initiatives and key players, arguing that healthcare has both the responsibility and the potential to make a big environmental impact given their health without harm mandate and huge resource use in the United States. Chapter 2 continues this argument, focusing on why environmental sustainability is both good for healthcare's bottom line, such as saving millions in medical waste disposal costs, and necessary, such as dealing with power outages from hurricanes and other climate change weather events. Although Gerwig's overview of climate change and its health impacts will seem overly basic for those working in the green industry, it is clear that some of Gerwig's main audience--higher level hospital executives--still need convincing, and her argument is strongest when giving healthcare-specific examples, such as hospital outages in New York City during Hurricane Katrina. Chapter 3 focuses on the business case for Kaiser's Total Health approach that includes environmental sustainability, and gives an overview of Kaiser's tools, approaches and case studies of their economic savings from green initiatives. This chapter can be a bit confusing in Gerwig's switching back and forth between the historical narrative, Kaiser's approach, and current initiatives, but is strongest when explaining the impact of the ACA on healthcare and sustainability, or why LEED was not originally appropriate for healthcare.Chapters 4, 5, and 6 make strong arguments on why food, waste, and chemicals are important for both environmental and human health. Chapter 4 excels at linking the current health focus on obesity with the need for holistic food policies and programs in healthcare, and is particularly strong in citing the hazards of chemicals in food and packaging and the opportunity for healthcare to support organic and community supported agriculture. …