2018Inova Sustainability andWellness ReportConnecting your environment andyour health.

Table of Contents

Inova Well

       Goals and Progress.............................3

       Six Dimensions of Health......................4

       Success Stories....................................5

Sustainability at Inova

       Goals and Progress....................................6           Sustainability Stoplight Report..........7

       Environmental Focus Areas..............8

              Waste Management.........................9

              Environmentally-Preferable                                     Purchasing.......................................10

              Sustainable Foods................................11

              Water and Energy Management............12

              Alternative Transportation and Green              Buildings..................13

              Engagement and Climate                                   Health..............................................14              

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Goals and ProgressWellness at Inova

KEY WELLNESS PRINCIPLES

INOVA WELL MISSION STATEMENTInova Well's mission is to create asustained culture of wellness by leveragingour clinical expertise to provide evidencebased solutions for healthy people, healthycommunity and healthy planet. 

Inova Well collaborates with all other Inovaentities in order to provide personalized,sustainable and evidence based wellnessinitiatives and activities that inspire and activateeach individuals personal wellness success andjourney.

Patient Always

Wellness intersects with Inova’s culturalbeliefs in a number of key ways, including:

Stronger Together

Inova Well's mission is to create a sustainedculture of wellness by leverage our clinicalexpertise to provide evidence based solutions forhealthy people, healthy community and a healthyplanet. 

INOVA'S CULTURE JOURNEY

2018 Wellness Accomplishments

2019 Wellness Opportunities

To improve team member health andwell-being through our six dimensionsof health.

Invest in our team members withhealth education and lifestyle skillsthat enable them to achieve optimalhealth and wellness.

Positively affect team member moraleand job productivity.

We had a 21% increase in team members visiting theirPCP We had a 34% increase in total participation in our InovaWell eventsAs a system we saw a 7% decrease in total cholesterolaverage in our health screeningsAs a system we saw a 21% decrease in LDL cholesterolaverage in our health screenings, the bad fatWe saw a 15% increase in HDL cholesterol average in ourhealth screenings, the good fatWe saw a 35% increase in team members who received adiscount on their health insurance premiums for the2019 year

Shifted from a point based team member wellnessprogram, to a more preventive care team memberwellness program and culture shiftTeam members may now visit with their IMG Physicianfor their 2019 health screening. If team members donot have a primary care physician, they now have oneand can start building a relationship with him or herwhile getting their screening doneMore health coaches to help support team member'swellness journeys while helping aid in the cultural shiftof wellness at our hospitalsNew and improved portal experience and incentiveprogram that focuses on routine check-ups with yourPCP and age appropriate screenings, such as dentist,dermatologist, OB-GYN, optometrist, and mentalhealth screeningsLaunch of Inova Well Ambassador program that willfocus on spreading the message of health and wellnesswhile assisting Inova Well in engagement

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The Inova Well program is focused on supporting whole health through ourseven dimensions of health.

What We Believe What We Do

Knowing and understandinginformation on your healthprofile is the important firststep in managing your uniquewellness needs.

Health Coaching

Be Aware

Health Coaching offersonline support or supportwith a personal health coachwho is as committed to yourhealth goals as you are.

Health Coaching

Be Aware

Eat WellGood nutrition and healthyeating habits provide afoundation for being healthyand can help reduce the riskof chronic diseases.

Physical fitness can producelong-term health benefitsand help prevent chronicdiseases.

Living life to the fullest iscentered on having a healthymind.

A commitment tocontributing to anenvironment that is safe andhealthy for team membersand community creates ahealthier environment fornow and for the future.

Get Active 

Healthy Mind

Live Green

Eat Well

Get Active 

Healthy Mind

Live Green

Multiple online health coaching program; WellBaby, PersonalBack/Quit/Weight Coaches, Fit and Fit Coach and moreIn person 1:1 health coaching to help develop individual wellnessgoals, create a plan and help with each step along the wayDedicated health coaches to support developing a culture ofwellness throughout Inova 

Biometric Health Screening for ALL Inova team membersHealth Screening (including bloodwork) for ALL Inova teammembersOnline health assessment to ALL Inova team membersVariety of health check-ins with our Health Coaches 

Enhancing healthy choice offerings in the cafeterias Reducing offerings of sugar sweetened beverages Registered Dietitian on team members to answer any nutritionrelated questions and guide team members to other helpfulresources 

Ability to track participation in a variety of activities includingwalking, water activity, sports, skiing and everything in betweenOn-site fitness walksOn-site fitness classesOn-going team-based challenges

Engaging in altruism through volunteer activities Developing a culture of wellness through the posting of helpful andhealthy comments on the internal social media platformOffering classes and programming with a focus on stress reductionincluding Virtual Reality and Mindful Gardening

Both on-site and virtual seminars and workshopsSessions about recycling, resource conservation, antibioticresistance, transportation and more Creates a better understanding of what is needed for a healthierand more sustainable environment

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Much time is spent workteammates. Finding sharedinterests and helping oneanother develop isparamount in creating asense of community in theworkplace

Be Connected Be Connected

A wellness portal to create an virtual connection between you andyour team membersAffinity Groups to help drive an engaging and connected cultureby offering support in the community, sports and fitness,professional develop, and joy at work!

Success Stories1.

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"Since I started the health coaching program with Inova Well, my quality of life has improved immensely! Along with reachingmy weight loss goal, I have reduced my blood pressure, dropped 3% body fat, and learned better coping strategies to improvemy stress and anxiety. Most importantly, I have learned to deal with setbacks and overcome barriers related to my health. Myhealth coach has been such a great resource for me in my journey to live well. She is always available for any of my questionsor concerns. I am so thankful that Inova offers this great free resource to all Inova team members and their spouses”

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"I started health coaching to address stress and the negative affects it was having onmy health. Through the coaching program, I learned taking on too much and nothaving an outlet was taking its toll on me physically, mentally and emotionally. Dueto events out of my control, I had completely lost all work-life balance, whichmanifest itself in the lack of sleep, depression, weight gain, low energy etc. Over theweeks my coach helped me realize the importance of taking time for my health. Theirpositive energy rubbed off and even though the balance isn't quite there yet, I ammore hopeful of change. At the very least, I am finding opportunities to exercise, makebetter food choices and taking advantage of even 3-5 minutes to close my eyes andshut out the world."

"I originally signed up for the coaching program because I wanted to improve myhealth screening results. In addition to encouragement and advice, I receivedsomeone who pushed me to do better without "nagging." I never felt judged for notimproving quickly enough and felt comfortable speaking honestly about my uphillbattle. My coach helped me see a different view about health and wellness and that itis a lifestyle change, not just a diet. I hope to continue to see positive changes in notjust my physical body but mentally as well."

2018 Sustainability Accomplishments

2019 Sustainability Opportunities

Goals and ProgressSustainability at Inova

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SUSTAINABILITY MISSION STATEMENTInova is committed to establishing anenvironment that is safer and healthier forour patients, team members andcommunity. 

The following strategic goals were establishedafter analysis of Inova's key priorities, currentsustainability programming and relateddata. The goals will guide Inova's sustainabilityprogramming over the next 5 years:

SUSTAINABILITY STRATEGIC GOALS

Reduce our climate footprint andrelated public health impacts.

Provide a healthy, productiveenvironment to heal and work.

Improve operational efficiencies toreduce waste and save resources.

Green the supply chain byensuring our products do not poserisk.

Engage both internal and externalstakeholders to create a networkof champions.

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Sustainability outcomes tie directly to Inova's keypriorities and cultural beliefs. These include:

Inova Fairfax Medical Campus was awarded one ofBecker's 68 Most "Green" Hospitals in the U.S. One of six non-DOD/Veterans health systems to berecognized for our system-wide sustainability effort.Converted to "No Antibiotic Ever" chicken breast andexpanded offerings in other sustainable food categoriesin support of patient health.Direct financial savings of just under $1.4 million throughwaste diversion, sourcing of reprocessed surgical devicesand transportation programming. Regular engagement of team members through EarthDay tree giveaways, Bike to Work Day, Chef’s ActionStations, waste projects, outreach tables (team memberpicnic and outside the cafeteria) and a numberof electronic touches (commuter survey and emails).Achievement of non-single occupancy vehicle modesplit goal at IMVH and IFMC related to team membercommute. 

Team member engagement effort around a series ofevents, projects and new offerings that support Inova'sGreat Place to Work initiative.Sustainability integration with leadership that includesregular updates, quarterly green team meetings andstrategic communications from our leaders. Clinical focus on waste segregation and recycling;            investigate strategies to reduce single-use plastics (ORand cafeteria) and evaluate medical waste reductioneffort.  Build on team member use of alternative transportationoptions with a focus on telework and carpooling.  Continue to evaluate the Inova supply chain todetermine opportunities for sustainability integrationand expand upon existing initiatives (reprocessing).

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CATEGORY METRIC STOPLIGHT

Solid Waste as % of total waste

Hazardous as % of total waste

% of cleaning chemical spend ongreen general purpose, bath, glass,carpet, and floor cleaners

12% 70% 100%

% spend on sustainable foods

% spend on local foods

% meat raised without ABX

% spend on healthier beverages

% food waste reduction

Energy use intensity (EUI)

% change in EUI from baseline

ENERGY STAR score

% offsite renewable energy

% onsite renewable energy

Gallons per square foot

Building projects pursuing LEED

Alternative transportation mode split 18% - IFMC23% - IMVH - -

4 - -

54.9 gal/sq.ft. 46 gal/sq.ft. 23 gal/sq.ft.

226 136

-17% -9% -32%

- 54 89

0% 24.7%

0% 13.5%

25% 9% 36%

14% 10% 38%

37% 35% 70%

37% 55% 85%

0% 19% 39%

9.9%

1.8%

Sustainability Stoplight ReportInova Health System

NATIONALAVERAGE

SYSTEMDATA

NAT'L 90THPERCENTILE

Recycling as % of total waste

RMW as % of total waste

16.8%

11.2%

71.4%

<1%

28%

6.1%

-

-

51%

2.4%

Total savings from reprocessingmedical devices

$708,810 - -

-

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287

1. Waste Management

2. Environmentally Preferable Purchasing

3. Sustainable Foods

4. Water and Energy Management

5. Alternative Transportation

6. Green Buildings

7. Engagement & Climate Health

Environmental Focus Areas

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Waste Management by the NumbersWaste Management Progress

In 2018, our total recyclingpercentage for the systemincreased more than 5% overlast year.   The sustainability teamworked with operationalteam members across thesystem to improve outcomes.  Medical donations hadanother strong year divertingmore than 50,000 pounds oflife-saving medical suppliesfrom the waste stream. Electronics data was alsocaptured in 2018, accountingfor 244, 334 pounds ofrecycled material. 

Operations and contractteam members must be fullyengaged in Inova'swaste programs in order tobuild upon progress made in2018.

Hazardous Waste RMW Recycling Solid Waste

2014 2015 2016 2017 20180

1020304050607080

Year

Percentage

Inova Health System Year Over Year Waste Trends

2018 Inova Waste Streams

Compare the above industrybenchmarks to Inova's actual2018 waste stream breakdown,at right. RMW is 11% and SolidWaste is 71%, while Recycling is17% of total--8% below theindustry benchmark. The totalwaste tonnage for Inova:

The chart below shows a year over year breakdown of Inova's wastestream percentage trends. Inova’s greatest opportunities are inreducing RMW and Municipal Solid Waste, while increasing recycling.

Recycling: 25-30% Solid Waste: 60-65% Regulated Medical Waste: <10%Hazardous Waste: <1%

Industry benchmarks for hospitals'waste stream tonnage as apercentage of total are as follows:

Recycling, 17%RMW, 11%

Haz Waste,<1%

Solid Waste, 71%

Recycling: 1,481.16 tonsSolid Waste: 6,277.87 tonsMedical Waste: 981.23 tonsHazardous Waste: 57.03 tons

Minimizing regulated medical waste (RMW), hazardous waste,and solid waste, while increasing reuse and recycling is crucialto reducing Inova’s environmental impact and operational costs.

Waste Management

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EPP by the NumbersEnvironmentally-PreferablePurchasing Progress

Inova’s approach toenvironmentally preferablepurchasing includesmaking progress in keyimpact areas includingGreening the Supply Chainand Greening the OR.  Inova continues work inenvironmentally-preferablepurchasing by regularlyconvening both vendorsand supply chain teammembers that touch theseareas.  

In 2018, Inova reducedplastic straw usage system-wide by switching to anenvironmentally-friendlypaper straw in non-patientretail areas. This initiative toreduce single-use plasticswill continue in 2019.

The goal in 2019 is todevelop a road map andframework that aligns allsupply chain functions andduties with sustainabilityrequirements. 

Hospital supply chain teams have an opportunity to help shift the healthcaremarketplace by using  purchasing power to demand safer, healthier, moreenvironmentally preferable products from supplier partners. 

Environmentally Preferable Purchasing (EPP)

The greatest cost savings for Inova resulting from our EPP program hascome from our medical device reprocessing efforts. In 2018, Inova saved$708,810 in reprocessing program savings alone. Inova realized anadditional $21,338 cost savings from diverting 90,811 pounds of medicalwaste from area landfills through reprocessing.

In 2017, IHS achieved a 56% green spend rate. In 2018, that investmentdecreased to 12% percent. Industry benchmarks for green spend oncleaning products suggests a 90% spend on green products compared tototal, signaling a large opportunity for expansion in this program area for2019. 

2018 Inova Reprocessing Data

Reprocessing Savings Waste Diversion (lbs.) Waste Savings

IAH

IFMC

IFOH

ILH

IMVH

$52,494

$323,700

$166,209

$89,101

$77,306

13,545

37,405

23,967

14,688

1,206

$3,088

$8,528

$5,464

$3,231

$1,207

Total $708,810 90,811 $21,338

2018 IHS Green Spend on Cleaning Products

Green Spend Conventional Spend Percentage Green Spend

$34,507 $245,083 12%

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Sustainable Foods by the NumbersSustainable Foods Progress

In an effort to capitalize onthe healing potential offood, the Office ofSustainability worksdiligently to ensure thefoods Inova servespositively contribute toevery patient’s journey towellness.  In May of 2018, all Inovacafeterias fully convertedto "No Antibiotic Ever"chicken breasts.

The sourcing of food forour cafeterias alsotransitioned in 2018. Thiswill provide transparencyand new opportunities in2019. 

Moving into 2019, thesustainability team willcontinue to work with allstakeholders to expandour sustainable foodsourcing. 

In 2016 and 2017 we experienced a transition period where Inovaadopted more rigorous standards around food procurement—particularly regarding antibiotic free meat and poultry. The Office ofSustainability has been working with Morrison, U.S. Foods and the Officeof Supply Chain to implement these new requirements. 

Expanding our local food buy in 2019 will include our cafeteriassourcing from local farms during the growing season as well aslaunching a system-wide Community-Supported Agriculture (CSA)Program that will enable Inova team members to purchase healthy andlocal foods. These initiatives will allow for better health outcomes andenvironmental protection in support of our organizational values.  

2018 Local Food Purchases

Local Spend Total Spend % Local Spend

$739,827 $5,358,427 14%

2018 Sustainable Purchases

Total Program $ Total Non-Program $ % Sust. Spend

Cage Free Shell Eggs (HFAC)CoffeerBGH-Free DairyABX-Free PoultrySustainable SeafoodCert. Humane/ABX-Free BeefCert. Humane/ABX-Free Pork

$35,617$12,551

$284,346$459,854$74,563$107,566$30,369

$252,581$270,170$177,600$587,329$110,229$369,509$160,201

12%4%

62%44%40%23%16%

Inova is committed to procuring and serving nutritious, sustainable foodsto improve the health and wellness of both the planet and our patients. 

Sustainable Foods

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Site EUI

2012 2013 2014 2015 2016 2017 2018200

275

350

Energy Efficiency by the Numbers

Water Management ProgressSustainability, FacilitiesManagement, andEngineering worktogether to implementwater conservationpractices and efficientequipment. 

 As Inova continues toexpand, water-efficienttechnologies will becrucial to sustained watermanagement strategies.

Water Management by the NumbersWater management is an essential component of Inova’ssustainability program, and we strive to make our waterconsumption as efficient and sustainable as possible. 

Gal/sq.ft.

60.8258.42

60.97

52.9955.79 56.4 54.9

2012 2013 2014 2015 2016 2017 201840

55

70

Inova Year Over Year Water Consumption (Gal/sq.ft.)

In maintaining 24-hour operations, healthcare facilities consumelarge quantities of energy and water. Conserving these resources, andutilizing them more efficiently, is key to Inova's sustainability efforts.

Water Management & Energy Efficiency

Inova employs a combination of energy reduction andenergy efficiency strategies to reduce our system-wideenergy footprint by 20% by year 2020, from a 2012 baseline.

2020 EUI goal: 277

In 2018, Inova achieved a17% Site EUI reductioncompared to 2012baseline.  Initiatives in 2018included focus onoperational remedies,LED lighting and greenbuilding projects. 

Moving forward, in orderto maintain and exceedthis goal, continualinvestigation of energyefficient measuresshould be explored innew building projectstaking place at Inova.

Energy Efficiency Progress

IHS Year Over Year Site EUI (Energy Use Intensity) Reductions

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Alternative Transportation by the Numbers

Alternative transportation reduces Inova’s carbon footprint and positivelycontributes to better air quality and climate mitigation in our communities. Healthybuildings result in healthier occupants, and we are committed to greening ourbuildings for patients, visitors, and team members.

Alternative Transportation & Green Buildings

Alt. Transportation ProgressEmissions fromtransportation areresponsible for 27% of theUnited States’ totalgreenhouse gas emissionsprofile.   This environmental burdentranslates directly to poorpublic health outcomes—particularly for Inova’s servicearea. All counties in NorthernVirginia received failinggrade for high ozone days inthe American LungAssociation’s 2018 State ofthe Air Report. As a result,the Office of Sustainability iscommitted to reducing mileson the road.

Inova’s transportationprogram complies with localgovernment mandates toreduce single-occupancyvehicle trips. It is also anessential tool for teammember engagement andwill be enhanced in 2019. 

Green Building ProgressGreen buildings have beentied to improved cognition,gains in productivity andimprovement in health andwell-being. These conceptsare essential to hiring andretaining top-talent at Inova. 

Inova understands the manner in which a building is constructed,operated and maintained can have a significant impact on both theenvironment and the people that interact within that space. We continueto pursue LEED certification in support of patient and teammember health with the following initiatives underway: 

Green Building Opportunities

IFMC Operating Room (OR) renovation is in the final stages ofsubmitting its LEED application and related documents. The goal is toachieve LEED certification for this project.  

The ICPH campus has multiple projects underway including the newrehab clinic in building A, the Inova Center for Healthy Living in theconference center building, as well as the new research building. Inova plans to build on these efforts in 2019 through a new greenbuilding standard that will ensure all projects, large and small, aredesigned and built to support our mission of healing. 

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Team member-focused transportation program offerings includingWageWorks (a pre-tax payroll deduction commuter benefit), a formaltelework policy and preferred carpool parking spots. 

Team member Commuter Fairs conducted by the sustainabilityteam in partnership with Fairfax County Department ofTransportation.  

Achieved our team member mode split goal at both Inova MountVernon and Inova Fairfax, staying compliant with our requirementsfrom Fairfax County Department of Transportation.

First Team Member Commuter Survey at Inova Alexandria, InovaLoudoun and Inova Fair Oaks to gather baseline data and determinehow team member transportation programs can be improved. 

In 2018, the Office of Sustainability assumed full oversight of alltransportation initiatives across the system, including County mandatesfor Transportation Demand Management. The office hired a newtransportation lead who works with team members at all hospitals todevelop programming that results in more alternative transportationtrips. In 2018, key efforts in this area included: 

Team Member EngagementTeam member engagement at Inova continued to be a significant focus in2018, resulting in a series of events and activities across the system. Asummary of those activities is listed below. 

Team Member Engagement Progress86% of workers believe it isimportant that theiremployer is responsible tosociety and the environment,with 55% feeling that it is“very important." (ProjectROI)

75% of workers wouldrecommend their company ifthey feel it is environmentallyresponsible vs. 43% if it is not.(Project ROI)

Sustainability engagementevents across Inova are agreat way to support thesebeliefs and enhance teammember retention,recruitment and well-being.

Climate Health ProgressWeather disasters in 2018amounted to an estimated$155 billion in damage. (TheWashington Post)

The spread of infectiousdiseases, more heat-relatedhospital admissions andhigher rates of cardiovascularillness are all scenarios in awarming climate. 

Inova will continue to lead onthis issue to ensure thatpatients continue to receiveexceptional care. 

The nexus between climate health and public health grows daily withInova clinicians witnessing the impact on patients first-hand. A variety ofmaladies including heatstroke, transmission of vector borne diseases,more intense allergies, and mental health stresses are all on the rise. 

To address these challenges, Inova is engaged in both mitigation activities(energy and transportation work) as well as education so that thecommunities we serve understand these health threats. Sustainabilityteam members are encouraging local practices to display the climate andhealth brochure series that was published in 2017.  

Inova team members will continue these efforts in 2019 with a goal ofbecoming a trusted leader on this issue both within the region as well asnation-wide.    

Climate Health

Team Member Engagement & Climate HealthTeam member engagement has a direct impact on staff retention and well-being. Ahigh percentage of workers, especially Millennials, look for opportunities to helptheir company become more sustainable (Inc. Magazine). A changing climate hasthe potential to impact delivery of service through storm-related damage and anincrease in climate and health related admissions.  

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Earth Day Tree Giveaway - Continued partnership with local non-profitthat provides tree seedlings for employers in the region. 500 seedlingswere distributed to team members, along with information aboutenvironmental programming.

Bike to Work Day - Organized and promoted annual Bike to Work Dayopportunities for team members in conjunction with the City ofAlexandria, Loudoun Commuter Services and Fairfax County'sDepartment of Transportation. Staff also participated in the teammember picnics to pass out information about related programs andactivities. 

Waste Diversion Activities - Worked with functional leads to addressany recycling challenges. This work will continue in 2019. 

JustOne Campaign - Launched a campaign to encourage teammembers to submit their eco-friendly actions and ideas to show thevast environmental impact of Inova team members. 

Plastic straw reduction - Held outreach tables for team members todiscuss the plastic straw reduction initiative in conjunction with theInova Well gardening bar.