Hospitals use purchasing power to 'green' interior design market

November 1, 2018


Hospitals and health system members of the nonprofit Practice Greenhealth are bringing their considerable purchasing power to bear in pressing manufacturers to offer furnishings and other interior design products that do not contain harmful chemicals. Those organizations operate about 1,300 hospitals as well as affiliated outpatient sites.

Ascension and its Medxcel facility management company created master standards that are used in the design of all Ascension facilities. Those standards include requirements for choosing materials that are free from harmful chemicals. This waiting room in an Ascension – St. Vincent's HealthCare urgent care center incorporates the design and furnishings guidelines. Ascension

"The impetus behind our focus on healthy interiors has to do with our concern for the health of patients, and the people who work for health care facilities and community members," Rachel Gibson said during a Sept. 13 CHA webinar offered in conjunction with the Feast of St. Francis, the patron saint of animals and ecology. Gibson directs the safer chemicals program for Health Care Without Harm, a broad-based coalition of organizations promoting environmental responsibility among health care providers. It is a partner organization of Practice Greenhealth.

"Products used in interior spaces in health care facilities can contain chemicals of concern, chemicals we know to be hazardous and chemicals we are starting to find present in the environment and in people," she said.

Gibson's co-presenters in the webinar were Mary Larsen and Heidi Fentress. Larsen is environmental affairs and sustainability director for Advocate Aurora Health. Fentress is interior design manager for Medxcel, Ascension's planning, design and construction subsidiary.

Pervasive threat
Gibson explained that biomonitoring by the Centers for Disease Control and Prevention has shown that chemicals potentially harmful to human health used in some plastics and in flame retardants are present in the bloodstreams of virtually all people studied. And, a biomonitoring study by Physicians for Social Responsibility and Health Care Without Harm found the vast majority of a group of participating health care workers had an array of industrial chemicals in their bodies, including mercury, perfluorinated chemicals, phthalates and bisphenol A. Such chemicals can enter the body through the breathing system, skin, ingestion of food and — for babies — through the placenta in utero and through breastfeeding after birth, according to Gibson.


The problematic chemicals have been linked to diseases including asthma, thyroid cancer, childhood leukemia and breast cancer as well as to developmental disabilities, said Gibson.

Potentially harmful chemicals can be present in a very wide array of interior design products, she said, including seating, beds, table and desk surfaces, shelving, window coverings, panels, flooring products and paint and other wall coverings. The chemicals contained in such products can enter the atmosphere in gaseous form during the products' use and upon disposal, said Gibson.

Industry solution
While there is a federal law intended to regulate chemicals used in interior and other consumer products, full implementation of the law has been lax, said Gibson. To counter that, eight years ago Practice Greenhealth, Health Care Without Harm, the Center for Health Design and 12 health systems launched Healthier Hospitals with the intent to use the market power of the health care industry to promote the manufacture of safe interior design products, among other products.

Its "Healthy Interiors Goal" established in 2012 says 30 percent of the furniture and other fabrics and finishes purchased each year by participating facilities will be free of flame retardants, formaldehyde, perfluorinated compounds, antimicrobials and polyvinyl chloride.

Gibson noted that some flame retardants used in interior products have been linked to negative health effects related to neurological, cognitive, reproductive and immune system functioning. In addition, she said that some antimicrobial compounds added to textiles to kill infectious agents can harm human health and can lead hospital staff to have a false sense of security about infection control. "With rare exception, very few data support the need for antimicrobials in furniture to reduce health care associated infection," she said.


Larsen said manufacturers of commercial furniture have been re-engineering their products to omit the concerning chemicals, working with client hospitals to develop and test alternative products and creating helpful lists of products that are compliant with the Healthier Hospitals criteria. "By demanding safer products, we are changing the market," she said.

Larsen and Fentress explained during the webinar how their systems have met — and even exceeded — the Healthy Interiors Goal.

Created through a merger this spring, Advocate Aurora Health is a nonprofit system with 26 hospitals in Illinois and Wisconsin. Larsen helped direct legacy system Advocate's participation in Healthier Hospitals and now is spreading that work throughout the merged organization. She said all the legacy Advocate system's sites pursue the Healthy Interiors Goal.

The system formed a team that includes representatives from planning, construction and design units. One member of the team has responsibility for the standardization activity connected with all furniture purchases across the system. This centralized model enables Advocate Aurora Health to strictly enforce environmental standards in line with the Healthy Interiors Goal, said Larsen.

She said that the legacy Advocate sites have exceeded the Healthy Interiors Goal. They have achieved this success by collecting manufacturers' data on the chemical content of all facility furnishing and interior product purchases; using that data to track and measure progress, ensuring that system hospitals are accountable for adhering to the standards and being persistent in urging manufacturers into compliance. Larsen said the system has gotten some pushback from manufacturers. Smaller shops in particular have had more difficulty complying with the criteria.

One brand
Medxcel handles facility management, planning, design, construction and other functions for Ascension's 151 hospitals and 2,600 other care sites across 21 states. Fentress said Medxcel collaborated with groups across Ascension to develop a single set of design standards. The team developed the standards with attention to the social, environmental and financial costs and benefits.


Fentress said Medxcel and Ascension worked together to create facility master standards that comply with the Healthy Interiors Goal as well as other industry guidelines for environmentally friendly interiors.

The team also consulted with infection control personnel, facility management, marketing, executive leadership, vendors and other key stakeholders at the system and facility levels. Using the input, Medxcel came up with "palette packages" of finishes and furnishings that aesthetically fit with Ascension's brand and that are in compliance with the environmental standards. All Ascension sites use the palettes and those standards when decorating or renovating interior spaces.

Fentress said Ascension developed illustrations and specification for all acute care and ambulatory care rooms to serve as design starters. The models are accessible on an intranet portal. Ascension got leadership buy-in at the facility level and engaged vendors to be champions of the standardization. She noted that environmentalism is top of mind when old interior products are replaced. Ascension aims to ensure all old items are reused, recycled or donated to charitable organizations, she said.

Larsen said Healthier Hospitals and its partners will continue to build upon their success in influencing the interiors and furnishing industries to make healthier products. "It's very powerful to align our voices," she said.



Copyright © 2018 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3490.

Copyright © 2018 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.