Medical gas: changing the culture of waste

Healthcare has, in some ways, been at the forefront of the Green Building Movement. Hospitals have a very high Energy Use Index (EUI), and hospital owners have been seeking to reduce their energy costs for decades. However, when tools such as LEED (Leadership in Energy & Environmental Design) first emerged, the healthcare industry was somewhat slow to join the green party.

Healthcare buildings are notoriously complex, heavily regulated, and prey to a pre-conceived conflict between sustainable operation and quality patient care. Healthcare took its first tentative step into the green buildings world with the advent of the Green Guide for Healthcare ( – a voluntary, self-certifying tool that gave healthcare owners a set of strategies, helping them think about their buildings and their operations in ways that moved towards more sustainable solutions. LEED for Healthcare soon followed, in

addition to other tools from the UK and other countries. And, since that time, many other tools and rating systems have emerged, trying to help healthcare owners shift towards more sustainable buildings and operations. However, most of these tools have

ignored an important part of healthcare infrastructure – medical gas systems. In general, medical gas systems have been seen as highly regulated and too intimately involved in patient care to be tampered

with in the name of environmental sustainability. But this impression is wrong. Innovative entrepreneurs are starting to create opportunities for the development of better solutions, including medical gas systems. In much of the developed world, in

an attempt to improve much-needed infection control and efficiency, medical professionals have developed a culture of relative indifference to the use and disposal of supplies of all kinds. But what if these supplies were less abundant? In the developing world, medical professionals cannot take their supplies for granted, and they frequently devise solutions that conserve resources. We can learn from these examples through reverse innovation.

Reverse innovation Reverse Innovation is a term that refers to an innovation seen first in the developing world before spreading to the industrialised world. Reverse Innovation is a concept originating from Dartmouth professors Vijay Govindarajan, Chris Trimble and EX-CEO of General Electric Jeffrey Immelt. As healthcare costs continue

to rise in areas that have greater available resources there will be important opportunities to learn from our developing neighbours to provide both better medical care and a shared reduction in the overall environmental footprint from the healthcare industry. Broadly speaking, some emerging strategies include


supply side strategies, distribution system strategies, and disposal strategies. This article suggests opportunities in each of these three parts of the system – supply system strategies, distribution system strategies, and disposal system strategies.

Supply system strategies On-site oxygen: The most frequently used medical gas is concentrated oxygen. In most areas of the world, hospitals use local oxygen concentrators, often serving

Walt Vernon Walt Vernon is the CEO of Mazzetti.

He has worked in the area of healthcare sustainability for decades, including the development of the Green Guide for Healthcare, the American Hospital

Association’s Sustainability Roadmap, and the World Health Organization’s book, Health in the Green Economy.

Brian Hageman

Brian Hageman is Mazzetti’s Chief Plumbing Engineer. He is a thought leader in the area of sustainable plumbing and medical gas strategies and has designed many

significant healthcare facilities and standards both in the United States and around the world.

Alex Arnold

Alex Arnold is a Mechanical and Plumbing Engineer at Mazzetti, he has four years of design, construction, and

commissioning experience and is a professional engineer (PE) in California.

Christopher Lash

Christopher Lash is a Mechanical Engineer at Mazzetti, designing and managing the integration of MEP systems

to support a wide range of industries including Healthcare facilities. He has experience in design and construction of air and water systems for healthcare facilities and is a professional engineer (PE) in California and Colorado.



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