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Green Heathcare & Patient Safety: Marketing Healthy Hospitals Mark Shelley, Lexington Medical Center Dan Dunlop, Jennings

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This is a presentation from the 2009 Customer Based Marketing Strategies Conference by Dan Dunlop and Mark Shelley. Dan is president of Jennings, a healthcare marketing firm based in Chapel Hill, NC. To visit Dan's blog go to http://thehealthcaremarketer.wordpress.com.

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Page 1: Green Healthcare Presentation

Green Heathcare & Patient Safety:Marketing Healthy Hospitals

Mark Shelley, Lexington Medical Center

Dan Dunlop, Jennings

Page 2: Green Healthcare Presentation

Green Marketing

• It’s everywhere

• Why is it so prevalent today?

• Has everyone suddenly become sensitive to the environment?

• Should hospitals be participating?

Page 3: Green Healthcare Presentation

Why Talk About Green Marketing?• It’s more prevalent to healthcare than you

may know• We’ll introduce a broader definition of what it

means to be green in healthcare, and new ways to talk about it

• It represents an opportunity for you to connect with your brand constituents on a ‘values’ level

• You are doing good work and should get credit for it

Page 4: Green Healthcare Presentation

Green Movement Data• Even during a strong recession:

– 55% of Americans worry they will not be able to maintain their standard of living (Gallup data)

– 29% said their personal finances were hurt a great deal– Another 37% said they were hurt a moderate amount– Yet, 49% still said that they would choose saving the

environment over economic growth (In 2000, 70% chose the environment over the economy.)

– Financial crisis weakens the commitment to the environment. But it is still there. People would like to help if they are able. Hence green marketing programs.

– It feels good to be green! And companies make it easy for us to be green without feeling any pain.

Page 5: Green Healthcare Presentation

Common “green” messaging in hotels

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Green taxis

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Green advertising and transportation

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Green colleges

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Green paper

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Green awards

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Green Conferences

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Household products

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Planet Green on television

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Green cleaning

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Green home design

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“Green” children’s menus in restaurants

Green Messaging for Kids

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Green Messaging for Kids

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Green Messaging for Kids

Green book marks from Scholastic

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Green Messaging for Kids

TFK - Time Magazine for Kids. Climate change issue

Page 20: Green Healthcare Presentation

Why All This Green Marketing?

• Echo Branding!– A form of consumer engagement– Consumers align their personal values with those

of other organizations/brands– Builds a bond stronger than mere product or brand

loyalty– The fusion of self and brand; plays on our need for

meaning and belonging; gives a deeper rationale for brand loyalty

– Our brand affiliations then help us with our own self-image and self-branding

Page 21: Green Healthcare Presentation

Why All This Green Marketing?

• Popular with Banks right now!

Page 22: Green Healthcare Presentation

Why All This Green Marketing?

• Popular with Banks right now!

Page 23: Green Healthcare Presentation

Beware of Greenwashing and Inconsistencies

• Greenwashing: “Greenwashing is the unjustified appropriation of environmental virtue by a company, an industry, a government, a politician or even a non-government organization to create a pro-environmental image, sell a product or a policy, or to try and rehabilitate their standing with the public and decision makers.”

• www.greenwashing.net• www.stopgreenwashing.org

Page 24: Green Healthcare Presentation

Greenwashing?

• The Green Checking Account

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Are You Ready to Answer the Hard Questions?

• One example:– Question: How does your hospital handle,

store and dispose of radioactive waste?

• If you’re going to market your green practices, you need to be prepared to speak to practices that may appear to be contradictory

Page 26: Green Healthcare Presentation

Why Should Hospitals Focus on Being Green?

• Hospitals rank second in the United States in electricity use

• Generate hazardous and non-hazardous waste, air emissions, and wastewater that can, if not properly managed, significantly contribute to air, soil and water pollution

• But there’s more…

Page 27: Green Healthcare Presentation

Green Movement is Different In Healthcare

• Not just about being earth-friendly

• Creating healthy environments for patients, family and employees

• The healthy hospital movement

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Healthy Hospitals

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Healthy Hospitals

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Healthy Hospitals

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Creating Healthy Environments for Patients, Family and Staff

• We can no longer tolerate hospital-acquired conditions such as infections and falls

• Injuries to staff• Subjecting patients to noisy, confusing

environments that increase stress and anxiety• We need to embrace the clear connection

between well designed healing environments and improved healthcare safety and quality for patients, family and staff, and the associated cost savings

Page 32: Green Healthcare Presentation

The Healthy Hospital Movement

Page 33: Green Healthcare Presentation

Smoke Free Hospitals• Providing a healthy environment for patients, staff and visitors• Part of a comprehensive employee wellness program• Why go smoke free?• Indoor air pollution is one of the top five environmental risks to

public health (includes smoke and VOCs)• Smoke-free workplaces are the #1 reason adults successfully quit

smoking• The Health Consequences of Involuntary Exposure to Tobacco

Smoke: A Report of the Surgeon General, June 27, 2006 (http://www.surgeongeneral.gov/library/secondhandsmoke/report/)

• Most preventable diseases result from poor nutrition, physical inactivity or tobacco use

• Should include smoking cessation counseling program

Page 34: Green Healthcare Presentation

Recycling Programs• The nation’s hospitals generate approximately 6,600 tons

of waste per day• As much as 80 to 85% of a healthcare facility’s waste is

non-hazardous solid waste—such as paper, cardboard, food waste, metal, glass, and plastics

• A hospital’s waste disposal cost ranged from $44 to $68 per ton, according to the Joint Commission

• Goal: Reduce waste disposal at healthcare sites• Become better environmental stewards• Involve staff• Resource: Practice Green Health Waste Reduction Guide

Page 35: Green Healthcare Presentation

Recycling Programs• Some simple steps:

– Require vendors to reduce packaging or use durable packaging

– Switch to reusable coffee mugs in break rooms– Use rechargeable batteries– Mandate the use of double sided copies

Page 36: Green Healthcare Presentation

Green Buildings/Design

“A growing body of research shows that the physical design of health care settings unintentionally contributes to negative outcomes. On the other hand, thoughtful evidence-based facility design can help bring the patient, staff and families into the center of the health care experience, increase patient safety and enhance the overall quality of care provided.” (Evidence for Innovation, NACHRI and The Center for Health Design)

Page 37: Green Healthcare Presentation

Healthy Building Design• According to scientific literature, there is

empirical evidence linking the physical environment with patient, family and staff outcomes:– Improved patient safety– Improved clinical outcomes– Improved psychosocial outcomes– Increase patient satisfaction– Increased staff effectiveness in providing care– Increased staff satisfaction– Improvements in staff health

Page 38: Green Healthcare Presentation

Healthy Building Design• Single patient rooms• Adequate space for families to spend the night• Access to natural areas - indoor and outdoor gardens• Ample natural light• Artwork on walls and other positive distraction tools

(TV, music, etc.)• Noise reduction wherever possible• Reduction of high light levels• Access to handwashing stations/dispensers• Use of music therapy

Page 39: Green Healthcare Presentation

Healthy Building Design• Patient and family control of environmental

settings• Effective way finding systems• Sound absorbing ceiling tiles• Use of booms and ceiling lifts in patient rooms• Circadian lighting with light levels changing

throughout the day• Supplies closer to patients• HEPA filtration

Page 40: Green Healthcare Presentation

Other Sustainable Practices• Use of organic sheets - It has been estimated

that a 300 bed hospital using organic cotton linen equals a reduction of pesticide use by 100,000 lbs. per year (Smyrna Organic Products)

• In California, five of the top nine pesticides used on cotton are cancer-causing chemicals (cyanazine, dicofol, naled, propargite and trifluralin).

• The EPA considers 7 of the top 15 pesticides used on cotton as "likely" or "known" human carcinogens.

Page 41: Green Healthcare Presentation

Healthy Food Programs• At North Carolina’s Duke University Health System and Duke

University, a linear relationship was shown between increasing BMI and workers’ compensation claims rates, workdays lost, and costs per claim

• Lifetime obesity-related medical costs increase as body mass index (BMI) increases

• Morbidly obese adults had estimated per capita health expenditures 81% greater than normal-weight adults in 2000

• Employees who are obese have higher health care costs, more injuries, and use more sick days than employees who are not obese across multiple industries

• Workplace interventions targeting even modest weight loss may be financially beneficial, as absenteeism costs are higher among obese workers compared to non-obese workers

Source: NCPP, Healthy Food Environments, www.ncpreventionpartners.org

Page 42: Green Healthcare Presentation

Healthy Food Programs• Worksite health promotion and disease management

programs can yield positive clinical and cost outcomes, including a decrease in health plan costs, sick leave, and workers’ compensation and disability costs

• Comprehensive worksite health promotion programs have been shown to yield a positive return on investment. This investment in human capital is less costly than medical treatment, and is associated with a slower rate of growth in healthcare costs for program participants versus nonparticipants

Source: NCPP, Healthy Food Environments, www.ncpreventionpartners.org

Page 43: Green Healthcare Presentation

Healthy Food Programs Elements• Incorporating locally and sustainably produced foods into

hospital food service• Holding a weekly farmers market on hospital grounds• Buying fair trade products• Integrating more fresh foods and vegetables into the menu• Using more whole grains• Switching to dairies that have eliminated the use of the

hormone rBGH• Buying antibiotic-free beef and poultry• Switching to reusable and biobased food service ware• Healthy vending machine options• Recycling fryer oil to be turned into biodiesel

Page 44: Green Healthcare Presentation

“It is an opportunity, commonly missed, to clearly state why new facilities or renovation projects are important to clinical outcomes, more effective work environments, and a reflection of the organization’s values. A communication plan that truly integrates the key message of facility design and cultural transformation can paint a unique picture of the significant investment and the rationale behind it.”

Culture Change and Facility Design: A Model for Joint Optimization, White Paper, The Center for Health

Design

The Opportunity: Communicating About Your Healthy Hospital

Page 45: Green Healthcare Presentation

Lexington Medical Center• West Columbia, South Carolina• 384-bed metropolitan medical complex• Comprehensive, county-wide healthcare

network• Nearly 5,000 employees• Affiliated physician practices, community

medical centers, extended care facility• NRC Consumer Choice Award winner• Press Ganey Summit Award winner

Page 46: Green Healthcare Presentation

Lexington Medical Center• A leader in sustainability practices

– Recognized for industry-leading recycling practices by the Business Recycling Assistance Program of the S.C. Department of Health & Environmental Control

– The first hospital to become a member in the South Carolina Environmental Excellence Program (SCEEP), a voluntary program that promotes environmental leadership

– 2007 SC Governor’s Council on Physical Fitness Worksite Award: Lexington Medical Center’s Health Directions Program

– 2008 Spare the Air Award - S.C. Dept. of Health & Environmental Control

– 2007 Medical Fitness Facility Award Winner– 2007 Greenstar Grand Award Winner for hospital landscaping

Page 47: Green Healthcare Presentation

Being Green at LMC

• What being green means to us:– Healthier environment for patients and families– Healthier environment for employees– Shared values with employees; communicated to

employees– Commitment to our community; being a

responsible corporate citizen– Reinforce our image as a leader– Fiscally smart

Page 48: Green Healthcare Presentation

Green Campaign Objectives• Communicate clearly with internal and

external audiences• Communicate breadth of campaign

– Patient safety focus– Green / LEED certified building– Recycling program– Healthy food program– Tobacco-free campus– Sustainable practices

Page 49: Green Healthcare Presentation

How We’ve Marketed LMC’s Healthy Hospital Initiative

• Internal communication:– Signage– Newsletter articles– Banners & posters– LMC’s Facebook Group– LMC Blog

• External communication:– Advertising– Story pitches to media– Press releases– Patient and family communication– LMC Facebook Group & Wordpress Blog

Page 50: Green Healthcare Presentation

Marketing a Healthy Hospital Environment

• It began with our patient safety ad campaign

• Healthy hospital initiatives often support patient safety via elements such as:– Staff health and satisfaction– Healthy patient room design

Page 51: Green Healthcare Presentation

Patient Safety 24/7

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Patient Safety 24/7

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Patient Safety 24/7

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LMC’s Sustainability Practices• Water conservation

– Waterless urinals - one waterless urinal saves 40,000 gallons of water each year

– New walk-in coolers that re-circulate water saving more than 3 million gallons per year

• Electric vehicles• Recycling program• Tobacco-free campus• Employee health and wellness

Page 55: Green Healthcare Presentation

Communicating the Healthy Hospital Message

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Communicating the Healthy Hospital Message

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Communicating the Healthy Hospital Message

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LMC’s Great Weight Challenge

• Number one risk factor facing our employees is excess body weight

• 8-week challenge

Page 59: Green Healthcare Presentation

LMC’s Healthy Food Program• Nutrition Services launched the Better Choices

campaign• Healthy menu options available in each café• A green apple designates a healthy menu

choice• Healthy choices are either low fat, have zero

grams of trans fats, or are a fruit or vegetable• Marketing includes floor banners, table tents,

posters and newsletter articles• Educational component: healthy eating tips

Page 60: Green Healthcare Presentation

Healthy Eating, Better Choices

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Healthy Eating, Better Choices

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Healthy Eating, Better Choices

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Healthy Eating, Better Choices

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Better Choice Campaign

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Better Choice Campaign

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Healthy Eating, Better Choices

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Healthy Eating, Better Choices

Page 68: Green Healthcare Presentation

Marketing Better Choices

LMC’s Internal Newsletter

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Marketing Better Choices

LMC’s Online Pressroom

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Marketing Better Choices

LMC Story in HealthLeaders

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Marketing Better Choices

LMC Blog on Wordpress

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Marketing Better Choices

LMC Facebook Group

Page 73: Green Healthcare Presentation

LMC’s Green MOB

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LMC’s Green MOB• More than 75% of the waste generated from

the project was recycled• Materials used contained at least 25%

recycled products• Products such as paint, carpets and sealants

were selected to minimize harmful chemicals (VOCs) emitted

• Heat island effect avoided with white roof and two level parking garage

Page 75: Green Healthcare Presentation

LMC’s Green MOB• Lighting turned on and off by motion sensors• Drip irrigation systems uses 50% less water• Water conservation plumbing includes

shower heads, faucets and urinals• Bicycle storage racks and showers

encourage staff to ride bikes to work and exercise on breaks

• Janitor closets have exhaust fans so that harmful chemicals are not recirculated throughout the building

Page 76: Green Healthcare Presentation

LMC’s Green MOB• Stormwater runoff was reduced by using an existing

retention pond to capture runoff from the new building.

• A shuttle system operated by the Medical Center also encourages use of public transportation.

• A 30% savings in energy usage was accomplished by using energy-efficient white roofing, improved building insulation, and energy-efficient windows.

• Air conditioning equipment was selected to use refrigerants (R-134a, a hydrofluorocarbon) that are less damaging to the earth’s ozone layer.

Page 77: Green Healthcare Presentation

Green MOB Marketing

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Green MOB Marketing

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Green MOB Marketing

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Green MOB Marketing

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Green MOB Marketing

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Green MOB MarketingUtopia Insert

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Green MOB Marketing

Premier Health Alliance

Page 84: Green Healthcare Presentation

Summary• If you’re going this route, you need to live it

everyday• Integrated with your overall brand messaging• Share with all audiences; start with your

internal audience - they are your ambassadors

• This is about more than being green:This is about creating a healthy environment for patients, family and employees

Page 85: Green Healthcare Presentation

Green Healthcare Resources

Page 86: Green Healthcare Presentation

Green Healthcare Resources• Green Guide for Health Care -

www.gghc.org– Free download of extensive guide– Promoting the health of patients, visitors,

employees, community members, and the global community

– Offers regular training for sustainability professionals in healthcare

Page 87: Green Healthcare Presentation

Green Healthcare Resources

• www.sustainablehospitals.org– Provides support to the healthcare industry

in the selection of products and work practices that reduce occupational and environmental hazards and maintain quality patient care while controlling costs.

Page 88: Green Healthcare Presentation

Green Healthcare Resources• Evidence For Innovation:

Transforming Children’s Health through the Physical Environment. (NACHRI & The Center for Health Design)

• Available for download at www.childrenshospital.net

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Green Healthcare Resources

• The Health Care Improvement Foundation - Green Hospital Pilot

• 20 pilot hospitals completed an assessment of environmental practices; then participated in initiative

• www.hcifonline.org

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Green Healthcare Resources

• The Center for Health Design - www.healthdesign.org

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Green Healthcare Resources• USGBC• US Green Building Council• www.usgbc.org• LEED® (Leadership in Energy and

Environmental Design) Green Building Rating System

• Very helpful and willing to work with the media

Page 92: Green Healthcare Presentation

Green Healthcare Resources

• Health Care without Harm• www.hcwh.org• Global coalition of 473

organizations in more than 50 countries working to protect health by reducing pollution in the health care sector

Page 93: Green Healthcare Presentation

Green Healthcare Resources

• “Healthy Food, Healthy Hospitals, Healthy Communities” - Institute for Agriculture and Trade Policy, Food and Health Program, 2005

• Available for download from www.noharm.org/us/food/resources#other

Page 94: Green Healthcare Presentation

Green Healthcare Resources

• Healthy Building Network

• Helpful list of resources, educational and training resources

• www.healthybuilding.net

Page 95: Green Healthcare Presentation

Green Healthcare Resources

• NCPP - North Carolina Prevention Partners

• www.ncpreventionpartners.org

• Resource for smoking cessation and hospital nutrition programs

• Case studies and fact sheets

• Links to additional resources

Page 96: Green Healthcare Presentation

Green Healthcare Resources

• Practice Green Health• Membership and networking organization for

institutions that have made a commitment to sustainable, eco-friendly practices

• Environmental Excellence Awards• Training for sustainability professionals• Hospitals for a Healthy Environment (H2E)• www.practicegreenhealth.org

Page 97: Green Healthcare Presentation

Green Healthcare Resources• CleanMed - Conferences for greening

healthcare• www.cleanmed.org• CleanMed 2009, Chicago, IL, May 18-20

Page 98: Green Healthcare Presentation

Green Healthcare Resources• PR News Online - “Going Green:

Outstanding Green Business Practices”• www.prnewsonline.com

Page 99: Green Healthcare Presentation

Green Healthcare Resources• www.TheDailyGreen.com - If you click on the

news tab, you are given a form for submitting your green news to their news editor.

• www.emPivot.com - The ‘green’ YouTube.• Http://green.newsladder.net - A resource for

posting green news. Just sign up and then click on the button that says “Post a Story.”

• www.Keetsa.com/blog - An eco-friendly and green blog search engine. You can post green news on this site.

Page 100: Green Healthcare Presentation

Green Healthcare Resources• www.GreenAtWorkToday.com - A sustainability

news portal where you can post links to your green news.

• http://Greenhackz.com - A green blog where you can submit news stories.

• www.EcoFirms.org - A directory of green manufacturers and retailers.

• www.GreenMaven.com/directory - A green directory where you can list your website.

• www.BestGreenBlogs.com - Directory of green blogs.

Page 101: Green Healthcare Presentation

Green Healthcare Resources• FTC’s “Guides for

the Use of Environmental Marketing Claims”

• Gives guidelines that define false claims and greenwashing

• http://www.ftc.gov/bcp/grnrule/guides980427.htm

Page 102: Green Healthcare Presentation

Contact Information• Mark Shelley

[email protected]– www.lexmed.com

• Dan Dunlop– [email protected]– www.jenningsco.com– Blog:

http://thehealthcaremarketer.wordpress.com– Online Community for Healthcare Marketers

http://healthcaremarketing.ning.com