?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.relation=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F19083%2F&rft.title=Understanding+and+Improving+Healthcare+Using+Environmental+Life+Cycle+Assessment+and+Evidence-Based+Design&rft.creator=Thiel%2C+Cassandra&rft.description=This+dissertation+quantifies+and+analyzes+the+environmental+and+human+health+impacts+associated+with+healthcare+through+assessment+of+the+physical+built+environment+of+a+hospital+as+well+as+the+processes+and+procedures+conducted+within+the+building.++Healthcare%2C+especially+in+the+United+States%2C+seeks+to+reduce+cost+and+improve+human+health+in+part+by+reducing+waste+and+improving+building+design+and+operational+practices.++This+work+shows+that+sustainability+engineering+tools+help+assess+the+effects+of+green+design+considerations+in+whole+hospital+performance+and+can+identify+areas+of+high+environmental+loading+in+the+operating+room+(OR).%0D%0AA+comparative+longitudinal+assessment+showed+the+hospital+performance+impacts+of+green%2C+holistic+hospital+design.++Following+the+move+into+the+new%2C+green+facility%2C+the+Children%E2%80%99s+Hospital+of+Pittsburgh+of+UPMC+significantly+improved+their+productivity%2C+quality+of+care%2C+and+staff+satisfaction.++The+utility+use+per+square+foot+dropped+over+50%25+for+electricity%2C+heating+energy%2C+water%2C+and+sewer%2C+while+hospital+expenses+per+patient+in+bed+remained+stable.++This+and+other+contributions+to+the+field+of+Evidence-Based+Design+inform+future+design+decisions+which+optimize+hospital+energy+use+and+maximize+positive+patient+outcomes+and+staff+satisfaction.%0D%0AThis+research+established+process+and+hybrid+life+cycle+assessment+(LCA)+frameworks+to+assess+hospital+operating+room+procedures.++Case+studies+of+infant+birth+procedures+and+hysterectomies+at+Magee-Womens+Hospital+of+UPMC+show+that+production+and+disposal+of+single-use+materials+and+devices+as+well+as+heating%2C+ventilation%2C+and+air+conditioning+systems+have+the+highest+environmental+loading+within+the+OR.%0D%0AThe+hysterectomy+study%2C+in+particular%2C+pointed+to+upstream+material+manufacturing+as+an+area+for+large+environmental+improvements+in+healthcare+facilities.++For+example%2C+single-use+cotton+materials+such+as+towels+and+gauze+make+up+only+9%25+of+vaginal+and+11%25+of+abdominal+hysterectomy+municipal+solid+waste+by+weight%2C+but+the+production+of+these+cotton+materials+accounts+for+55-90%25+of+the+total+environmental+impacts+of+vaginal+and+abdominal+hysterectomies+in+nearly+all+categories+analyzed.++A+Monte+Carlo+assessment+of+the+hysterectomy+LCA+showed+ranges+of+environmental+impacts+based+on+variability+of+OR+procedures+and+uncertainty+in+impact+assessment+methods.++%0D%0A&rft.date=2013-09-25&rft.type=University+of+Pittsburgh+ETD&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.language=en&rft.identifier=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F19083%2F1%2Fthielcl_etd2013.pdf&rft.identifier=++Thiel%2C+Cassandra++(2013)+Understanding+and+Improving+Healthcare+Using+Environmental+Life+Cycle+Assessment+and+Evidence-Based+Design.++Doctoral+Dissertation%2C+University+of+Pittsburgh.++++(Unpublished)++