In recent years, as resources have become tighter, energy costs have risen and healthcare costs have skyrocketed, a commitment to sustainable operations has become more essential. Hospital Sisters, composed of 13 hospitals and an integrated physician network across Illinois and Wisconsin, recently partnered with Practice Greenhealth to ratchet up its commitment to sustainability, and for its work received the 2014 Practice Greenhealth System for Change Award for Environmental Excellence.
When healthcare systems like Hospital Sisters commit to making a difference for the environment, purchasing departments are key drivers in meeting that goal. Supply chain professionals are often the first experts consulted since they look at the total cost of a product, including its associated water, utility and labor costs, says Laura Brannen, sustainability consultant and previously executive director of Hospitals for a Healthy Environment, which became Practice Greenhealth in 2008.
From a purely “first-cost” perspective, purchasing decision-makers may choose the least expensive fluorescent light bulbs. But a total-cost perspective considers the labor costs involved in changing light bulbs more frequently, making energy-efficient bulbs the less expensive choice, Brannen says.
A commitment to sustainability in the supply chain can achieve bottom-line results. Wentworth-Douglass Hospital in Dover, New Hampshire, initiated a series of “Green Light Projects” through the American Hospital Association (AHA’s) Sustainability Roadmap and realized over $470,000 in annual energy and water savings.
The high energy requirement in the healthcare sector makes hospitals vulnerable to increases in the cost of fossil fuels. Growth in primary energy consumption worldwide is projected to continue at an annual rate of 1.4 percent until 2030.
Energy-saving choices can have other advantages, too. “Our patients, community and bottom line all benefit from environmentally preferable purchasing,” says Bonnie Eskenazi-Melendez, managing director of the Deirdre Imus Environmental Health Center at Hackensack University Medical Center (HackensackUMC) in Hackensack, New Jersey, recipient of a 2014 HealthTrust Social Stewardship Award and a Top 25 Environmental Excellence Award from Practice Greenhealth. “If we can prevent potential toxic exposures by selecting a healthier product that works just as well, with less waste, then we are delivering better healthcare.”
Historically, many supply chain professionals assumed that environmentally preferable purchasing (EPP) costs more than traditional purchasing, says J. Michael Jones, former director of clinical education and sustainability at HealthTrust. But that’s not true.
Construction Energy Consumption
According to the U.S. Environmental Protection Agency and the U.S. Green Building Council, U.S. building construction and operations result in the following consumption of resources at any given time:
72% of electricity resources
39% of total energy used
3 billion tons of raw materials annually (40 percent of raw stone, gravel, sand and steel; 25 percent of virgin wood)
Construction and operation of all buildings in the United States result in the following generation of waste materials:
25-40% of municipal solid waste (trash or garbage)
50% of chlorofluorocarbons (CFCs)
30% of CO2 production
“As more facilities become better informed and recognize that EPP incorporates value analysis and total cost of ownership considerations, they realize that it can help their organizations reduce operating costs and save money while concurrently decreasing their environmental impact,” Jones says.
Brannen, who led development of the AHA’s Sustainability Roadmap, recommends that hospital supply chain professionals embed sustainability considerations into their value analysis process. “When the value analysis process changes across an entire sector, the marketplace will begin changing,” she says.
More resources are emerging to help supply chain professionals implement these sustainability plans. “Don’t think you have to do this all by yourself,” Brannen says.
Here’s how some HealthTrust member facilities have realized cost savings and made social stewardship strides by implementing more environmentally friendly practices.
Bigfork Valley Hospital
Bigfork, Minnesota-based Bigfork Valley Hospital was recognized as another 2014 HealthTrust Social Stewardship Award winner. “As a facility located in the middle of the lakes and pines area of northern Minnesota, we have a strong sense of environmental stewardship,” says Sally Sedgwick, executive director of marketing for the facility. “If it is financially responsible, we try to do what is environmentally responsible in terms of purchasing, recycling and other stewardship initiatives.”
For instance, as part of its building projects, Bigfork Valley installed 64 wells that are 200 feet deep and 250 feet long with 40 horizontal geothermal loops. These wells provide geothermal heating and cooling assistance and have significantly reduced energy costs and propane use. In addition, Bigfork Valley reduced lighting costs by replacing existing lights with energy-efficient bulbs throughout the facility. And through its HealthTrust membership, the facility purchased a new chemical analyzer that uses no water and discharges virtually no hazardous or liquid waste products.
For Bigfork Valley, making sustainability a priority for purchasing decisions just makes good business sense. The organization understands social stewardship as a comprehensive package. “We provide top-quality care to patients while promoting and enabling health and fitness for the community through events, education, fitness equipment and healthy spaces,” Sedgwick says. “In order to do this in a rural community, Bigfork Valley must look at carefully administering its assets and creating sustainable facilities.”
Catholic Health Initiatives
Based in Englewood, Colorado, Catholic Health Initiatives (CHI) operates 93 hospitals in 18 states. The system has made sustainability a top priority for several years and won a Practice Greenhealth Award for Environmental Excellence earlier this year.
That award was a result of member hospitals’ ongoing focus on sustainability in a number of areas, including preferred purchasing, energy reduction, sustainable and nutritious food, use of less toxic chemicals, greening the operating room, and sustainability leadership, says Rozi Arends, CHI sustainability manager.
“Environmentally preferred purchasing is very important because … you not only improve the environment, but you can also save money,” Arends says. “Through OR pack consolidation and component reduction, you send less to the landfill and many times save on the price of the OR pack. By reprocessing single-use devices, you can make a big difference in your supply bill and save tons of waste from going to landfills.”
In addition to those examples, CHI works in a mutually beneficial way with suppliers to reduce packaging. “They do not have to produce all that packaging, and we don’t have to get rid of it,” Arends says.
The system’s greatest successes have come from using key HealthTrust contracts. One has helped the system to significantly reduce energy costs, and the other has made it possible to reprocess supplies, saving millions of dollars for CHI.
Hackensack University Medical Center
In 2005, HackensackUMC built one of the first “green” hospitals in the country, the Sarkis & Siran Gabrellian Women’s & Children’s Pavilion. In constructing that facility, the team purchased everything from cotton denim insulation to recycled steel and non-toxic toys, and it worked with manufacturers to develop a non-PVC railing throughout the facility. “Back then, it was challenging to source these types of products,” Eskenazi-Melendez says.
Today, however, HackensackUMC has taken the lead in choosing quality alternatives to traditional healthcare products that are better for the patient and the environment. For example, the hospital system selects green cleaning products that deliver the same efficacy as their conventional counterparts without potential exposures to known carcinogens and other chemicals that could harm humans.
In terms of its overall spending, the healthcare industry is resource-intensive—17.9 percent of the U.S. GDP in 2010 and rising—and it represents a significant carbon footprint.
Source: Sustainability Roadmap for Hospitals, www.sustainabilityroadmap.org
HackensackUMC’s Greening the Cleaning program, which involves using only non-toxic or less-toxic products for everyday cleaning, has helped improve indoor air quality, reduced costs, enhanced employee health, and contributed to a greener and more sustainable building environment. Hackensack has also eliminated all polystyrene cups and foodware from campus cafeterias and replaced them with biodegradable options. In addition, the facility switched to purchasing pigment-free basins, zero-VOC paints and LED surgical lighting, and increased its use of reprocessed single-use medical devices. According to Brannen, facilities can purchase a reprocessed device for 30 to 50 percent of the original price.
The use of cotton insulation made from pre-consumer recycled jeans has helped eliminate the coughing, nosebleeds and other respiratory ailments that can be caused by inhaling fiberglass particles from conventional insulation. HackensackUMC’s women’s and children’s hospital has more than 117,000 pairs of recycled blue jeans behind its walls, Eskenazi-Melendez says. “Denim insulation holds more heat and absorbs more sound. Formaldehyde [included in conventional insulation] is suspected of causing a variety of illnesses, including cancer; illnesses of the respiratory tract; developmental, reproductive and skin disorders; and problems of the nervous system, according to the Environmental Protection Agency.”
In addition to earning Practice Greenhealth’s 2014 Environmental Excellence Award, HackensackUMC also achieved the Making Medicine Mercury-Free Award, which recognizes facilities that have demonstrated a commitment to being mercury-free, virtually eliminating the chemical element.
Hospital Sisters Health System
Most of the hospitals in the Hospital Sisters network have community gardens on site, a nod to the system’s focus on the world around it. “Some of our hospitals grow their own produce, and others donate to food pantries,” Beckler says.
HealthTrust’s Environmental Sustainability Network Streamlines Planet-friendly Purchasing Choices
Healthcare facilities that are attempting to build more sustainable purchasing practices can benefit from HealthTrust’s new Environmental Sustainability Network (ESN), an advisory group of leaders in the areas of sustainable healthcare operations with successful track records at their own organizations.
“After several years of gradual implementation of a formal Sustainability and Environmentally Preferable Purchasing (EPP) program, HealthTrust recognized the need to provide a venue for direct input from its members into these activities,” says J. Michael Jones, HealthTrust’s former director of clinical education and sustainability. “This evolution of the sustainability program and creation of the ESN is driven by the fact that all EPP activities directly impact the sustainable products and services available to our members through HealthTrust’s contract portfolio.”
ESN members are intimately engaged in the environmentally preferable purchasing activities and decisions at HealthTrust, offering members the assurance that their sustainability-related perspective and goals are being considered in the sourcing process. As a result, “when an EPP-related category is announced, members can access the agreement with less delay and without the additional commitment of time and resources,” Jones says. “The sooner members are utilizing EPP-related agreements after they become available, the more significant the impact of the program can be.”
In addition to growing gardens on site, Hospital Sisters facilities recycle many of the products in the waste stream and have converted many hazardous waste products into recyclable waste, Beckler says. Once a week, the hospitals’ cafeterias avoid serving meat to reduce their carbon footprints. And across the system, cleaning staffs use microfiber mops to reduce water and chemical usage.
All 13 hospitals in the system were recognized with an Environmental Excellence Award from Practice Greenhealth, in addition to the system award. “We call it reverence for the earth,” Beckler says. “We have a respect for future generations. We are here to try and fix what happened in the past and to leave a better world for the future.”
In the process of making significant changes for sustainability, Hospital Sisters has found a valuable partner in HealthTrust. “It’s important to be connected to a GPO for environmentally preferable purchasing, because it knows the acceptable products and reasons we shouldn’t purchase some conventional ones. The people in our hospitals have an expectation that the products we use will not put them in harm’s way or create a greater health risk if there is a safer alternative available,” Beckler adds.
Additional Sustainability Resources
Sustainability Roadmap for Hospitals: The Sustainability Roadmap website—accessible at www.sustainabilityroadmap.org—shows hospitals how to implement real-world sustainability projects that can enhance their existing efforts and provide a platform for sharing successes with other facilities. The website features search functions, how-to guides, tools, case studies and other technical resources. The roadmap was created by three professional membership groups within the American Hospital Association (AHA): the American Society for Healthcare Engineering (ASHE), the Association for the Healthcare Environment (AHE) and the Association for Healthcare Resource & Materials Management (AHRMM).
ENERGY STAR Portfolio Manager: Facility managers can use the Environmental Protection Agency’s ENERGY STAR Portfolio Manager online benchmarking tool to securely track energy and water use over time. Access the tool and get more information at http://portfoliomanager.energystar.gov.
Energy to Care program: The free Energy to Care program helps hospitals track energy consumption and rewards progress. Participating hospitals track their energy use through the Portfolio Manager online benchmarking tool and can visualize energy trends using a robust dashboard. In addition to gaining recognition for reducing energy use, hospitals can participate in challenges that add friendly competition to the mix. Hospitals can compete against other facilities in their health systems, states or regions. The program is coordinated by ASHE. Information is available at www.energytocare.com.
Health Care Without Harm is an international coalition of hospitals, healthcare systems, medical professionals and other environmental health groups that implements ecologically sound and healthy alternatives to healthcare practices that pollute the environment and contribute to disease. Its programs work to combat poor waste management, use of toxic chemicals, unhealthy food choices and reliance on polluting technologies. Learn more at http://noharm.org.
Energy University: Energy University, a supplier-neutral e-learning program from Schneider Electric, offers online courses to facility managers and others involved in facility operations and maintenance. ASHE members can access these tools for free. Visit www.ashe.org/energyuniversity for more information.
Source: “Environmental Sustainability in Hospitals: The Value of Efficiency.” Health Research & Educational Trust, Chicago, May 2014. Accessed at www.hpoe.org.