Hospitals can’t simply shut down at the end of the night.

They are 24/7 energy consumers, needing power to run their arrays of complex equipment and care for their patients.

They use large quantities of water as well. And they can create a lot of waste that needs to be disposed of — more than 25 pounds of it per bed per day.

All this sounds like an environmentalist’s nightmare, but things are changing. Over the last decade, the idea of creating a “sustainable hospital’’ has gained momentum. Many hospitals are working harder than ever to reduce energy and water use and cut down on waste.

And some are bringing in fresh local produce to improve the nutritional value of the cafeteria fare.

“This is not a fad or trend — it’s here to stay,’’ says Anna Gilmore Hall, director of health care sustainability for Weston Solutions, a Pennsylvania-based consulting firm.

This sustainable hospital trend has recently blossomed in Georgia.

Children’s Healthcare of Atlanta at Hughes Spalding became the first hospital in the state to receive a Leadership in Energy and Environmental Design rating of Gold from the U.S. Green Building Council. LEED is considered a key benchmark for green construction.

The hospital’s “green’’ elements include a reflective roof to help cooling, and energy-efficient and natural lighting.

At the new Piedmont Newnan Hospital, the landscaping plan uses indigenous plants, drip irrigation and moisture sensors, projected to reduce water usage by up to 50 percent. The hospital’s roof is “green-irrigated” with plant material to provide greater insulation.

The total amount the hospital expects to see in energy savings over the next year is $655,000.

Meanwhile, Grady Memorial Hospital and Emory University Hospital Midtown have joined the Atlanta Better Buildings Challenge, with an overall goal of cutting energy use by 20 percent by 2020.

Hospital chains HCA and Tenet, each with hospitals in the state, are among the participants in the Healthier Hospitals Initiative, which promotes a more sustainable model.

One goal is to reduce the hospital’s environmental load on the communities it serves.

“Every [hospital] is doing something,’’ says Dale Woodin of the American Hospital Association. “It varies by degrees.’’

Energy savings have been sought for decades, Woodin says, with current strategies including better regulating the temperature in surgical suites.

Some upfront costs of going greener can be daunting, but experts say the savings can more than make up for initial outlays. Most projects can produce a return on investment within 10 years, if not sooner, Gilmore Hall says.

Tenet, a Dallas-based health care company with hospitals in Atlanta, Roswell, East Point, Griffin and Jackson, spent $75 million nationally last year to make its building more energy-efficient, including replacing roofs, air handling units and chillers.

And Tenet says it has eliminated redundancies in its surgical kits, saving money and reducing waste.

For many older facilities, the challenge is the complexity of the hospital’s physical plant.

A typical model is the main hospital core being built in the 1950s and ’60s, and then having additional structures cobbled together, with different HVAC systems.

Grady is a case in point. The original building was constructed in the 1950s, and air conditioning was added in the 1960s. Renovations came in the 1990s.

“We have original steam boilers that support the entire campus from the 1950s,’’ says Craig Tindall, senior vice president in charge of operations and facilities. “They’re way too big.’’

Grady also has hundreds of air handlers.

But the 2008 reorganization of the hospital and subsequent corporate philanthropy has allowed Grady to look at upgrading its facilities. “We didn’t have a lot of funds for this in the past,’’ Tindall says.

The Atlanta safety-net hospital had been working on its facilities plan when it joined the Atlanta Better Buildings Challenge.

“We’ve got a long way to go,’’ Tindall says. “It’s an enormously complex system to get right.’’

One goal is to eventually replace the boilers. Currently it’s saving money from recycling nonmedical waste, among other tactics.

“Every dollar we save can go to the bedside,’’ Tindall says.