While the growth of environmentally friendly hospital construction and operations practices has been steady for at least 10 years now, it's always been a bit of an open question whether it would be able to maintain its trajectory during difficult economic times.

Indeed, though the arguments supporting the long-term cost benefits of sustainability often are unassailable, a short-term outlook can easily triumph when budgets are squeezed by a recession, a credit crisis and uncertainties surrounding health care reform.

However, data from surveys we've conducted this year appear to show that "green" continues to gain adherents in many parts of the health care industry despite the tough economy.

For instance, 83 percent of the 570 hospitals that responded to our February Hospital Building Report survey said they specified green or environmentally friendly construction materials in at least some of their current construction and renovation projects.

Likewise, results from our sustainable operations survey, which will appear as next month's cover story, found that adoption of sustainable practices over a variety of energy, water, waste management and cleaning areas has achieved a certain level of acceptance.

While much of this progress is undoubtedly due to hospital sustainability goals and individual champions within health care organizations, momentum also has been helped in no small measure by the growing legion of vendors, consultants, professional societies and research groups serving as a support network for the sustainable hospital movement in good times and bad.

With this kind of infrastructure in place, it's unlikely that the health care industry will ever turn back.