By Janet Brown, Director, Sustainable Operations, Practice Greenhealth.
The Center for Health Design describes healing environments as meeting three criteria – reducing stress of building occupants, improving safety and contributing to ecological health. Healthcare’s emerging commitment to environmental action is intertwined with the worker and patient experience. Acknowledging the connection between worker and patient satisfaction reminds us to properly care for the care provider. Addressing safety issues, efficiency and respect issues are nourishment and help maintain the physical and emotional capacity to give of themselves to the patient – healing the healer. Healing the healer is an investment in health care’s biggest resource – the worker.
Healthcare sustainability leaders recognize that sustainability programs go beyond arrows and bins and impact investments, real estate, sizing, construction, energy systems, job descriptions, patient education, health screening and the entire patient model of care. This programming require employee engagement at every level and inspiring the masses takes a variety of forms – research and other evidence, clinical presentations, public meetings, leadership training, forums, financial incentives, orientation, awards, raffles and job descriptions. The best way to engage the worker is to know the worker, to listen to the worker, to include the worker in decision-making and to honor the worker.Engagement isn’t just about education and raffles – the physical space impacts how one feels at work and on break. Renovation and new construction can benefit from sustainable design policies and an integrated design team so that operational issues are addressed with the new space that facilitate team-work, the worker and patient experience and the commitment to healing environments. Health care workers have the highest rate of workplace asthma, more than any other industry, and chemical sensitivities can be taken seriously through fragrance free work environments, greener cleaners, safer building materials and toxin-free furniture and flooring that doesn’t require waxing and stripping, to name a few. Artwork, meditative spaces, views of nature, farmer’s markets and educational events can inform and inspire patients and staff.
The employee messaging starts from the moment they step foot in the door through new employee and departmental training. Engagement is also demonstrated through timeliness in addressing concerns around air quality, toxicity or other safety issues, clean and pleasant break room environments, nutritional food and regular monitoring of workplaces. When top performing health care facilities explain how their leadership got onboard (which is something that many are still working towards), it starts off with leadership having their “Ah ha” moment. Leadership buy-in is critical but it’s not enough – sustainability, passion for positive change, continuous improvement, understanding of the connection between human health and the environment and man’s impact on global climate change should be part of any decision-making, staff interviewing and job descriptions and articulated within values and organizational goals.
Working in a health care facility and walking the floors for as many years as I did offered cherished gifts from all walks of life. Just like pearls are found mixed under sand and shells, so is wisdom found beneath long hours, too many patients and packed shifts.
In my 13 years working in a facility in New York City, I worked hard to motivate departments to tackle environmental improvement activities as a departmental quality improvement initiative. Through a contest, rewarding the most progress, we celebrated the department of engineering for their efforts in bulb recycling and energy conservation. We set up a celebratory event, purchased food as requested by the workers, had a fancy cake and secured leadership’s participation. The workers wanted to hold the event in their workspace in the sub basement, where they were comfortable. We hired a photographer to take pictures of the event and gave each worker an earth pin to celebrate their departmental and individual accomplishments. One of the supervisors who had been there over 20 years said that in his career at this facility, the administration had NEVER been in their workspace and voiced how great it was to have them on their turf. We made posters out of the event and placed them on easels at the entranceway to each facility and issued a press release to local papers with photographs of the workers. This was a way to both educate leadership of the specific activities that made up “going green” in a support area and celebrate the worker, their new healthier habits and the departmental impact.
The “Portrait of” Campaign was an effort to raise awareness around worker safety and respect. The campaign put a name and a face to a job title and to learn more about them as an individual. This campaign was well-received and helped raise awareness around team work and respect for others.
My success was not easily achieved. Resistance to change can happen anywhere in the organization ranging from the researcher who will go to the grave clutching his/her mercury-containing barometer, to a purchaser who isn’t interested in spending more for energy efficient equipment (even if operating costs are less) to a food service employee who throws chicken bones into a recycling bin, to a housekeeper saving time by collecting red and clear bags into the same red bag. It’s these little individual challenges that can lead up to one big mess and really limit the reach of sustainability and culture changing efforts.
Workers are very busy and changing habits can be tough, even for those who are onboard in spirit. While the new hires may not have past culture to serve as an obstacle, those with the longest history with the organization may have the most resistance to change. Environmental improvement activities should be simple, clear and efficient and piloted to work out any kinks before kicking off house-wide. Too many changes at once can lead to chaos and many mediocre initiatives. Pacing, prioritization and strategic decision-making help with quality programs and outcomes. But there will always be those that don’t want to participate and just like Dr. Seuss’ north and south going zax, progress will continue in spite of them. Some may stand firmly in their tracks and progress will grow around them.