1.2-million-square-foot Lebanon campus, which opened in 1991. The design of the complex incorporated an innovative cooling system that substantially reduced peak demand for airconditioning, plus environmentally friendly materials and a spacious loading dock to accommodate trash removal and recycling. And even before the building was done, a new staff position for a waste and recycling coordinator was filled—a role that many hospitals have yet to institutionalize. (See this article's on DHMC's waste management operation.)

Local wood, lots of light
By 2006, when DHMC's $220-million Project for Progress expansion was completed, additional green features included the use of locally harvested red oak for interior trim, the latest in high-performance glass to incorporate lots of daylight without compromising energy efficiency, and a six-level garage that provides ample parking while keeping vast swaths of adjacent woodland from being paved over. "Dartmouth is committed to figuring out how to make our buildings as green as possible," says Charles Mannix, associate dean and chief operating officer of the Medical School. "Located where we are, that's part of our responsibility."

DHMC's maintenance and operations have long been green as well. By the late 1990s, DHMC was virtually mercury-free, and since January 2002, ethylene oxide—a substance used to sterilize medical supplies but associated with an increased risk of liver cancer and miscarriage—has been on the Medical Center's list of banned chemicals. Housekeeping uses green cleaning supplies. An environmentally conscious purchasing committee oversees the hospital's supply chain. And additional energy-saving features have been incorporated during scheduled upgrades.

Meanwhile, the waste-management department has moved far beyond simply separating paper and plastic. For example, DHMC recycles waste ethylene glycol from the chillers in its on-site energy plant and installed an autoclave to reduce the amount of waste slated for incineration. "The principles of trying to minimize the effect that we have on our environment, on our natural resources, are broadly understood in this organization," says Gail Dahlstrom, DHMC's vice president for facilities. "When I think about our responsibility as an industry, a producer, a workplace, I think one of the key aspects is how we

DHMC got in on the act early, setting ambitious energy- conservation and site-preservation standards for its 220-acre Lebanon campus, which opened in 1991. The design of the complex incorporated an innovative
cooling system that substantially reduced peak demand for
summer air conditioning.

affect the public health. And that includes things like what kind of toxic materials do we ask our employees to use and what kind of effluent do we put into the air?"

This spring, DHMC garnered its fourth environmental leadership award from Hospitals for a Healthy Environment (H2E), a nonprofit dedicated to promoting and recognizing environmental sustainability in health care—for the benefit not only of patients, but also of workers, their communities, and the global environment. "There are so many opportunities to do better in health care," says Laura Brannen, H2E's executive director and DHMC's first environmental programs coordinator back in 1990. "From the materials that we use, to purchasing less stuff, to purchasing safer materials, to building green buildings, energy, water. Health care is so big." At DHMC, she says, everyone "gets it"—environmental responsibility is featured in orientation and training for all employees, recycling and waste reduction are part of every employee's job description, and the

2,000,000

Tons of garbage generated annually by U.S. hospitals

33%

Percentage of the total waste stream at DHMC that is recycled

4

Number of years DHMC has been honored for environmental leadership by Hospitals for a Healthy Environment