Water quality and availability are both essential to protecting patient health and critical to daily hospital operations. Water conservation measures in hospitals prioritize these needs while addressing wasteful or unnecessary practices. Performance improvement measures focus on fixing leaks, eliminating avoidable use, and implementing new technologies that get the same job done using significantly less water. In addition to saving water, water conservation measures in hospitals save operating costs and energy.

Because water quality is a public health issue and thus a special concern for the health care community, it makes sense that health care organizations are part of the solution. There are both regulatory and best practice aspects to a health care facility's use and discharge of water. For example, although disposing of glutaraldehyde, formalin, or other hazardous chemicals down a drain may be permitted, if there is an opportunity to eliminate use of the product or recycle it, either alternative would be a preferred practice. Pharmaceuticals detected in the water supply have also surfaced as a concern, according to the EPA.

The long-term availability of potable and fresh water in urban areas is also a significant concern. Population growth strains fresh water supplies and increases demand from agricultural and industrial applications. According to the Natural Resources Defense Council, the collection, distribution, and treatment of drinking water and wastewater nationwide consume tremendous amounts of energy and release approximately 116 billion pounds of carbon dioxide (CO2) per year—as much global warming pollution each year as 10 million cars. The impacts of climate change on water supply include disruptions in traditional rainfall and runoff patterns, degradation of water quality, and increased frequency and severity of floods and droughts. All of these events affect human health and strain the health care system.

Reducing reliance on outside suppliers for water allows facilities to take more control over the quality of their water, which can improve equipment operation and duration as well as protect against contaminants that can impact patient health.

Compliance Considerations

Water is regulated at the local, state, and federal levels.

Government Regulation. At the federal level, the Clean Water Act (CWA), overseen by the U.S. Environmental Protection Agency (EPA), was enacted to protect the nation’s water. The EPA’s Office of Water is the place to go for information on water regulations and conservation resources.

The National Pollutant Discharge Elimination System (NPDES) is the national water permitting program that covers stormwater discharge issues, pretreatment programs, effluent guidelines and standards, and building issues such as water for cooling. The frequently asked questions page on the NPDES website is a good place to start gathering information. The site also contains many links to other water management resources.

Additional water regulations and standards are set at the state or local level. Connect with your local authority to obtain permits and permissions regarding all things related to water.

Pending Legislation. As fresh water becomes less available, it will become more valuable and will be a driving force for competitive advantage among utilities and government entities. This is likely to result in new legislation to regulate the distribution and use of potable water. For example, the State of California has overcommitted its water supply by eightfold, and new legislation has been implemented to increase water use efficiency and reduce per capita water consumption. Although this legislation currently applies only to urban and agricultural water suppliers, it would be prudent to assume that regulatory agencies will eventually broaden their scope to include the commercial, residential, and institutional sectors. Implementing a water conservation strategy early on can put a health care organization ahead of the curve, and help you avoid some of the costs and operational strains associated with adapting to new regulations.

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Opportunities and Benefits

In addition to the benefits resulting from reduced potable water consumption and decreased reliance on outside suppliers, conscious water management planning may have other positive effects:

Disaster Preparedness. Having a reliable source of water is a critical aspect of continuing operations in the event of an environmental or biological catastrophe.

Economic Savings. Being proactive with water management not only mitigates the burden of complying with new regulations; it also can generate opportunities for savings. Reducing potable water consumption results in lower utility costs, for both water use and generation of sewage.

Sustainability Management Programs. Maintaining newly acquired practices and moving sustainability efforts forward requires a management program—a standardized framework for setting priorities, monitoring progress, and evaluating the overall success of the effort. The Roadmap Consumer Guide offers a side-by-side comparison of available management and rating systems as well as green building certification programs. With the direction provided by a sustainability management plan, health care facilities can move beyond compliance goals and incremental improvements to take part in stewardship opportunities and exhibit leadership.

The U.S. Green Building Council (USGBC) Leadership in Energy and Environmental Design (LEED®) program, along with most other voluntary green building certification programs, includes credits related to water efficiency. See the USGBC website to learn more the LEED rating system. For your convenience, see a summary of available LEED water credits.

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Using the Roadmap for Water Management

The Roadmap is intended to help facilities identify opportunities for better water management, and strategies are presented for taking advantage of these. Using the Roadmap as a guide, an organization can develop a customized plan for reducing potable water consumption based on its current progress and how aggressively it is able to pursue its sustainability goals.

For easy-to-implement water management projects that make a difference, see the Roadmap's list of Green Light projects for reducing water use.

The Roadmap identifies opportunities for reduction of potable water consumption and explains the strategies involved to achieve those reductions. The site also allows you to customize a plan based on your facility's current progress on sustainability and how aggressively your organization wants to pursue reductions in potable water consumption.

Click on the Roadmap sections below to learn about taking the next steps:

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