Green Healthcare System: Main Features in Supporting Sustainability of Healthcare System—A Review

  • Jazla FaddaEmail author
Part of the Innovative Renewable Energy book series (INREE)


Objectives: (a) To review the main components and characteristics of successful and sustainable healthcare system, (b) to review the main pillars of green healthcare, (c) to provide an evidence of the role of green healthcare as a driven force impacting the sustainability of healthcare system.

Background: Green healthcare system is likely to be most compelling because of its potential to protect and promote health, both directly and indirectly. “A successful health system has three dimensions: outcomes—means attaining the highest level of healthcare that is effective, safe, timely, patient-centered, and efficient; equity—meaning that treatment is applied without discrimination or disparities to all individuals and families, regardless of age, group identity, or place; and fairness—the system is fair to the health professionals, institutions, and businesses supporting and delivering care. According to IOM, there are were six objectives of the twenty-first century healthcare system: safe by avoiding injuries to patients, effective by avoiding underuse and overuse, patient-centered by ensuring that patient values guide all clinical decisions.

Key Finding: Green healthcare system will lead to health benefits operated at three scales; local scale, within the walls of a health facility, by promoting green construction and operation to protect patients, workers, and visitors. The review outlined the main components of Green Healthcare System: (1) leadership: Leadership is essential at all levels towards safety and sustainability key organizational priorities, through education, goal setting, accountability, and incorporating these priorities in all external relations and communications. (2) Substitute harmful chemicals with safer alternatives: The healthcare sector is a major consumer of chemicals including those well documented to cause serious impacts on health and the environment. Thus, a sector whose mission is to protect human health is contributing to the burden of disease. (3) Reduce, treat, and safely dispose of healthcare wastes: Hospitals generate millions of tons of waste each year, the combined toxic and infectious properties of medical waste represent an underestimated environmental and public health threat. (4) Implement energy efficiency and clean, renewable energy generation: Solar and wind can both significantly reduce greenhouse gas emissions and protect public health from the myriad impacts of climate change, including increased heat-related illnesses, the expansion of vector borne diseases, and increased droughts and water scarcity in some regions and storms and flooding in others. (5) Reduce hospital water consumption and supply potable water: Lack of water and sanitation infrastructure is a major problem that directly impacts hospitals and healthcare systems through overburdening them with more disease in the population. Health facilities can conserve water resources by closely metering water use, installing water-efficient fixtures and technologies, and growing drought-resistant landscape. (6) Improve transportation strategies for patients and staff: The health sector is a transportation-intensive industry that requires lots of ambulance hospital vehicles, delivery vehicles, and staff and patient travel, which leads to air pollution impacts. Shifting to hybrid technologies, all-electric vehicles, and compressed natural gas and encouraging hospital staff and patients to use bicycles can reduce emissions. Improve transportation strategies for patients and staff. (7) Food: A growing number of healthcare facilities in developed and developing countries that purchase and serve food to patients and workers are reducing their environmental footprint and improving patient and worker health by making changes in hospital service menus and practices. (8) Pharmaceutical Pollution and Safer Pharma: Levels of pharmaceuticals in the environment are likely to rise in years to come, as the global demand for pharmaceuticals grows the impact of pharmaceutical industry on the environment has implications for human health including antimicrobial resistance. (9) Green Building: The health sector has the potential, through its market power, to influence the construction industry to develop safer, more resilient, greener, and healthier building products and systems. The significant environmental and health impacts associated with hospital buildings have led to the creation and adoption of a wide variety of “green building” tools and resources related to healthcare. (10) Purchasing: The health sector spends huge amounts of money on purchasing goods. Healthcare purchasing results in a significant environmental impact and can also have significant human rights impacts.

Conclusion: Green healthcare system is not merely go green concept, it’s going beyond by incorporating all the aspects of healthcare system, such as leadership, substituting harmful chemicals with safer alternatives, safe disposal of wastes, energy efficiency, renewable energy generation, transportation strategies, food, green building, safer pharma, and purchasing.


Healthcare system–sustainable healthcare system Goals of healthcare system Green healthcare–green hospital Healthcare leadership Chemicals Wastes Pharmaceutical pollution Green building 


  1. 1.
    IOM Institute of Medicine (US). (2018). Roundtable on environmental health sciences, research, and medicine. Washington: National Academies Press.Google Scholar
  2. 2.
    Admas, K. (2012). Sustainable healthcare. Published by health after oil.Google Scholar
  3. 3.
    Fineberg, H. V. (2012). A successful and sustainable health system—how to get there. New England Journal of Medicine, 366(11), 1020–1027.CrossRefGoogle Scholar
  4. 4.
    IOM (Institute of Medicine). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.Google Scholar
  5. 5.
    OFEE (Office of Federal Environmental Executive). (2003). Federal commitment to green building: Experiences and expectations. Scotts Valley, CA: CreateSpace Independent Publishing Platform. Retrieved January 30, 2007, from Scholar
  6. 6.
    Green Healthcare Institutions. (2007). Health, environment, and economics: Workshop summary. Washington, DC: National Academies Press.Google Scholar
  7. 7.
    Beauchamp, T. L. (2001). Principles of biomedical ethics (5th ed.). New York: Oxford University Press.Google Scholar
  8. 8.
    Engelhardt, H. T. (1995). The foundations of bioethics (2nd ed.). New York: Oxford University Press.Google Scholar
  9. 9.
    Roberts, M. J., & Reich, M. R. (2002). Ethical analysis in public health. Lancet, 359, 1055–1059.CrossRefGoogle Scholar
  10. 10.
    Thomas, J. C., Sage, M., Dillenberg, J., & Guillory, V. J. (2002). A code of ethics for public health. American Journal of Public Health, 92, 1057–1059.CrossRefGoogle Scholar
  11. 11.
    Chile | Green Teams, Hospital Penco Lirquén. Download case study.Google Scholar
  12. 12.
    South Africa | Hospital Staff Empowerment and Cost Savings, Victoria Hospital.Google Scholar
  13. 13.
    United Kingdom | Creating the Conditions for Change, Sustainable Development Unit of NHS England and Public Health England.Google Scholar
  14. 14.
    Argentina | Elimination of Mercury-Based Medical Devices, Austral University Hospital. Download case study (in Spanish).
  15. 15.
    Australia | Anaesthetic Gases—Greenhouse Gas Reductions, Western Health.Google Scholar
  16. 16.
    Nacional de Traumatologia e Ortopedia Jamil Haddad. Download case study (in Portuguese).
  17. 17.
    Brazil | Recycling Sterile Surgical Material Wrapers, Hospital Israelita de San Paulo Albert Einstein.Google Scholar
  18. 18.
    India | Improving the Management of Waste and Generating Revenue, Aravind Eye Care System.Google Scholar
  19. 19.
    Nepal | Safe and Sustainable Waste Management, Gunjaman Singh Hospital.Google Scholar
  20. 20.
    Global Green and Healthy Hospitals. (2014). Annual program report. Retrieved from
  21. 21.
    Australia | Community Energy Efficiency Program, Uniting Care Queensland.Google Scholar
  22. 22.
    Malaysia | Water—A precious commodity: Conserving and reducing water consumption using recycled reject water processed from water treatment system, Buddhist Tzu-Chi Dialysis Centre (Penang Branch).Google Scholar
  23. 23.
    Australia | Transport Access Guide, Mater Health Services.Google Scholar
  24. 24.
    Chile | Creating Incentives for Use of Public Transportation, Hospital Las Higueras. Download case study.Google Scholar
  25. 25.
    Malaysia | Vegetarianism and utilization of reusable food containers reduces carbon emissions, Buddhist Tzu Buddhist Chi Dialysis Centre (Penang Branch).Google Scholar
  26. 26.
    New Zealand | Growing People at Woodford Gardens—Waitakere Hospital, Waitemata District Health Board.Google Scholar
  27. 27.
    China | Green Hospital Design at Yanzhou People’s Hospital, Chinese Hospital Association Hospital Architecture, System Research Branch. Download case study.Google Scholar
  28. 28.
    Australia | Paper Reduction, Mater Health Services.Google Scholar
  29. 29.
    AHA. (1998). Memorandum of understanding between the American Hospital Association and the United States Environmental Protection Agency. Retrieved January 30, 2007, from
  30. 30.
    Alevantis, L., Frevert, K., Muller, R., Levin, H., & Sowell, A. (2002). Sustainable building practices in California state buildings. In Proceeding of indoor air 2002: 9th international conference on indoor air quality and climate (Vol. 3, pp. 666–671). Santa Cruz, CA: Indoor Air 2002.Google Scholar
  31. 31.
    Polakoff JS, Rabovsky J, Salmon AG. Noncancer chronic reference exposure levels. Oakland: California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Air Toxicology and Epidemiology Section; 2000. Retrieved May 3, 2007, from
  32. 32.
    Alexeeff GV, Budroe JD, Collins JF, Dodge DE, Fowles JR, Faust JB, Lam RF, Lewis DC, Marty MA, Mycroft FJ, Olson H, Polakoff JS, Rabovsky J, Salmon AG. Noncancer chronic reference exposure levels. Oakland: California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Air Toxicology and Epidemiology Section; 2000. Retrieved May 3, 2007, from
  33. 33.
    Alvarez, L. (2004). Where the healing touch starts. New York: New York Times. Retrieved May 3, 2007, from Scholar
  34. 34.
    Antonovsky, A. (1987). The salutogenic perspective: Toward a new view of health and illness. Advances, 4, 47–55.Google Scholar
  35. 35.
    ASHE (American Society for Healthcare Engineering). (2002). Green healthcare construction guidance statement. Retrieved April 26, 2007, from
  36. 36.
    Australia | Development of a local sustainability action plan, Western Health.Google Scholar
  37. 37.
    Beauchemin, K. M., & Hays, P. (1998). Dying in the dark: Sunshine, gender and outcomes in myocardial infarction. Journal of the Royal Society of Medicine, 91, 352–354.CrossRefGoogle Scholar
  38. 38.
    Benedetti, F., Colombo, C., Barbini, B., Campori, E., & Smeraldi, E. (2001). Morning sunlight reduces length of hospitalization in bipolar depression. Journal of Affective Disorders, 62, 221–223.CrossRefGoogle Scholar
  39. 39.
    Benedetti, F., Colombo, C., Barbini, B., Campori, E., & Smeraldi, E. (2001). Morning sunlight reduces length of hospitalization in bipolar depression. Journal of Affective Disorders, 62, 221–223.CrossRefGoogle Scholar
  40. 40.
    Bergsland, K. H. (2005). Nytt Rikshospital tre år etter—Hva har bygget betydd for driften? (Nytt Rikshospital three years after—How does the new facility influence the running of the hospital?). Trondheim: Stiftelsen for industriell og teknisk forskning ved NTH (SINTEF).Google Scholar
  41. 41.
    Bernheim, A., Levin, H., & Alevantis, L. (2002). Special environmental requirements for a California state office building. In Proceeding of indoor air 2002: 9th international conference on indoor air quality and climate (Vol. 4, pp. 918–923). Santa Cruz, CA: Indoor Air 2002.Google Scholar
  42. 42.
    Bernheim A, Levin H. Material selection for the public library. Proceedings of Healthy Buildings/IAQ 1997. 1997;3:599–604.Google Scholar
  43. 43.
    Berry, L. (1999). Discovering the soul of service: The nine drivers of sustainable business success. New York: The Free Press.Google Scholar
  44. 44.
    Berry, L. L., Parker, D., Coile, R. C., Jr., Hamilton, D. K., O’Neill, D. D., & Sadler, B. L. (2004). Can better buildings improve care and increase your financial returns? Frontiers of Health Services Management, 21, 3–24.CrossRefGoogle Scholar
  45. 45.
    Biley, F. C. (1994). Effects of noise in hospitals. British Journal of Nursing, 10–23(3), 110–113.CrossRefGoogle Scholar
  46. 46.
    Bjorseth, O., Bakke, J., Iversen, N., Martens, B. (2002). Characterization of emissions from mechanical polishing of PVC floors. Retrieved April 26, 2007, from
  47. 47.
    Black, M., Pearson, W., Brown, J., & Sadie, S. (1993). Material selection for controlling IAQ in new construction. Proceedings of Indoor Air, 2, 611–616.Google Scholar
  48. 48.
    Blomkvist, V., Eriksen, C. A., Theorell, T., Ulrich, R., & Rasmanis, G. (2005). Acoustics and psychosocial environment in intensive coronary care. Occupational and Environmental Medicine, 62, e1.CrossRefGoogle Scholar
  49. 49.
    Bornehag, C., Sundell, J., & Sigsgaard, T. (2004). Dampness in buildings and health (DBH): Report from an ongoing epidemiologic investigation on the association between indoor environmental factors and health effects among children in Sweden. Indoor Air, 14, 59–66.CrossRefGoogle Scholar
  50. 50.
    Bornehag, C. G., Sundell, J., Weschler, C. J., Sigssgaard, T., Lundgren, B., Hasselgren, M., & Hagerhed-Engman, L. (2004). The association between asthma and allergic symptoms in children and phthalates in house dust: A nested case-control study. Environmental Health Perspectives, 112, 1393–1397.CrossRefGoogle Scholar
  51. 51.
    Bornehag, C.-G., Sundell, J., Weschler, C. J., Sigsgaard, T., Lundgren, B., Hasselgren, M., & Hägerhed-Engman, L. (2004). The association between asthma and allergic symptoms in children and phthalates in house dust: A nested case–control study. Environmental Health Perspectives, 112, 1393–1397.CrossRefGoogle Scholar
  52. 52.
    Boyden, S. (1971, April). Biological determinants of optimal health. Human biology of environmental change conference; Blantyre. pp. 5–12.Google Scholar
  53. 53.
    Boyden, S. (2004). The biology of civilization: Understanding human culture as a force in nature. Sydney, New South Wales: University of New South Wales Press.Google Scholar
  54. 54.
    Brent, R. J. (2003). Cost-benefit analysis and health care evaluations. Northampton: Edward Elgar Publishing.CrossRefGoogle Scholar
  55. 55.
    Cabrera, I. N., & Lee, M. H. (2000). Reducing noise pollution in the hospital setting by establishing a department of sound: A survey of recent research on the effects of noise and music in health care. Preventive Medicine, 30, 339–345.CrossRefGoogle Scholar
  56. 56.
    Carnegie Mellon University Center for Building Performance. From the ongoing building investment decision support (BIDS) research project with funding from the advanced building systems integration consortium (ABSIC) (p. 2005). Pittsburgh, PA: Vivian Loftness.Google Scholar
  57. 57.
    CDC (Center for Disease Control and Prevention). (2000). Hospital infections cost US billions of dollars annually. Retrieved March 17, 2007, from
  58. 58.
    Chow, S.-C., & Liu, J. P. (2004). Design and analysis of clinical trials: Concepts and methodologies. Indianapolis, IN: Wiley Interscience.zbMATHGoogle Scholar
  59. 59.
    Christensson, B., Jansson, A., & Johansson, J. (2002). Particles indoor in sick and healthy buildings. Frösön: IVL Swedish Environmental Research Institute Ltd. Retrieved January 31, 2007, from Scholar
  60. 60.
    CIA (Central Intelligence Agency). (2007). World fact book 2007. Washington, DC: CIA Library.Google Scholar
  61. 61.
    CIWMB (California Integrated Waste Management Board). (2000). Green building design and construction guidelines. Retrieved January 30, 2007, from
  62. 62.
    Conlin, M. (2000). Is your office killing you. Business Week. Retrieved January 30, 2007, from
  63. 63.
    CRI (Carpet and Rug Institute). (2004). Carpet and Rug Institute launches Green Label Plus Program. The Carpet and Rug Institute. Retrieved May 2, 2007, from
  64. 64.
    Dean, L. (2000, October 16). Conference remarks. Conference summary setting healthcare’s environmental agenda. Retrieved January 31, 2007, from
  65. 65.
    Dick Corporation. (2006). Childrens hospital project to be a local gem. Large, PA: A Publication of Dick Corporation. Retrieved March 1, 2007, from Scholar
  66. 66.
    Donaldson, C., Mugford, M., & Vale, L. (2002). Evidence-based health economics. London: BMJ Books.Google Scholar
  67. 67.
    Douglas, M. R., & Douglas, C. H. (2004). Patient-friendly hospital environments: Exploring the patients’ perspective. Health Expectations, 7, 61–73.CrossRefGoogle Scholar
  68. 68.
    Drummond, M., O’Brien, B., Stoddart, G., & Torrance, G. (1997). Methods for the economic evaluation of health care programmes (2nd ed.). New York: Oxford University Press.Google Scholar
  69. 69.
    Eastman, C. I., Young, M. A., Fogg, L. F., Liu, L., & Meaden, P. M. (1998). Bright light treatment of winter depression: A placebo-controlled trial. Archives of General Psychiatry, 55, 883–889.CrossRefGoogle Scholar
  70. 70.
    EIA (Energy Information Administration). Commercial buildings energy consumption survey U.S. Energy Information Administration Washington. 1995. Retrieved May 03, 2007, from
  71. 71.
    Elkington, J. (1998). Cannibals with forks: The triple bottom line of 21st century business. Gabriola Island, BC: New Society Publishers.Google Scholar
  72. 72.
    EPA (Environmental Protection Agency). (1996). National dioxin emissions from medical waste incinerators. Retrieved March 1, 2007, from
  73. 73.
    EPA. (2006). Why study indoor air quality. Retrieved January 31, 2007, from
  74. 74.
    Esty, D. C., & Winston, A. S. (2006). Green to gold: How smart companies use environmental strategy to innovate, create value, and build competitive advantage. New Haven, CT: Yale University Press.Google Scholar
  75. 75.
    Friedman, L. M., Furberg, C. D., & DeMets, D. L. (1999). Fundamentals of clinical trials (3rd ed.). New York: Springer.zbMATHGoogle Scholar
  76. 76.
    Fung, F., & Hughson, W. (2003). Health effects of indoor fungal bioaerosol exposure. Applied Occupational and Environmental Hygiene, 18, 535–544.CrossRefGoogle Scholar
  77. 77.
    Furtaw, E., Pandian, M., Nelson, D., & Behar, J. (1996). Modeling indoor air concentrations near emission sources in imperfectly mixed rooms. Journal of Air and Waste Management Association, 46, 861–868.CrossRefGoogle Scholar
  78. 78.
    Gawande, A. (2007). Better: A surgeon’s notes on performance. New York: Metropolitan Books.Google Scholar
  79. 79.
    GGHC (Green Guide for Health Care). (2006). The green guide for health care, version 22. 2006. Retrieved January 30, 2007, from
  80. 80.
    Hawthorne, C. (2003). Turning down the global thermostat. Metropolis magazine. Retrieved January 30, 2007, from
  81. 81.
    Hendrich, A., Nyhuis, A., Kippenbrock, T., & Soja, M. E. (1995). Hospital falls: Development of a predictive model for clinical practice. Applied Nursing Research, 8, 129–139.CrossRefGoogle Scholar
  82. 82.
    Hill Burton Act. 1946. Public Law 79-725.Google Scholar
  83. 83.
    Hudnell, H. K., Otto, D. A., House, D. E., & Molhave, L. (1992). Exposure of humans to a volatile organic mixture, II, sensory—A selection of papers from Indoor Air ‘90 concerning health effects associated with indoor air contaminants. Archives of Environmental Health, 47, 31–38.CrossRefGoogle Scholar
  84. 84.
    India | Conserving and Reducing Water Consumption Using a Decentralized Wastewater Recycling System, Aravind Eye Care System.Google Scholar
  85. 85.
    IOM (Institute of Medicine). (1999). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.Google Scholar
  86. 86.
    Jaakkola, J., Oie, L., Nafstad, P., Botten, G., Samuelsen, S., & Magnus, P. (1999). Interior surface materials in the home and the development of bronchial obstruction in young children in Oslo, Norway. American Journal of Public Health, 89, 188–192.CrossRefGoogle Scholar
  87. 87.
    Jaakkola, J., Parise, H., Kislitsin, V., Lebedeva, N., & Spengler, J. (2004). Asthma, wheezing, and allergies in Russian schoolchildren in relation to new surface materials in the home. American Journal of Public Health, 94, 560–562.CrossRefGoogle Scholar
  88. 88.
    Jackson, R., & Frumkin, H. (2004). Urban sprawl and public health. Public Health Reports, 117, 201–217.Google Scholar
  89. 89.
    Johnsen R. Health systems in transitions. European Health Systems Observatory. London 2006. p. 31. Retrieved March 9, 2007, from
  90. 90.
    Kats, G., & Capital, E. (2003). The costs and financial benefits of greening buildings. 2003. In A report to California’s sustainable building task force. Westborough: Massachusetts Technology Collaborative.Google Scholar
  91. 91.
    Kats, G. (2003). Green building costs and financial benefits. Westborough: Massachusetts Technology Collaborative.Google Scholar
  92. 92.
    Katz, D. L. (2006). Clinical epidemiology & evidence-based medicine: Fundamental principles of clinical reasoning & research. Thousand Oaks, CA: Sage Publications.Google Scholar
  93. 93.
    Kozlowski, D. (2004). Green building report: Guides make it easier to green hospitals. In Building Operating Management. Milwaukee: Trade Press Publishing Company. Retrieved May 3, 2007, from Scholar
  94. 94.
    Lawrence, D. (2000, October 16). Conference remarks. Conference summary setting healthcare’s environmental agenda. Retrieved January 30, 2007, from
  95. 95.
    Lent, T. (2006). Improving indoor air quality with the California 01350 specification. Washington: Healthy Building Network. Retrieved January 31, 2007, from Scholar
  96. 96.
    Lerner, M. (2000, October 16). Conference remarks. Conference summary setting healthcare’s environmental agenda. Retrieved January 30, 2007, from
  97. 97.
    Levin, H. (1998). Toxicology-based air quality guidelines for substances in indoor air. International Journal of Indoor Air Quality and Climate, 5, 5–7.Google Scholar
  98. 98.
    McDonough, W. (1998). The next industrial revolution. The Atlantic Monthly, 282(4), 82–92.Google Scholar
  99. 99.
    McLennan, J. F. (2004). The philosophy of sustainable design. Bainbridge Island, WA: Ecotone Publishing Co.Google Scholar
  100. 100.
    Mexico | Herbal Therapy—Hospital Grown Medicinas, Hospital General de Ecatepec Dr. José Ma. Rodríguez, Instituto de Salud del Estado de Mexico. Download case study.Google Scholar
  101. 101.
    Microsoft is curbing use of PVC a popular plastic. Wall Street Journal. Vol. 7. Dec, 2005. p. D7.Google Scholar
  102. 102.
    Nepal | Safe potable water using the SODIS principle, Gunjaman Singh Hospital.Google Scholar
  103. 103.
    Norbäck, D., Wieslander, G., Nordstrom, K., & Walinder, R. (2000). Asthma symptoms in relation to measured building dampness in upper concrete floor construction, and 2-3ethyl-1-hexanol in indoor air. International Journal of Tuberculosis and Lung Disease, 4, 1016–1025.Google Scholar
  104. 104.
    NRC (National Research Council). (2002). Multiple chemical sensitivities. Washington, DC: The National Academy Press.Google Scholar
  105. 105.
    NRC. (2006). Green schools: Attributes for health and learning. Washington, DC: The National Academies Press.Google Scholar
  106. 106.
    Oie, L., Nafstad, P., Botten, G., Magnus, P., & Jaakkola, J. (1999). Ventilation in homes and bronchial obstruction in young children. Epidemiology, 10, 294–299.CrossRefGoogle Scholar
  107. 107.
    Orians, G. H., & Heerwagen, J. H. (1992). Evolved responses to landscapes. In The Adapted Mind (pp. 555–579). New York: Oxford University Press.Google Scholar
  108. 108.
    Philippines | Hospital Engineers Discharge Cleaner Water, Philippine Heart Center.Google Scholar
  109. 109.
    Philippines | Initiative on Waste Management, St. Paul Hospital Cavite Inc.Google Scholar
  110. 110.
    Pierce, J., & Jameton, A. (2004). The ethics of environmentally responsible health care. New York: Oxford University Press.CrossRefGoogle Scholar
  111. 111.
    Pommer, L., Fick, J., Sundell, J., Nilsson, C., Sjostrom, M., Stenberg, B., & Andersson, B. (2004). Class separation of buildings with high and low prevalence of SBS by principal component analysis. Indoor Air, 14, 16–23.CrossRefGoogle Scholar
  112. 112.
    Progress report on sustainability. Building Design & Construction. Nov 22–24, 2003.Google Scholar
  113. 113.
    RICS (Royal Institution of Chartered Surveyors). (2005). Green value, green buildings, growing assets. London: Royal Institution of Chartered Surveyors. Retrieved February 02, 2007, from Scholar
  114. 114.
    Roshanaei, H., & Braaten, D. (1996). Indoor sources of airborne particulate matter in a museum and its impact on works of art. Journal of Aerosol Science, 27, 443–444.CrossRefGoogle Scholar
  115. 115.
    Rubin, H. R., Owens, A. J., & Golden, G. (1998). Status report: An investigation to determine whether the built environment affects patient medical outcomes. Martinez, CA: Center for Health Design.Google Scholar
  116. 116.
    Sadler, B. L. (2004). Designing with health in mind; innovative design elements can make hospitals safer, more healing places. Modern Health Care, 34, 28.Google Scholar
  117. 117.
    Savitz, A. W., & Weber, K. (2006). The triple bottom line: How today’s best-run companies are achieving economic, social and environmental success—And how you can too. San Francisco, CA: Jossey-Bass.Google Scholar
  118. 118.
    Schettler, T. (2001). Environmental challenges and visions of sustainable health care. Presented at CleanMed Conference; Boston. Retrieved January 30, 2007, from
  119. 119.
    Schickler, P. (2005). Achieving health or achieving well being? Learning in Health and Social Care, 3, 217–224.CrossRefGoogle Scholar
  120. 120.
    SCS (Scientific Certification System). (2005). Floor score. Retrieved April 26, 2007, from
  121. 121.
    Seligman, M. E., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Journal of Psychology, 55, 5–14.CrossRefGoogle Scholar
  122. 122.
    Shertzer, K. E., & Keck, J. F. (2001). Music and the PACU environment. Journal of Perianesthesia Nursing, 16, 90–102.CrossRefGoogle Scholar
  123. 123.
    Skyberg, K., Skulberg, K., Eduard, W., Skaret, E., Levy, F., & Kjuus, H. (2003). Symptoms prevalence among office employees and associations to building characteristics. Indoor Air, 13, 246–252.CrossRefGoogle Scholar
  124. 124.
    Slotterback, S. (2006). Building green at a large scale. Washington, DC: PowerPoint presented at the IOM Green health-care institutions: Health, environment, and economics workshop. Retrieved February 22, 2007, from Scholar
  125. 125.
    Smith, P. C. (2005). Performance measurement in health care: History, challenges and prospects. Public Money & Management, 25, 213–220.CrossRefGoogle Scholar
  126. 126.
    South Korea | Water Management and Recycling System, Yonsei University Health System. Download .
  127. 127.
    Spain | Measures to reduce production of hazardous health care waste, Departamento de Salud de Xàtiva—Ontinyent. Download case study (in English | in Spanish).Google Scholar
  128. 128.
    Spengler, J., & Chen, Q. (2000). Indoor air quality factors in designing a healthy building. Annual Review of Energy and the Environment, 25, 567–601.CrossRefGoogle Scholar
  129. 129.
    Sundell, J. (1999). Indoor environment and health. Stockholm: National Institute of Public Health.Google Scholar
  130. 130.
    Sustainability Commitee. (2005). Sustainability vision for Emory. Atlanta, GA: Emory University. Retrieved May 3, 2007, from Scholar
  131. 131.
    Sustainable Development Commission. (2006). Healthy futures. 2006. Retrieved April 26, 2007, from
  132. 132.
    Taiwan | Establish Environment Friendly Green Hospital in Multiple Aspects, China Medical University Hospital.Google Scholar
  133. 133.
    Topf, M. (1992). Stress effects of personal control over hospital noise. Behavioral Medicine, 18, 84–94.CrossRefGoogle Scholar
  134. 134.
    Tuomainen, A., Seuri, M., & Sieppi, A. (2004). Indoor air quality and health problems associated with damp floor coverings. International Archives of Occupational and Environmental Health, 77, 222–226.CrossRefGoogle Scholar
  135. 135.
    Turner Green Building. (2006). Turner green building market barometer. Retrieved February 05, 2007, from
  136. 136.
    Ulrich, R. (1991). Effects of healthcare interior design on wellness: Theory and recent scientific research. Journal of Healthcare Interior Design., 3, 97–109.Google Scholar
  137. 137.
    Ulrich, R. S., Zimring, C., Quan, X., Joseph, A., & Choudhary, R. (2004). The role of the physical environment in hospitals of the 21st century: A once in a lifetime opportunity. Princeton, NJ: Robert Wood Johnson Foundation.Google Scholar
  138. 138.
    Ulrich, R. S. (1999). In C. Cooper, C. C. Marcus, & M. Barnes (Eds.), Effects of gardens on health outcomes: Theory and research, Healing gardens (pp. 27–86). New York: Wiley.Google Scholar
  139. 139.
    United Kingdom | Reducing the Carbon Footprint of Medicinal Waste Disposal, Newcastle upon Tyne Hospitals NHS Foundation Trust.Google Scholar
  140. 140.
    United Kingdom | Unique food waste Digestor saving thousands for NHS, Stockport NHS Foundation Trust.Google Scholar
  141. 141.
    United Kingdom | Water Savings, Barts and The London NHS Trust.Google Scholar
  142. 142.
    United States | Engaged Leadership, Bon Secours Health System, Practice Green health.Google Scholar
  143. 143.
    United States|Healthy Beverage Case Study, Vanguard Health Chicago, Practice Green health.Google Scholar
  144. 144.
    United States | Less Waste: Red Bag Reduction Success at Inova Fairfax Hospital, Practice Greenhealth.Google Scholar
  145. 145.
    United States | Safer chemicals: Eliminating HHI chemicals of concern for healthy interiors at Beaumont Health System, Practice Greenheath.Google Scholar
  146. 146.
    USGBC (U.S. Green Building Council). (2006). Leadership in energy and environmental design. Retrieved January 31, 2007, from
  147. 147.
    Walch, J. M., Rabin, B. S., Day, R., Williams, J. N., Choi, K., & Kang, J. D. (2005). The effect of sunlight on postoperative analgesic medication use: A prospective study of patients undergoing spinal surgery. Psychosomatic Medicine, 67, 156–163.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Visionary Mindset Professional & Management Development TrainingDubaiUnited Arab Emirates

Personalised recommendations