Green and Clean Standard for

Hospitals
 Bureau Veritas: A world of knowledge at your service

•Safety & performance verified

•Timber legality & forest •Coal & Minerals tested
management certified

•Airworthiness verified
•Sea water
quality
tested
•Agricultural products tested

•Water & air

emissions •Oil tested
•QHSE management •Ships classed
controlled •- Risk &
systems verified
conformity
assessed
•Containers
certified
•Disabled access verified
•Automotive supply chain &
components verified
•Fuel quality
tested
•Consumer products
tested & inspected •Imports &
exports
inspected
•Industrial processes verified •Fire safety
•- Industrial & environmental inspected
risks monitored

•Railway •Energy •Textiles & •Electronic supply chain &

performance garments components verified •Solidity
maintenance &
certified tested verified
safety of
equipment
certified
•Car safety •Food health &
controlled safety tested
•Smartphone conformity &
interoperability verified

•Construction
materials tested
•Elevator & escalator
•Transport safety certified •Code compliance verified safety inspected
Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 2
Bureau Veritas: A large and balanced portfolio of businesses

Marine & Offshore ► Classification and certification of ships and offshore units

► Risk management, quality assurance, quality control and asset

Industry
integrity management of facilities and equipment

In-Service Inspection
► Periodic inspection of equipment & facilities in operation
& Verification

Construction ► Conformity assessment of buildings and infrastructures

► Certification of QHSE management systems and second party

Certification
auditing services

►Commodities inspection and testing: oil & petrochemicals,

Commodities
metals & minerals, agriculture

Consumer Products ► Testing, inspection and certification of consumer goods

Government Services &

►Trade facilitation services
International Trade

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 3
Association of Healthcare Providers (India)

The Association of Healthcare Providers (India)'s vision is to have healthy India, encompassing
Our Vision society, community and common man at grass root.

Association of Healthcare Providers (India) represents the majority of healthcare providers in

India. It works as "not for profit" organization and advocates with the government, regulatory
bodies and other stake holders on issues, which have bearing on enabling its member
Our Aim organizations to deliver appropriate healthcare services to community at large. The
association functions through an empowered secretariat which facilitates the member
organizations in improving their systems, processes and outcomes on continuous basis, in line
with the vision, mission and objectives of the association.

AHPI shall work with all stake holders in establishing a national system where, common man
can avail assured universal access to basic health services. The Federation will facilitate its
Our Mission members and partnering bodies, in carrying out healthcare improvements to serve the
community effectively and efficiently.

AHPI as on date has more than 10000 Member Hospitals.

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 4
 SUMMARY

•01 •02 •03

•Introduction •Assessment Pillars • Certification Process
•Assessment Pillars for Green •Certification and training to
•Background Info and Clean Hospital deliver continuous improvement

•2
•© Copyright Bureau
Veritas

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 5
What does Green & Clean Standard for Hospitals entail?

The GREEN and CLEAN Hospital aims to mitigate Hospitals shall develop Green and Clean
adverse effects of environment (GREEN) on patients Management System addressing the requirements
and staff and even hasten the recovery process of the standard and suitably incorporate the
through infection free ambience (CLEAN). The requirements within the existing hospital system.
compliance to this Standard shall provide tangible The five pillars identified in this Standard are:
economic benefits like; • Leadership And Commitment
1. Reduced raw material/ resource use • Legal Compliance
2. Reduced energy consumption • Environment Sustainability
3. Improved process efficiency • Operational Control
4. Reduced waste management and disposal cost • Monitoring, Measurement and Improvement
5. Utilisation of recoverable resource
6. Include use of renewable energy
7. Reduced hospital acquired infection and
therefore reduced patient length of stay.

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI •66
Green and Clean Hospital

► A Green and Clean hospital is one that promotes public health by continuously

reducing its environmental impact and ultimately eliminating its contribution

to the burden of disease.

► A Green and Clean hospital recognizes the connection between human health

and the environment and demonstrates that understanding through its

governance, strategy and operations.

► It connects local needs with environmental action

practices primary prevention by actively engaging in efforts to foster

community environmental health, health equity and a green economy.

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 7
Pillars of Green & Clean Hospital

Environment
Sustainability

Leadership And Legal Compliance

Commitment

Monitoring, Operational
Our Measurement & Control
Objective Improvement

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 8
Leadership And Commitment
Leadership and Commitment Pillar shall cover the following parameters:

Management Responsibilities
• strategic Green & Clean objectives, G&C scope and results, policies
and processes, communication, culture, fostering a commitment to
G&C, providing resources and training opportunity, and even
“inspiring, encouraging and recognizing the contribution of people.

Human Resource Management Facility Management

• Education and communication • Infrastructure upkeep
• Participation • Environment friendly maintenance
• Support adjustment practices
• Negotiate agreement
Infrastructure Management
• Green Buildings and Facilities
• Technology
• Equipment & Support
• Disabled friendly zones
Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 9
Legal Compliance

Legal Compliance Pillar shall cover the following parameters:

Legal, Statutory and Regulatory Requirements
• Commissioning of Hospital
• Qualification, Practice and conduct of Professionals
• Sale, Storage of Drugs and Safe Medication
• Governing Management of Patients
• Environment Safety
• Safety of Patients, Staff and Public within Hospital premises
• Medicolegal aspects
• Professional Training & Research
• Mandatory Licences
• Other Business & Employment related Laws (ESIC, PF, Labour welfare
etc.)

Bio-Medical Waste Management

• Health-care waste includes all the waste generated by health-care establishments,
research facilities, and laboratories. In addition, it includes the waste originating from
“minor” or “scattered” sources, such as that produced in the course of health care
undertaken in the home (dialysis, insulin injections, etc.)

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 10
Environment Sustainability
Environment Sustainability Pillar shall cover the following Parameters:
Water Footprint
• Conserve water; avoid bottled water when safe alternatives exist.

Energy Footprint
• Reduce hospital energy consumption and costs through efficiency and
conservation measures.
• Produce and/or consume clean, renewable energy onsite to ensure
reliable and resilient operation.
• Use alternative fuels for hospital vehicle fleets; encourage walking and
cycling to the facility; promote staff, patient and community use of public
transport; site health-care buildings to minimize the need for staff and
patient transportation.

Carbon Footprint
• Build hospitals that are responsive to local climate conditions and
optimized for reduced energy and resource demands.

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 11
Operational Control
Operational Control Pillar shall cover the following Parameters:
Hospital Infection Control
• Nosocomial infections known also as hospital-acquired infections, hospital-
associated infections, and hospital infections are infections that are not present
in the patient at the time of admission to hospital but develop during the
course of the stay in hospital.
Sanitization Process
• Autoclaving (moist heat)
• Dry heat
• Use of chemical sterilants and disinfectants
• Others:
Food Hygiene Practices
• Contamination is one of the most common causes of food borne dieses. It happens when harmful
bacteria are spread onto food from other food, surfaces, hands or equipment. These harmful bacteria
often come from raw meat/poultry and eggs. So it is especially important to handle these foods
carefully. Other sources of bacteria can include, staff, pests, equipment, cloths.
Health & Safety
• Hand hygiene
• Use of PPE (gloves, face protection, gown)
• Respiratory hygiene and cough etiquette
• Safe handling of contaminated equipment and surfaces in the patient environment, used linens,
• Environmental cleaning
Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 12
Monitoring, Measurement And Improvement
Monitoring, Measurement And Improvement Pillar shall cover the following Parameters:

• Monitoring, Measurement of Operational and Legal Compliance

• Green and Clean Improvement Programmes
• Internal Audits
• Management Review

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 13
Certification Process
Roadmap & Criteria
Roadmap to Certification

@ 18 Months
Wk - 13
Wk - 01 Wk - 04
Wk - 07 Wk - 09
Wk - 02 Wk - 06 Wk - 15

G&C team Closure

formation Review of of Gaps
1st Internal Certifica Issue of Surv.
& Training SAQ Fill-up Assessment certificate Audit
Assessment tion &
Registrati results
Audit
on Rating

The dates indicated are tentative. The actual dates may vary depending on readiness from client.

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 15
 Certification Process Assessment
The Hospital shall perform effectively and efficiently to achieve “Green and Clean Practices” status by:
• Understanding and satisfying the requirements of the Green and Clean Practices.
• Monitoring the changes in Hospital environment
• Defining and deploying strategies towards making Green & Clean Hospital
• Managing all required process and relevant resources efficiently and effectively.
• Demonstrating confidence in its employees, leading to increased motivation, commitment and involvement
This assessment tool uses five maturity levels. Hospital should review its performance against specified criteria to
identify current maturity levels and determine its strength and weaknesses.

NA Level 1 / Rating 1 Level 2 / Rating 2 Level 3 / Rating 3 Remarks

Elements of Not Requirements Requirements Requirements
Green and Clean applicable not defined implemented but defined and
Hospital not implemented not defined implemented

Q1
Q2

Assessment Criteria
Size of Hospital Surveillance Audit Recertification
Main Audit
[@18 Months] [End of 3 years]
Up to 100 beds 3.5 2.5 2.5
101- 300 Beds 4.5 2.5 3.5
300+ Beds 6.5 3.5 4.5
Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI •116
Certification Process Onsite audit & Rating

Based on the conditions defined in above assessment tool the percentage of maturity will be calculated. Based
on the calculations of the percentage (Qualifying score), Hospital’s “Green and Clean” Status will be confirmed.

Platinum Diamond Gold

Assessment Tool Criteria Silver Category
Category Category Category
A. Leadership & Commitment >=90% >=80% - <90% >=70% - < 80% >=60% - <70%

B. Legal Compliance >=90% >=80% - <90% >=70% - < 80% >=60% - <70%
C. Environmental
>=90% >=80% - <90% >=70% - < 80% >=60% - <70%
Sustainability
D. Operational Control >=90% >=80% - <90% >=70% - < 80% >=60% - <70%

E. Monitoring, Measurement
>=90% >=80% - <90% >=70% - < 80% >=60% - <70%
and Improvement

Range >=90% >=80% - <90% >=70% - < 80% >=60% - <70%

(1) In order to be eligible for a particular category, apart from the overall
score, there should be no criteria with Rating 1.
NOTE :
(2) An overall score of <60% would not be considered eligible for
certification

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 17
Graphical Representation of Assessment Score
The certificate shall be issued to the Hospital once all the criteria comply with the scoring
requirements. Green score in all of the criteria will only entitle hospital to get the
certificate. The validity of the certificate will be for 3 years with one surveillance audit mid
interval i.e. after 18months.

Leadership and
Commitment
0.9 80%
0.8
0.7
0.6
0.5
Monitoring, 0.4
Measurement & 0.3 Legal Compliance
Improvement 0.2 90%
65%
0.1
0

89%
Environment
Operational Control
Sustainability
70%

Green and Clean Standard For Hospitals, An Initiative by Bureau Veritas and AHPI 18
Educating & Advocating for well Being of
Common Man