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Synthesis/Regeneration 48   (Winter 2008)

Reducing Energy Use in Hospitals

by Abbe Sudvarg

When I was asked to give a presentation at the Surviving Climate Change roundtable, it was the first time I had really ever given any thought, or time to research, on the question of reducing energy consumption in health care. As a family practice physician, I have worked for 20 years in community health centers. Because the mission of my work has been to provide health care to underinsured and uninsured people, I have spent much of my life thinking about improving health care access while reducing costs.

Now that I have researched energy consumption in health care, I understand that the solutions for improving health care access, reducing costs, and reducing energy consumption and greenhouse emissions in health care are much the same. In the United States, we have a for-profit health care system. In order to solve all of these problems in health care, we need a coordinated, single-payer, universal health care plan in this country.

Hospitals are probably the largest consumers of energy in the health care field. According to a statement released on July 23, 2008 by the US Department of Energy (DOE), in 2007 hospitals spent more than $5 billion on energy costs alone. Hospitals use 836 trillion BTUs of energy annually and produce more than 30 pounds of CO2 per square foot of space — an energy intensity that is more than two and a half times higher than the consumption and CO2 emissions of commercial office buildings. In order to reduce these numbers, the DOE has started a program called EnergySmart Hospitals.

Even within the current structure of health care, the DOE has demonstrated that it is possible for existing hospitals to lower their energy consumption by 20–30%. Most of the solutions for this modest (but significant) reduction are simple. In a typical hospital, lighting, heating and hot water account for more than 60% of total energy use.

Hospitals can install occupancy sensors in rooms and on computers. They can install higher efficiency lighting. They can adjust thermostats to reduce heating and cooling in unused rooms. Modern detergents and bleaches allow laundering of biohazard-contaminated fabrics at 120°F instead of the traditional 160°F.

Hospitals also use and discard large quantities of petroleum-based processed and transported products, ranging from gels and lubricants to plastic dinnerware, syringes and IV tubing. Large sets of disposable operating room materials will be opened to obtain a single item. (And, of course, the rest of the unused disposable instruments in the set will then be thrown away.) Cloth drapes in operating rooms and obstetrical delivery suites have been substituted with paper that is thrown away after a single use (or non-use).

Although modest changes in energy consumption and CO2 production are possible under the current US health care system, real change can only come through true systemic change. We will, and must, always have hospitals. People get sick. Or hurt. It is the moral obligation of our society to take care of our sick and injured.

But if we placed more emphasis on preventive care and public health, we would have fewer illnesses requiring hospitalizations. Every person living in this country should be fully insured and have a doctor. They should have what is now called a “health care home.”

Why do we have a system where, in a large city, three hospitals will exist in a five-mile radius, each only half filled? Profit.

Every pregnant woman should have quality, early prenatal care, so that she will be less likely to have a premature baby who spends weeks in the neonatal intensive care unit (ICU). Everybody should have access to care for their hypertension and high cholesterol, so that they will be less likely to end up in an emergency room (ER) with a stroke or a heart attack. Every person should have a doctor, with whom they have a relationship, who will help them stop smoking. Every infant should be immunized against Rotavirus, so that there will be fewer hospitalizations for severe dehydration. Every diabetic should get the flu shot, to prevent the severe lung illnesses that can lead to time in an ICU. An ounce of prevention really is worth a pound of cure, and a pound of cure uses many more BTUs of energy.

The ER has become the primary care home for the poor and underinsured. If an individual goes to the ER for a headache or back pain, s/he will get radiology studies and blood work. But if a 25-year-old woman has a doctor, and has a relationship with that doctor, she is not likely to get a CT scan of the brain when she presents with a simple migraine headache. She will get appropriate pain relief and will get sent home to rest in a darkened room.

One of the most important aspects of reducing energy consumption depends on reducing the number of individuals who will need health care. As a nation, we must get past the religious and political barriers that make universal access to family planning services so difficult for many individuals. Every man and woman should responsibly control their reproduction. All forms of contraception should be free and accessible to every individual of reproductive age.

Until we have a universal health care system that is driven by the best interests of the public, and not by profit, we will continue to have too many hospitals sucking too much energy. Only with public planning will we have a reduction in the number of redundant services. Why do we have a system where, in a large city, three hospitals will exist in a five-mile radius, each only half filled? Profit.

We can significantly reduce the consumption of energy in health care, and reduce the CO2 emissions we produce. As a nation, we must have the will to completely change our view of our health care delivery system, put more emphasis on prevention and community health, and reduce the use of hospitals.

Abbe Sudvarg chairs St. Louis’ Peace Economy Project, which educates and organizes around the human and economic costs of militarism and weapons production.

[17 dec 08]

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