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ASSESSMENT OF GREEN HOSPITAL CRITERIA: CASE OF TRABZON
YEŞİL HASTANE ÖLÇÜTLERİNİN İRDELENMESİ: TRABZON ÖRNEĞİ
Research Assist. Zeynep Nilsun KONAKOĞLU
Avrasya University, Faculty of Architecture and Engineering, Institute, Department of Interior Architecture and Environmental
Design, Trabzon, Turkey
ORCID ID: 0000-0002-1539-305X
Associate Prof.Dr. Funda KURAK AÇICI
Karadeniz Technical University, Faculty of Architecture, Institute, Department of Interior Architecture, Trabzon,Turkey
ORCID ID: 0000-0003-2592-2266
Cite As: Konakoğlu, Z.N. & Kurak Açıcı, F. (2021). “Assessment Of Green Hospital Criteria: Case Of Trabzon”, International
Social Mentality and Researcher Thinkers Journal, (Issn:2630-631X) 7(54): 3512-3522.
ABSTRACT
Globalization affects the whole world and brings with it such problems as environmental pollution, rapid consumption of natural
resources and excessive energy use, resulting in a focus on sustainability in design. The concept of sustainability aiming at efficient
use of energy, water, material and space, preserving natural resources and using eco-friendly and renewable materials is also
addressed in healthcare field as well as other fields. The amount of energy, water and material consumed, and chemical waste
disposed are high in hospitals, which, therefore, damage the environment a lot. This fact makes the concept of green hospitals that
take building, environment and human health as a whole more and more important every day. Green hospitals are sustainable
buildings that aim to use natural resources efficiently, support recycling and minimize environmental and medical waste use. In order
for a hospital to be a green building, it should meet such criteria as waste, environment, water, energy and hazardous substances
management, material selection and sustainable facility size. Turkey, however, has very few hospitals that completely satisfy the
green hospital design criteria. The aim of this study is to draw attention to this low number and to emphasize the significance of
green building designs that focus on sustainable use and management of natural resources. The study sample consists of hospitals in
the city center of Trabzon. The hospitals were selected for ease of transportation and user preferences. Hospital managers were
interviewed to determine whether the hospitals in question satisfy the green hospital design criteria; waste, environment, water,
energy and hazardous substances management, material selection and sustainable facility size.
Key Words: Hospital, Green Hospital, Sustainability, Design
ÖZET
Bütün dünyayı etkisi altına alan küreselleşme kavramı ve beraberinde getirdiği; çevre kirliliği, doğal kaynakların hızlı tüketimi, fazla
enerji kullanımı gibi sorunlar tasarımlarda sürdürülebilirlik kavramına yönlendirmektedir. Doğa dostu, kullanıcının sağlığını göz
önünde bulunduran, enerjiyi, suyu, malzemeyi ve bulunduğu alanı etkin şekilde kullanan; sürdürülebilirlik kavramı her alanda olduğu
gibi sağlık alanında da hâkim olmaktadır. Enerji, su, malzeme tüketiminin ve kimyasal atık malzeme miktarının yüksek olduğu
hastane yapılarının çevreye verdiği zarar da fazla olmaktadır. Bu yüzden; yapı, çevre ve insan sağlığını bir bütün olarak ele alan yeşil
hastane yapıları günümüzde daha fazla önem kazanmaktadır. Yeşil hastaneler; doğal kaynakları verimli kullanmayı amaçlayan, geri
dönüşümü destekleyen, çevresel olumsuzlukları, tıbbi atıkları en aza indirgemeyi hedefleyen sürdürülebilir yapılardır. Bir hastanenin
yeşil bina olarak isimlendirilmesi için atık yönetimi, çevre yönetimi, su yönetimi, enerji yönetimi, tehlikeli maddeler yönetimi,
malzeme seçimi ve sürdürülebilir tesis boyutları gibi kriterlere uyması gerekmektedir. Fakat Türkiye’de yeşil hastane kriterlerine
tamamen uyan çok az sayıda hastane bulunmaktadır. Bu çalışmada, bu sayının azlığına dikkat çekmek ve doğal sistemlerin varlığını
ve geleceğini tehlikeye sokmadan yerine getirmeyi hedefleyen yeşil binanın önemine vurgu yapmak amaçlanmaktadır. Çalışma
kapsamında, Trabzon merkezde yer alan ulaşım kolaylığı ve kullanıcı tercihleri doğrultusunda seçilen hastaneler ele alınmaktadır.
Hastane yöneticileri ile görüşmeler yapılarak seçilen hastane yapıları yeşil hastane ölçütlerinden; atık yönetimi, çevre yönetimi, su
yönetimi, enerji yönetimi, tehlikeli maddeler yönetimi, malzeme seçimi ve sürdürülebilir tesis boyutları kapsamında irdelenmektedir.
Anahtar Kelimeler: Hastane, Yeşil Hastane, Sürdürülebilirlik, Tasarım
1. INTRODUCTION
In today's global environment, institutions compete with each other in terms of quality, cost, flexibility and
speed, and most recently, environmental awareness. Environmental pollution and climate change have made
environmental sensitivity an important competitive factor for institutions (Porter, 1995; Soysal, 2014).
Human interaction with nature changes both of them. The interaction in the early ages was affected by
cultural and social changes and the concept of sustainability and sustainable development have reached
different dimensions together with advances in technology (Ozmehmet, 2008). Eco-friendly buildings, also
known as sustainable, ecological, green or eco-friendly buildings, are assessed according to land selection,
designed in a holistic and socially and environmental responsible manner, contain low-consuming and
renewable energy sources and recyclable materials with low carbon release suitable for climate data and
conditions and encourage cooperation and are sensitive to ecosystems (URL-1, 2019). Residences, offices,
hotels and hospitals become more and more sensitive to environmental concerns with the increase in
Doı : http://dx.doi.org/10.31576/smryj.1256
e-ISSN: 2630-631X
Smart Journal 2021; 7(54) : 3512-3522
SMART JOURNAL
International
International SOCIAL MENTALITY AND RESEARCHER THINKERS Journal
Research Article
Arrival : 11/11/2021
Published : 27/12/2021
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ecological awareness, and therefore, the number of energy-saving green buildings made from healthy and
natural materials increases.
Hospitals operate in a global competitive environment and provide 24/7 health services and use complex
biomedical technologies. Weather conditions, cooling, generator systems and medical equipment play a very
important role in health care provided by them. Health care services are heterogeneous and involve complex
engineering services. Therefore, hospitals are very hard to manage in terms of green sustainability (Zawawi,
Kamaruzzaman, Ali and Sulotion, 2010; Hoşgör, 2014). The aim of this study is to draw attention to the low
number of green hospitals and to highlight the significance of “green building” which aims to protect natural
systems and use natural resources effectively. The study sample, therefore, consists of hospitals in the center
of the city of Trabzon. The hospitals were selected based on ease of transportation and user preferences. The
study addresses seven green hospital criteria: waste management, environmental management, water
management, energy management, hazardous substances management, material selection and sustainable
facility. These criteria were determined based on interviews with hospital managers and experts.
2. GREEN BUILDING
Eco-friendly and ecological buildings have become important in the construction sector due to global
warming, increased production, carbon dioxide emissions, environmental pollution and consumption of
natural resources and reduction in natural resources. The growing interest in eco-friendly buildings has led to
the construction of green buildings, which are certified according to certain standards. Green buildings are
ecological and comfortable buildings that use natural resources efficiently, respect the nature, ensure the
integration of people with nature and protect their health (Şimşek, 2012). They emerged at the end of the
nineteenth century and at the beginning of the twentieth century and have recently become popular. With
their sustainable developments and designs, green buildings have made significant contributions to
sustainability since the 1980s. The concept of green building is addressed with reference to developments in
sustainable architecture (Wu and Low, 2010). Green buildings have numerous advantages. They;
✓ Reduce the emission of carbon dioxide;
✓ Minimize environmental damage during construction;
✓ Reduce operating costs;
✓ Allow the use and development of renewable energy;
✓ Allow the reuse of debris;
✓ Allow rainwater harvesting (green roof);
✓ Allow the use of natural light;
✓ Save energy;
✓ Reduce heating and cooling costs (insulation systems);
✓ Increase the value of the building;
✓ Provide users with a healthier and more productive environment;
✓ Add value to urban spaces (Erdede, Erdede and Bektaş, 2014).
Globalization, urbanization and rapid consumption change life rapidly and increase the value of the concepts
of sustainability, ecology and green building. Green buildings provide users with functional, efficient,
durable and eco-friendly spaces. The next section defines the concept of green hospital, draws attention to
their scarcity and presents example to highlight their significance.
3. GREEN HOSPITAL
Hospitals consume a lot of energy and water, produce a large amount of chemical and non-chemical waste
and potential hazardous substances and contain a large number of equipment. The concept of “green” has
become a current issue for hospitals due to limited resources, insufficient waste storage and disposal areas,
narrow-scoped personnel training on the use and disposal of hazardous substances and little incentive for the
use of renewable energy sources. The implementation “green” to hospitals aims to use alternative sources,
promote more efficient use of energy, water and materials, reduce wastefulness and design eco-friendly
buildings (Terekli, Özkan and Baygın, 2013). In the short term, sustainable health service seeks to reduce the
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negative effects of the built environment on human health. In the long term, its objective is to ensure that
buildings contribute to the physical and mental and spiritual well-being of people. Hospitals reduce their
environmental impact, and thus, pollute the environment less. For example, they reduce the amount of
pollutants in the air and soil by disposing of or incinerate toxic waste (Wittmann, 2010; Palteki, 2013).
Figure 1. İstanbul Şişli Florence Nightingale Hospital (URL-2, 2019)
There has been a growing interest in the construction of green hospitals in Turkey in only recent years, and
therefore, there are only a few of them. Having been designed as a smart hospital, Istanbul Florence
Nightingale Hospital is the first in Turkey to receive TUV Hessen Green Building Certificate and be
awarded the title of “Green Hospital.” The 219 bedded hospital in Şişli has 11 operating rooms and 2
delivery rooms equipped with laminar airflow where the number of particles and microorganisms,
temperature, humidity, fresh air, ambient air pressure and air movements are monitored (URL-3, 2019).
Figure 2. Pittsburgh Children’s Hospital (URL-4, 2019)
Located on 10 acres of land and consisting of two buildings constructed using the latest technology,
Pittsburgh Children's Hospital ranks first in the 30 most eco-friendly hospitals in the world. It has erosion
control, effective natural light and water and energy use, good indoor air quality and smoke control
technologies and heating system and showers with humidity control. The applications that make it a green
hospital are: a water-efficient garden design, use of certified wood products, non-toxic cleaning agents and
micro-fiber cloth, recycling programs for paper, cardboard, plastic, batteries and bulbs, and a green education
program for hospital staff, patients and their family members (Stevens, 2014; Savaş, 2018).
Green hospital is a recent concept for Turkey, and therefore, the number of green hospitals is few (Kılıç and
Güdük, 2018). Hospitals serving 24/7 are of paramount importance for human health, comfort and
sensitivity. With new laws and regulations, most countries aim to increase the number of green hospitals.
3.1. Green Hospital Criteria
The seven green hospital criteria are waste management, environmental management, water management,
energy management, hazardous substances management, material selection and sustainable facility (Figure
3). This section addresses them one by one.
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Figure 3. Green Hospital Criteria
3.1.1. Waste Management
Creating an action plan is an important element of waste management. The action plan should include:
✓ Modification of a process in a way to reduce waste generation (e.g., keeping records in electronic format);
✓ Purchase of eco-friendly products;
✓ Waste management (waste sorting);
✓ Analysis of materials in terms of environmental risk before purchase and use;
✓ Reduction of the number of products or equipment containing polyvinyl chloride (PVC);
✓ Determination and reduction of toxic substances and avoiding the use of bioaccumulative substances;
✓ Regular evaluation of waste and waste resources and review of opportunities for waste disposal and
recycling (Wissenschaftszentrum, 2005; Palteki, 2013).
3.1.2. Environmental Management
Health institutions focus not only on patient care, but also on creating high-performance and therapeutic
environments. Environmental designs help prevent hospital infections, increase patient satisfaction and staff
productivity and reduce injuries. Research associate’s environmental management in health institutions with
benefiting from daylight, access to external spaces and in-door air quality, and reduction in drug
administration errors, length of hospital stay, and patients' and family members' stress (Özkan, Bayın and
Terekli Yeşilaydın, 2014).
3.1.3. Water Management
Hospitals use water for different purposes. Water management in green hospitals involves using water
resources efficiently, reducing the polluting effect of waste water and controlling the water cycle. Therefore,
hospitals should develop water flow charts and identify water use areas and quantities and develop strategies
to reduce water consumption. These strategies can be listed as follows:
✓ Including sterilizable bubble particles in water stream and creating automatic water volume control to
measure the amount of water consumption;
✓ Using smart shower and thermostat systems to save water;
✓ Installing cisterns for rainwater harvesting (Soysal, 2014).
3.1.4. Energy Management
Energy-saving building designs take into account such variables as climate, direction and prevailing wind
and focus on efficient use of energy. They require appropriate active and passive supervision, high
performance in terms of heating, cooling, ventilation and daylighting and energy conservation control
(Dikmen, 2011).
✓ Using solar panels;
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✓ Using energy effective lighting elements;
✓ Using film or thermal insulation glass in windows to prevent heat loss;
✓ Using natural ventilation in addition to mechanical ventilation;
✓ Developing building automation systems;
✓ Using more than one boiler;
✓ Installing an insulation system (Terekli, Özkan and Bayın, 2013).
3.1.5. Hazardous Substances Management
Hazardous substances management is an important daily activity of hospitals. Some of the potential
hazardous substances used in hospitals are organic and inorganic compounds, corrosive substances (acid/
base), disinfectants and other compounds containing carcinogenic, mutogenic or reproductive toxins.
Minimizing their impact on staff, patients, visitors and the environment is critical. Therefore, green hospitals
can prevent potential hazards by using less hazardous substances (Özkan, Bayın and Terekli Yeşilaydın,
2014).
3.1.6. Material Selection
Building materials are also part of the ecosystem and, therefore, should be eco-friendly and natural.
Ecological designs should consist of materials that are produced and transported cheaply and do-little
damage to nature (Aktuna, 2007). Materials should harm the environment as little as possible during
construction, use and demolition and should be able to be reused after demolition. Some criteria should be
determined to assess materials in terms of building biology.
✓ The amount of energy required during production;
✓ Waste and by-products as harmful substances during production;
✓ Recyclability of materials;
✓ Reusability of materials;
✓ Availability of materials from local sources;
✓ Production and application possibilities aside from center major facilities;
✓ The reusability and recyclability of materials reduces the consumption of natural resources, which should
be taken into account when selecting materials (Stahel, 1990; Çilhoroz and Işık, 2018).
3.1.7. Sustainable Facility
In order to satisfy this criterion, hospitals should have:
✓ Natural ventilation;
✓ Sufficient number of windows for daylighting;
✓ Outdoor recreation areas for visitors and non-bedridden patients;
✓ Transportation options;
✓ Adequate parking spaces (Çilhoroz and Işık, 2018).
4. STUDY AREA
The study sample consists of Numune, Fatih State, Farabi, Yıldızlı Medical Park, Karadeniz Medical Park
and Imperial Hospitals situated in the city center of Trabzon. The hospitals were selected for ease of
transportation and user preferences. However, we could not access the data of Karadeniz Medical Park and
Imperial Hospitals. Another reason for the selection of these hospitals is that they have different departments
(dentistry, cardiology, etc.). Table 1 shows the location of the hospitals.
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Table 1. Location of Hospitals
Table 2 provides the addresses and construction years of the hospitals.
Table 2. Id of Hospitals
Hospitals
IDs
Numune Hospital
Address: İnönü Neighborhood, Maraş Street Numune Kampüsü,
61250 Merkez/Ortahisar/Trabzon
Year of Construction: 1937
Fatih State Hospital
Address: Inönü Neighborhood, Inönü Street No:177, 61040
Ortahisar/Trabzon
Year of Construction: 1958
Farabi Hospital
Address: Üniversite Neighborhood, Farabi Street No:64, 61080
Trabzon Merkez/Ortahisar/Trabzon
Year of Construction: 1986
Medical Park Hospital
Address: Merkez Neighborhood, Sahil Road Street. No: 46, 61310
Akçaabat/Trabzon
Year of Construction: 2015
5. FINDINGS
This study analyzes Numune, Fatih State, Farabi, Yıldızlı Medical Park Hospitals in terms of waste
management, environmental management, water management, energy management, hazardous substances
management, material selection and sustainable facility. Interviews were conducted with experts working in
the hospitals. Data were tabulated and interpreted.
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Table 3. Waste Management
Waste management
Numune
Hospital
Fatih State
Hospital
Farabi
Hospital
Medical Park
Hospital
Waste management guide
Yes
Yes
Yes
Yes
Examination of materials in terms of environmental risk before
purchase and use
Yes
Yes
Yes
Yes
Warehouses for storing waste before recycling
Yes
Yes
Yes
Yes
Deposition, decomposition and storage
Yes
Yes
Yes
Yes
Regular inspection of waste and waste resources
Yes
Yes
Yes
Yes
Waste transport
Yes
Yes
Yes
Yes
Achieving targets for waste reduction
Yes
Yes
Yes
Yes
Regular training on waste management for staff
Yes
Yes
Yes
Yes
Table 3 investigates whether the hospitals meet the criteria of waste management. All hospitals apply a
comprehensive written waste management program. There are warehouses where waste is kept before being
transferred to recycling units. However, Farabi Hospital does not have a special storage for waste vegetable
oil. None of the hospitals produce nuclear waste. They all follow guidelines for collection, separation,
storage and disposal. They regularly inspect waste and waste resources. Waste is transported from the
hospitals to private contractors or landfills. They have written objectives and seek ways to reduce the
production of hazardous or non-hazardous wastes. The results show that the hospitals meet the criteria for
waste management.
Table 4. Environmental Management
Environmental management
Numune
Hospital
Fatih State
Hospital
Farabi
Hospital
Medical
Park
Hospital
Waste management guide
Yes
Yes
Yes
Yes
A guide (if there is one) that contains environmental protection
No
Yes
Yes
Yes
Defined environmental protection responsibilities and informed staff
Yes
Yes
Yes
Yes
High performance and therapeutic environments
Yes
Yes
Yes
Yes
Staff responsible for waste, chemicals, energy, pollutants, radiation
safety and hygiene
Yes
Yes
Yes
Yes
Table 4 evaluates the hospitals in terms of environmental management. They have guidelines containing
environmental management and protection. All hospitals, except for Numune, have defined responsibilities
related to environmental protection and informed staff. They aim to construct high performance and
therapeutic environments. They have staff (albeit few in number) responsible for waste, chemicals, energy,
pollutants, radiation safety and hygiene.
Table 5. Water Management
Water management
Numune
Hospital
Fatih State
Hospital
Farabi
Hospital
Medical Park
Hospital
Using water-saving faucets
No
No
Yes
No
Regular inspection of faulty installations
No
Yes
Yes
Yes
Using low-flow showers, thermostats and dual flush toilets
No
No
No
Yes
Cutting off regional flow to prevent water leakage
Yes
Yes
No
Yes
Rainwater harvesting
No
No
No
No
Considering the amount of water to decide on the garden
landscape
No
Yes
Yes
No
Table 5 evaluates the hospitals in terms of water management. Unlike waste management and environmental
management, the hospitals have shortcomings in water management. Yıldızlı Medical Park Hospital has
dual-flush toilets and low-flow faucets, does regular inspections to prevent leaks and discharges dialysis
wastewater in accordance with the law. Fatih State Hospital does regular inspections to prevent leaks, has
regional flow-cutting equipment to prevent water leakage, takes into account the amount of water needed in
the garden and discharges dialysis wastewater and lab chemicals properly. Numune Hospital does regular
inspections to prevent leaks, has dual-flush toilets and water-saving faucets and has a radioactive decay
system for nuclear medicine wastewater.
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Table 6. Energy Management
Energy management
Numune
Hospital
Fatih State
Hospital
Farabi
Hospital
Medical Park
Hospital
Reducing energy consumption
Yes
Yes
Yes
Yes
Thermal insulation
No
No
Yes
Yes
Solar panels
No
No
No
Yes
Energy-saving lighting systems
Yes
Yes
Yes
Yes
Low-energy electronic devices
No
Yes
Yes
Yes
Table 6 evaluates the hospitals within the scope of energy management. They all seek ways to reduce energy
consumption. Yıldız Medical Park and Farabi Hospitals have thermal insulation. It is only Yıldızlı Medical
Park Hospital that has solar panels. They all have energy-saving lighting systems, and all of them, except
Numune, have energy-saving electronic devices.
Table 7. Hazardous Substances Management
Hazardous substances management
Numune
Hospital
Fatih State
Hospital
Farabi
Hospital
Medical Park
Hospital
A program for hazardous substances
Yes
Yes
Yes
Yes
Hazardous waste storage
No
Yes
Yes
Yes
Using mercury-containing materials
Yes
No
No
No
Table 7 analyzes the hospitals in terms of hazardous substances management. All hospitals have a program
to reduce hazardous substances and all, except for Numune, store hazardous substances properly. Yıldız
Medical Park, Fatih State and Numune Hospitals do not use mercury-containing materials. Farabi Hospital
uses mercury-containing materials but makes efforts to reduce their use.
Table 8. Material Selection
Material selection
Numune
Hospital
Fatih State
Hospital
Farabi
Hospital
Medical Park
Hospital
Using recycled materials
No
Yes
No
No
Reusing materials
No
Yes
No
No
Using local materials
Yes
Yes
Yes
Yes
Using fresh vegetables and fruits
No
Yes
Yes
Yes
Table 8 examines the hospitals in terms of material selection. It is only Fatih State Hospital that recycles and
reuses materials. All hospitals use local materials, and all, except for Numune, serves fresh fruits and
vegetables.
Table 9. Sustainable Facilities
Sustainable facilities
Numune
Hospital
Fatih State
Hospital
Farabi
Hospital
Medical Park
Hospital
Sufficient number of windows for natural ventilation and lighting
Yes
Yes
Yes
Yes
Outdoor recreation areas
Yes
Yes
Yes
Yes
Transportation options
Yes
Yes
Yes
Yes
Adequate parking space
No
Yes
Yes
Yes
Table 9 examines the hospitals in terms of sustainable facility. All hospitals conform to the criteria of
sustainable facility. They have a sufficient number of windows for natural ventilation and lighting, outdoor
and indoor recreation areas and transportation options such as buses and minibuses. All hospitals, except for
Numune, have parking spaces for private vehicles.
6. CONCLUSION
The concept of green architecture is becoming more and more important all over the world due to the
ecological consequences of the global warming. Green buildings reduce energy consumption, ensure
efficient use of natural resources, help to integrate with nature and protect human health. Increased energy
and water consumption and the amount of chemical waste also force hospitals to be green. The aim of green
hospitals is to use energy, water and materials less and more efficiently and to raise ecological awareness. To
be green, hospitals should meet many criteria under the headings of waste management, environmental
management, water management, energy management, hazardous substances management, material selection
and material selection. The aim of this study was to draw attention to the low number of green hospitals and
to emphasize the significance of green buildings. The study sample consisted of Yıldızlı Medical Park, Fatih
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State, Numune, Karadeniz Medical Park, Imperial and Farabi Hospitals situated in the city center of Trabzon.
They were selected for ease of transportation and user preferences. Hospital managers and experts were
interviewed to determine whether the hospitals satisfy the criteria for green hospital designs.
Numune Hospital is largely in compliancewith the criteria for waste management. In terms of environmental
management, the hospital has a guideline for the quality of health care services, and the guideline contains
regulations on environmental protection. However, the hospital has neither clearly defined environmental
responsibilities nor informed staff. It also has shortcomings in water management. It carries out activities for
energy management and has energy-saving light bulbs. It meets the criteria for hazardous waste
management. It has a program to reduce or substitute hazardous substances but does not store hazardous
substances properly enough and does not pay attention to using recyclable materials and serves canned and
frozen food. It has a sufficient number of windows for ventilation and lighting but insufficient parking areas.
It is, therefore, the only hospital that fails to meet some of the criteria for sustainable facility.
Fatih State Hospital implements a waste management program and meets the criteria for environmental
management. However, it has shortcomings in water management. It has no dual-flush toilets and water-
saving faucets. It concentrates on reducing consumption but does not have thermal insulation. It has energy-
saving light bulbs and electronic devices. It complies with all the criteria for hazardous substances
management. It uses recycled materials and does not serve frozen or canned food. It has a sufficient number
of windows, recreation areas, transportation options and parking areas, and therefore, meets the criteria for
sustainable facility.
Farabi Hospital has a written waste management program, storage units for medical, domestic, packaging,
electronic, vegetable oil wastes, however, it has a partial capacity to store nuclear medical waste. It has staff
responsible for waste, hazardous chemicals, wastewater, energy, pollutants, hazardous emissions, radiation
safety and hygiene. It also has shortcomings in water management. It seeks ways to reduce energy
consumption. It is partially insulated. It uses mercury-containing materials but tries to reduce the amount. It
has not yet put the project of using recycled materials into effect. It has a sufficient number of windows,
recreation areas, transportation options and parking areas, and therefore, meets the criteria for sustainable
facility.
Star Medical Park Hospital has a written waste management program, storage areas for medical, domestic,
packaging, electronics, vegetable oil wastes to be kept in until they are transferred to the disposal or
recycling area, written objectives to reduce the productionvolumes of hazardous or non-hazardous wastes,
carries out internal inspections on waste regulations and has written objectives to reduce the amount of
hazardous or non-hazardous wastes and produces no wastewater and nuclear medicine waste. The hospital
largely meets the criteria for environmental management and has a guideline with environmental protection.
It has clearly defined responsibilities related to environmental protection, of which the staff is informed. It
has, however, shortcomings regarding water management. It has double-flush toilets and performs regular
inspections to prevent plumbing leaks. It is insulated and seeks ways to reduce energy consumption. It meets
the criteria for hazardous substances management and does not use mercury. It takes recycling and reuse into
account in material selection. It has a sufficient number of windows, recreation areas, transportation options
and parking areas, and therefore, meets the criteria for sustainable facility.
All four hospitals have shortcomings. Although Medical Park is the newest hospital, it also fails to meet
certain criteria. These criteria, which should be taken into account before building a hospital, are critical for
both the environment and people. In conclusion, there are few green hospitals, and therefore, new buildings
should be designed based on sustainable criteria, which should also be taken into account in the renovation
of historic buildings.
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