case study: engaged leadership - bringing sustainability ... · return on investment:...
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SummaryOver the past 20 years Bronson Methodist Hospital has put considerable effort toward creating a solid sustainability program through initiatives such as recycling programs, local food sourcing efforts, and hazardous chemical reduction strategies. However the hospital reached a point where if it were to continue to expand and improve its sustainability program, it needed to grow beyond the more easily-captured efforts and focus on initiatives that would require considerably more time and effort to achieve.
Traditionally, most of the sustainability initiatives within the hospital had been employee-driven and localized to individual departments. Overall Bronson lacked a centralized department and staff to coordinate existing efforts, provide assistance to employees, create community partnerships, and have the time to drive new program implementation. To address this issue Bronson Methodist Hospital partnered with a local college to create an internship position to evaluate the advantages of a full-time position focused solely on sustainability efforts. Through calculating a return on investment, the intern was able to successfully demonstrate the value for a full-time sustainability coordinator position (refer to the “Benefits” list for identified cost savings examples) and further investment in healthier environments. The HHI Engaged Leadership Challenge provided the steps to take a good sustainability program to the next level.
Bronson Methodist Hospital, Kalamazoo, MichiganThe Problem While Bronson Methodist Hospital had accomplished numerous sustainability
successes in the past, the more easily achieved efforts had been implemented
and next level strategies would require a much greater cost commitment of
time and effort to achieve. As a result, old successes were maintained but
new initiatives were slow in development, even when significant cost-reduction
opportunities were identified. In order for Bronson to maintain its reputation as a
leader in environmental stewardship in the sector, a method for increasing focus
and attention solely on sustainability would have to be developed.
The Strategy SelectedBronson Methodist Hospital’s environment of care and sustainability manager,
Lisa Hardesty, partnered with local college Aquinas to create an internship
for a student in the sustainable business program, a program made possible
by Steelcase, Herman Miller and other regional businesses. The focus of the
internship would be to produce a return of investment analysis for the creation
of a position focusing on hospital reduction of resource use and capturing of
sustainability financial incentives, such as ENERGY STAR rebates.
Bronson brought in intern Brendan Molony in June of 2014. He used the Green
Guide for Health Care LEED O + M (operations and maintenance) Program as
a template to assess the state of the current program and to begin to roadmap
future sustainability activities. A final ROI assessment was completed in the fall
of 2014 and successfully demonstrated beneficial financial and environmental
outcomes associated with a full-time sustainability position. Using the ROI,
the environmental safety and sustainability manager was able to present a
case for budgeting resources from recently vacated positions to develop the
new role around sustainability programming (see the “Return on Investment”
document at the end of the case study for the list of activities and the return
on the investment analysis). The new position of sustainability coordinator was
created in the fall of 2014, and would have the resources to explore potential
opportunities that would lower operations costs, reduce resource utilization within
the hospital, and capture financial incentives.
Case Study: Engaged Leadership - Bringing Sustainability Programming to the Next Level
Implementation ProcessThe HHI Engaged Leadership Challenge was used to elevate the established
hospital sustainability program to the next level. Bronson Methodist Hospital
performed a gap analysis of the Challenge to establish a list of objectives that
would further embed sustainability into the core operations of the health care
environment.
One baseline requirement of the challenge was to create an executive
commitment statement. The intern was tasked with developing the documentation
while leadership was engaged for review and approval. Having an intern to
evaluate the qualitative measures, as well as the support of the environmental
safety and sustainability manager to drive engagement of upper management,
was a very important aspect which attributed to the success of this Challenge.
The Engaged Leadership Challenge identified 24 other qualitative activities that
can be tackled to further support a long-term, successful initiative integrated
into the overall operations of the facility. The measures were identified as key
activities which would create a more formal sustainability program that could
withstand staffing changes, competing agendas and a 24/7 operation. The full
list of opportunities is identified below. Bronson Methodist Hospital achieved
the highest recognition of Level 3 by implementing more than the ten required
qualitative measures.
About Bronson Methodist Hospital
Bronson Methodist Hospital, located
in heart of the downtown area
Kalamazoo, Mich., is the flagship of
Bronson Healthcare, a not-for-profit
healthcare system serving all of
southwest Michigan and northern
Indiana. With 434 licensed beds
and all-private rooms, Bronson
Methodist Hospital provides care in
virtually every specialty—cardiology,
orthopedics, surgery, emergency
medicine, neurology, oncology
—with advanced capabilities in
critical care as a Level I Trauma
Center; in neurological care as a
Joint Commission certified Primary
Stroke Center; in cardiac care as the
region’s first accredited Chest Pain
Emergency Center; in obstetrics as
the leading BirthPlace and only high-
risk pregnancy center in southwest
Michigan, and in pediatrics as one
of only six children’s hospitals in the
state.
Bronson serves the largest
percentage of Medicaid patients in
the area and provides a substantial
benefit to the community through
outreach and charitable care. It is
the recipient of the 2005 Malcolm
Baldrige National Quality Award,
the nation’s highest presidential
honor for quality and organizational
performance excellence. In 2009, the
hospital received the AHA McKesson
Quest for Quality Prize awarded
annually to only one U.S. hospital
and joined the top five percent
of hospitals in the nation to be
designated a Magnet Hospital for
Nursing Excellence.
2
HHI Engaged Leadership Challenge Activities
Yes Baseline: Sign and submit an executive commitment statement.
No Create a strategic sustainability plan.
Yes Create an environmental mission statement/guiding principles/charter.
No Formulate a sustainability program budget. (in the works)
Yes Appoint a sustainability executive owner.
No Build in sustainability measures as an organizational priorty.
Yes Create a sustainability reporting structure.
Yes Create sustainability responsibilities within the organization.
Yes Create an environmental steering committee with routine meetings.
Yes Conduct a sustainability baseline assessment.
No Define measurable sustainability objectives
Yes Identify leader for sustainability efforts.
Yes Identify the clinical champion.
Yes Demonstrate progress on at least two HHI challenges.
Yes Communicate progress on sustainability initiatives to the board.
Yes Report progress regularly on sustainability initiatives to the leadership team.
No Communicate sustainability progress from the leadership team to the organization regularly.
No Create and distribute an annual sustainability report.
No Provide a feedback mechanism for sustainability initiatives.
Yes Participate in programs to support employee and community engagement.
Yes Educate all employees about sustainability including new employee orienation.
No Share sustainability best practices within the industry.
Yes Engage organizational leaders to act as spokespeople for the sustainability program.
No Include sustainability initiatives in the community benefit report.
The Green Team
Brian DeRoo, Contract Specialist
Carolyn Wyllie, Communications Specialist
Dan Kettenbeil, Director of Facilities
Daphne Johnson, Property Coordinator
Dorinda L Diaz, Manager Materials Management
Grant Fletcher, System Director of Nutrition and Retail Services
Lisa Hardesty, Environment of Care and Sustainability Manager
Mike Way, Senior Vice President
Tiffany Brady, System Director of Environmental Services and Patient Transport
3
Factors Included in Bronson Hospital’s ROI Analysis:
Financial Benefits (savings or cost avoidance)
• $3,560 Battery Savings
• $912 Lead Recycling
• $50,223.95 PC Management
• $50,839 - SUD Reprocessing
• $17,800 - Energy Rebates
Environmental Benefit (reduced energy, pounds reduced)
• 502,239 kWh PC Management
• 15,756 kWh AHU4 $27,439
• 73,220 kWh Lighting Project $29,288
• 160,017 kWh $17,601.87
• Increased Recycling Rate from 16.9% (2013) to 29.35% (2014)
Other Measurable Outcomes (reduced exposure, increased satisfaction)
• Better understanding of programs and outcomes.
• Increased amount of sustainability programs and employee engagement.
• Continuation of car seat recycling program.
Challenges and Lessons LearnedHospitals can realize great benefit to a sustainability program through a team
approach, and may benefit from considering internships or other low-cost
strategies to focus on certain key areas. However in order to maximize the
capabilities of a program, an identified team lead is optimal. The case for a full-
time sustainability lead can be made by tracking positive outcomes and cost
savings, increasing staff engagement, and improving safety.
4
Return on Investment: Sustainability Coordinator
Investment
• One FTE Salary + Benefits • Job Training (One-time cost)
o $550 Building Operator Certification ($1,450 - $900 rebate) o $3,750 Power Logic ($1,400 + $2,350 travel) o $4,800 Tridium ($3,200 + $1,600 travel)
$9100 = Total Training Cost
Savings
• $136,550 (Consumers Energy rebates) • $114,398 (energy reduction) • $4,909 (water) • $5,593 (natural gas) • $2,109 (solid waste) • $25,000 (can/bottle deposits) • $48,000 (contractor hours saved) • $3,062 (batteries)
$339, 621 = Total Savings
Soft Savings
• $50,000 - $100,000 (sustainability report - consultant cost) • $60,000 (LEED O+M (Existing Building ) analysis)
Return on investment (%) = (Net profit / Investment) × 100
Cost Savings %ROI $ROI
Salary = xxx Training = $9,100 $339,621
1 Year xxx
5 Year xxx
5
Job
Dutie
s De
liver
able
s Be
nefit
s Co
st
Savi
ngs
1
Man
age
Cons
umer
s En
ergy
Sm
art B
uild
ing
Prog
ram
for B
rons
on
Heal
thca
re S
yste
m
1.1
Assis
t Fac
ilitie
s Ser
vice
s in
com
plet
ing
pre-
appr
oval
1.
2 Re
sear
ch &
Iden
tify
Prog
ram
Crit
eria
1.3
Trac
k pr
ojec
ts fr
om p
re-a
ppro
val t
hrou
gh c
ompl
etio
n
1.4
Ope
rate
as a
mai
n co
ntac
t for
Con
sum
ers E
nerg
y 1.
5 Re
sear
ch F
utur
e Co
nsum
ers E
nerg
y Pr
ogra
ms
1.6
Build
ing
Ope
rato
r Cer
tific
atio
n (B
OC)
1.
7 Gr
ow th
e pr
ogra
m th
roug
hout
the
Bron
son
Syst
em
Redu
ce C
ost t
o Ca
pita
l Pr
ojec
ts
Reco
gniti
on
Redu
ctio
n in
Ope
ratio
n co
sts
BOC
– N
atio
nal D
atab
ase
Show
s $16
,000
yr in
ene
rgy
redu
ctio
n
1.6
BOC-
$1,
450
- $90
0 re
bate
= $
550
Up
to $
1,00
0,00
0 fo
r the
syst
em
AHU
4 –
$87
,000
in re
bate
s 20
12 e
stim
ated
loss
: $22
1,40
0 20
13 e
stim
ated
loss
: $22
0,36
0 20
14 p
oten
tial g
ain:
$18
8,30
0 20
15 p
oten
tial g
ain:
$13
6,55
0
2 M
onito
r and
Red
uce
Ener
gy C
onsu
mpt
ion
2.1
Gai
n a
bett
er u
nder
stan
ding
of e
nerg
y us
age
2.2
Esta
blish
ene
rgy
redu
ctio
n go
als
2.3
Max
imize
Pow
er L
ogic
s 2.
4 De
velo
p pr
ogra
ms t
o ch
ange
beh
avio
r rel
ated
to e
nerg
y us
age
2.5
Targ
et a
reas
to in
vest
in e
nerg
y ef
ficac
y up
grad
es
2.6
Rese
arch
inno
vativ
e en
ergy
savi
ng te
chno
logy
and
tech
niqu
es
Ener
gy R
educ
tion
M
ore
know
ledg
eabl
e de
cisio
n-m
akin
g on
cap
ital
proj
ects
Le
ss re
lianc
e on
ven
ders
LE
ED C
redi
ts
Pow
er L
ogic
Cos
t- $
2,35
0 tr
aini
ng +
$1,
400
trav
el
$3,7
50/1
00 p
er h
r =
37.5
hr (b
y el
imin
atin
g co
ntra
ctor
fees
)
Redu
ctio
n of
Ene
rgy
Cons
umpt
ion
1 Ye
ar P
lan
3% =
$11
4,39
8 5
Year
Pla
n - 1
5% =
$57
1,99
0 Re
duce
fees
to c
ontr
acto
rs to
pul
l tre
ndin
g re
port
s. C
urre
ntly
10-
30 h
ours
per
mon
th
($24
,000
yr)
To
tal S
avin
gs o
f $1
38,3
98
3
Mon
itor a
nd R
educ
e Al
l U
tiliti
es o
f BM
H W
hen
Poss
ible
3.1
Add
wat
er to
Key
Gre
en so
lutio
ns
3.2
Targ
et W
ater
Red
uctio
n Ar
eas f
or A
naly
sis
Out
side
Sprin
klin
g Sy
stem
An
alyz
e Ch
iller
Pla
nt a
nd C
oolin
g To
wer
s 3.
3 Pr
efor
m a
stud
y on
BM
H’s d
epen
denc
y on
City
Wat
er
3.4
Cert
ified
on
Trid
ium
Bui
ldin
g Au
tom
atio
n Sy
stem
3.
5 Cr
eate
a b
asel
ine
for a
ll ut
ilitie
s 3.
6 N
orm
alize
d m
eani
ngfu
l dat
a of
all
Util
ities
Bett
er u
nder
stan
ding
of
utili
ties
Less
exp
ensiv
e to
ope
rate
Ab
ility
to su
stai
n in
a d
isast
er
A se
cond
opi
nion
of p
lant
op
erat
ions
LE
ED C
redi
ts
Trid
ium
Cos
t- $
2,20
0 tr
aini
ng c
osts
+ $
1,60
0 Tr
avel
O
n-sit
e cu
stom
edu
catio
n $1
,000
$4
,800
/$10
0 pe
r hr =
48hr
pa
ybac
k (b
y el
imin
atin
g co
ntra
ctor
fees
)
Redu
ctio
n of
Wat
er C
onsu
mpt
ion
1
Year
Pla
n 3%
= $
4,90
9 5
Year
Pla
n 15
% =
$24
,547
Re
duce
fees
to c
ontr
acto
rs to
pul
l tre
ndin
g re
port
s: 1
0-30
hrs
mon
th (
$24,
000
yr)R
educ
tion
of N
atur
al G
as
3% =
$5,
593
Tota
l sav
ings
34,
502.
4 M
aint
ain
Com
preh
ensi
ve W
aste
M
anag
emen
t Sys
tem
4.1
Com
plet
e an
ann
ual w
aste
aud
it
4.2
Educ
ate
staf
f on
prop
er w
aste
disp
osal
4.
3 Tr
ack
all w
aste
stre
ams t
o pr
omot
e re
duct
ion
Re
gula
ted
Med
ical
Was
te
Cons
truc
tion
Ph
arm
Was
te
Haza
rdou
s Was
te
5% re
duct
ion
in m
unic
ipal
w
aste
in 5
yrs
Redu
ce L
iabi
lity
Re
duce
Pro
ject
s cos
t
Em
ploy
ee S
afet
y
Reco
gniti
on
LEED
Cre
dits
Up
to a
$50
,000
fine
per
da
y
Solid
Was
te R
educ
tion
5% =
$2,
109(
Min
us In
crea
sed
Recy
clin
g)
Regu
late
d M
edic
al W
aste
redu
ctio
n: 5
% $
$2
,550
To
tal s
avin
gs o
f $ 4
,659
5 Id
entif
y Ar
eas t
o Im
prov
e Re
cycl
ing
Effic
acy
5.1
Rese
arch
new
opp
ortu
nitie
s to
incr
ease
recy
clin
g
5.2
Crea
te p
rogr
ams t
hat h
elps
faci
litat
e pa
rtic
ipat
ion
in re
cycl
ing
5.3
Iden
tify
oppo
rtun
ities
to re
cycl
e w
ith lo
cal/
regi
onal
buy
ers
5.4
Use
ann
ual w
aste
aud
it to
find
are
as o
f im
prov
emen
t
Incr
ease
d re
cycl
ed m
ater
ial
New
par
tner
ship
s with
loca
l an
d re
gion
al b
uyer
s In
crea
sed
Recy
clin
g
5% =
$1,
574
adde
d co
st
Esta
blish
reba
tes f
or re
cycl
ing
$3,4
00
Tota
l Sav
ings
of $
3,40
0
6 Pr
omot
e Re
duce
Reu
se
Recy
cle
6.1
Faci
litat
e a
Redu
ce R
euse
Rec
ycle
cam
paig
n 6.
3 W
ork
with
all
depa
rtm
ents
to id
entif
y op
port
uniti
es
6.4
Org
anize
Gre
en L
eade
rs th
roug
hout
BM
H
Incr
ease
d re
cycl
ing
Co
nnec
tivity
of B
MH
Cultu
re S
hift
6
7 Su
stai
nabi
lity
Com
mun
ity E
ngag
emen
t
7.1
Iden
tify
and
cont
act c
omm
unity
par
tner
ship
s
KV
CC
Wes
tern
Mic
higa
n U
nive
rsity
So
uthw
est M
ichi
gan
Sust
aina
ble
Busin
ess F
orum
W
est M
ichi
gan
USG
BC
7.2
Crea
te c
omm
unity
inte
rest
in su
stai
nabi
lity
Publ
icity
Co
mm
unity
Eng
agem
ent
Reco
gniti
on
Know
ledg
e Sh
arin
g
Cert
ifica
tions
Pa
rtne
rshi
ps
Add
dolla
rs to
the
annu
al c
omm
unity
ben
efit
repo
rtin
g
8 Es
tabl
ish
and
Mon
itor
Envi
ronm
enta
l Goa
ls
8.8
Set r
ealis
tic b
ut a
chie
vabl
e go
als f
or re
duct
ion
in w
aste
, re
cycl
ing,
ele
ctric
ity, w
ater
, gas
, and
loca
l foo
d pu
rcha
sing
Not
e: G
oals
incr
ease
pro
duct
ivity
by
50%
Com
mon
Goa
ls
Prog
ress
ion
of g
oal a
reas
In
ter h
ospi
tal p
artn
ersh
ips
9 En
viro
nmen
tal
Repo
rtin
g
9.1
Crea
te a
n se
mia
nnua
l sus
tain
abili
ty re
pot
9.2
Crea
te re
port
s int
erna
lly to
hel
p ex
plai
n en
ergy
usa
ge
9.3
Mai
ntai
n Pr
actic
e Gr
een
Heal
th a
war
d ap
plic
atio
n
9.4
Rese
arch
oth
er o
ppor
tuni
ties f
or a
war
ds
Gai
n hi
gher
reco
gniti
on fr
om P
ract
ice
Gre
en H
ealth
for t
he sa
me
fee
Enga
gem
ent o
f int
erna
l and
ex
tern
al st
akeh
olde
rs
Reco
gniti
on
Tran
spar
ency
Fu
ture
Opp
ortu
nitie
s
Prof
essio
nal f
ee e
stim
ate
of $
50,0
00 to
$10
0,00
0 fo
r a su
stai
nabi
lity
repo
rt
10
Mon
itor a
nd R
educ
e Ha
zard
ous C
hem
ical
s
10.1
Mai
ntai
n an
env
ironm
enta
l man
agem
ent s
yste
m th
at tr
acks
ha
zard
ous c
hem
ical
s 10
.2 R
esea
rch
alte
rnat
ives
for e
xist
ing
chem
ical
s
Redu
ced
liabi
lity
In
crea
sed
awar
enes
s
Be
tter
hea
lth a
nd sa
fety
11
Fost
er a
Gre
en C
lean
ing
Prog
ram
11.1
Ass
ess n
ew c
lean
ing
prod
ucts
11
.2 R
esea
rch
tren
ds to
be
curr
ent w
ith n
ew o
ppor
tuni
ties
Heal
th a
nd sa
fety
Po
ssib
le c
ost r
educ
tion
Re
duce
cos
t ass
ocia
ted
with
da
mag
ing
furn
iture
, wal
ls,
floor
s
12
Mon
itor a
nd im
prov
e En
viro
nmen
tally
Pr
efer
able
Pur
chas
ing
12.1
Cre
ate
sust
aina
bilit
y st
anda
rds f
or n
ew p
rodu
cts
12.2
Pro
vide
an
expe
rtise
on
envi
ronm
enta
l iss
uers
for n
ew p
rodu
cts
Re
cogn
ition
Re
duce
d Li
abili
ty
In h
ouse
exp
ertis
e
13
Cons
ult W
ith F
ood
Serv
ices
13.1
Mon
itor t
he a
mou
nt o
f loc
ally
/ org
anic
food
bou
ght
13.2
Des
ign
a w
aste
man
agem
ent s
yste
m
13.3
Cre
ate
a co
mpr
ehen
sive
com
post
ing
prog
ram
13
.4 H
elp
build
a st
rong
con
nect
ion
with
KVC
C
Cost
Red
uctio
n
New
Par
tner
ship
s
St
akeh
olde
r Eng
agem
ent
LEED
Cre
dits
Bott
led
Beve
rage
s Dep
osits
- $25
,000
in
miss
ed d
epos
its
Tota
l Sav
ings
$25
,000
14
Carb
on F
oot-
prin
ting
and
Redu
ctio
n 14
.1 C
reat
e a
rela
tive
carb
on fo
otpr
int o
f BM
H
14.2
Use
CFP
to e
ngag
e in
tern
al a
nd e
xter
nal s
take
hold
ers
Stak
ehol
der e
ngag
emen
t
Re
duce
d lia
bilit
y
CO
-pot
entia
l car
bon
tax
$35,
873
CA-p
oten
tial c
arbo
n ta
x $1
74,1
39
15
Fost
er A
ltern
ativ
e Tr
ansp
orta
tion
15.1
Res
earc
h al
tern
ativ
e tr
ansp
orta
tion
oppo
rtun
ities
15
.2 P
rovi
de k
now
ledg
eabl
e ad
vice
for
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105
7
ENVIRONMENTAL MISSION STATEMENT
GUIDING PRINCIPLES &
REPORTING STRUCTURE PHILOSOPHY Bronson strives to create a healthy healing environment for the health and safety of its patients, employees and the community. The hospital’s focus is on four key areas—waste responsibility, green building design, local/sustainable purchasing and community involvement. GUIDING PRINCIPLES PEGS Pollution Prevention: The goal is to reduce waste by focusing on what can be eliminated, reused or recycled, use of less harsh chemicals while maintaining high standards of infection control to create a healthy environment for patients and staff. Energy Conservation: The goal is to reduce the amount of gas, electricity and water used through facility ugrageds and staff behavioral changes and to reduce the amount of fossil fuels used during transportation by establishing contract with local vendors and suppliers. Green Building Design. The goal is to design and build using healthier building materials as a means of improving public health and preserving the global environment. Bronson will strive to use natural, environmentally friendly products and low-emitting materials to provide a healthy healing environment. Sustainable Food: The goal is to offer healthy food options that are locally grown without the use of harmful chemicals to our patients, visitors and staff.
REPORTING STRUCTURE A number of departments within the hospital have created department specific green teams that report up through the hospital wide Green Team. The Green Team is a subcommittee of the Hazardous Materials and Waste committee. This committee reports to the EOC Oversight Committee that reports up to the Board. The Green Team is a multidisciplinary group that includes; Director of Facilities Services, Director of Housekeeping, Food Services Manager, Distribution Center Manager, Safety Manager, Process Management Consultant, Corporate Communications Consultant, IT Tech, Surgery Nurse and Labor and Delivery Nurse. The Executive over this group is the VP of Facilities Services.
8