sustainability in hospitals - 3m...

3M Health Care AcademySM

© 3M 2015. All Rights Reserved


Sustainability in Hospitals

Ann Peddle Meitz

March 7 , 2017



House Keeping

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House Keeping

Continuing Education

• Each 1 hour web meeting qualifies for 1 contact hour for nursing.

• 3M Health Care Provider is approved by the California Board of

Registered Nurses CEP 5770.

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Disclosure

Potential Conflict of Interest

Speaker Bio• Ann Peddle Meitz is the Sustainability Director for 3M’s

Health Care Business Group. Prior to assuming this role, Ann led the Research, Development, and Clinical Affairs organization for 3M’s Infection Prevention Division. Ann has also held cross functional leadership roles in a number of other 3M divisions and staff groups in her 30 years with 3M. Ann holds a B.S. in Chemical Engineering and an M.B.A. in Marketing.




Polling Question #1

Does your hospital have a formalized Sustainability Program?

A. Yes

B. No

C. Don’t Know



© 3M 2015. All Rights Reserved 6

Between now and 2050 the global population

is expected to increase from 7.3 billion

to more than 9 billion, with 98% of this

growth happening in cities and in the

developing and emerging world.

Source: United Nations World Population Prospects



3M’s Technology & Innovation Can Help Solve these Challenges

Population growth presents Sustainability challenges

Health & Safety Education & Development

Raw Materials Energy & Climate Water



Three Pillars of Sustainability

Environmental Stewardship

Social Responsibility

Economic Success



Why is Sustainability Important to Hospitals?

US Hospitals are energy hogs

• Use >2.5x more energy/ft2 than other commercial buildings

• Spend $8.5 billion on energy

Hospitals generate enormous amounts of waste

• 5.9 million tons/year (Practice Greenhealth)

Hospitals use chemicals of concern

• Mercury (limited), phthalates, halogenated flame retardants, some disinfectants, reproductive toxicants, etc.

Health care institutions are big water users

• 250k-700k gallons/bed/year Book by Kathy Gerwig,Kaiser Permanente



Why do Hospitals Start Sustainability Initiatives?

• Improves brand/reputation

• Drives efficiency/cost savings

• Fits with mission of health care. . . “Do no harm”

• Helps mitigate regulatory/compliance risks

• Increases employee satisfaction and engagement


© 3M 2015. All Rights Reserved© 3M 2015. All Rights Reserved3M Health Care AcademySM

11

Hospital Success Stories



Kaiser Permanente: A Sustainability LeaderExcerpt from 2025 Environmental Stewardship Goals

• Become carbon net positive

• Recycle, reuse, or compost 100% of non-

hazardous waste

• Increase purchase of products & materials

which meet environmental standards to

50%

• Reduce water use by 25%/ft2 of buildings

• Buy all food locally or from sustainable

producers

Source: https://share.kaiserpermanente.org/article/kaiser-permanente-pledges-bold-2025-environmental-performance-to-benefit-people-and-planet/



Sustainability at Advocate Health Care

• Saved $23,000,000 from energy efficiency!

• From 2008-2015

• 23.3% annual reduction in weather adjusted energy

consumption

• Equal to the energy needed to power 18,604 homes

for one year

• Recycled 88% of construction waste in 2015

• Decreased medical waste by 43%

• 2009-2014

Source: EnvironmentalStewardship Report & website

http://www.advocatehealth.com/environmental-stewardship-what-were-doing



• Reduced Waste (47% hospitals reporting)

• Achieved 17% recycle rate & reduced RMW to 11%

• Achieved LEED Silver Certification

• Resolute Health Hospital in New Braunfels, TX

• Reducing energy use by 5%

• Baptist Health replaced light fixtures, decreasing lighting energy consumption by 57%

• Adopted healthier food standards

• Reduced amount of meat served/meal to 1.44 oz

• Increased spend on Safer Chemicals to 69% of total spend

• Green Seal and EcoLogo purchases

Sustainability at Tenet

Sources: Tenet2014 Sustainability Report,

website, & Business Roundtable 2015 Sustainability Report

https://www.tenethealth.com/community-main/community



National Health Service (UK) Sustainability

• Annual Sustainability Day: March 23, 2017

• Goal: reduce carbon footprint 34% by 2020

• Procurement (61%)

• Building energy (17%)

• Travel (13%)

• Commissioned Services (9%)

• Partnership with the Sustainable

Development Unit and Public Health England

• Provide toolkits, planning and mapping support

• Many Case Studies on the website

http://www.sduhealth.org.uk/

http://www.nhssustainabilityday.co.uk/case-studies/



• Goal: Reduce Energy Use 20% by ’20*

• 12.4% reduction through 2015 (J. Utech presentation)

• Enterprise Landfill Diversion Rate

• 33.3% through 2015 (J. Utech presentation)

• Green Building

• 13 LEED Certified facilities

• Green Cleaning

• Green Seal Certified supplies for all purpose, glass, floor and bathroom

Sustainability at Cleveland Clinic

http://my.clevelandclinic.org/about-cleveland-clinic/office-for-healthy-environment

Buildings, Operations, Better Buying, Involvement

*vs. 2010 baseline



Sustainability at Gundersen Health System

Sources: Gundersen Website & Healthcare FinanceSaved $11.2 MM since 2008!

2/3/15

http://www.gundersenenvision.org/

• Top 1% for energy efficiency in hospitals in the Midwest

• Recycled 46% of waste in 2015

• Reduced food waste by 88% (2008-2015)



Sustainability at Beaumont®• Recycled 29% of its waste in 2014

• Reduced regulated medical waste to less than 8%

• Collected $866,000 in recycling rebates & diverted 13 MM lbsfrom landfills in last 5 years

• Decreased energy consumption by >14% in 2014

• Generated $1.4 MM savings from energy & water programs including lighting projects, boiler upgrades, low flow sprinkler heads, and more

• Increased purchasing on local/sustainable food by 22%

• Increased use of green cleaning products

• 84% bathroom, general purpose, window, & carpet cleaners were Green Seal or EcoLogo certified

• Created DEHP/PVC elimination plan

Source: 2015 Sustainability Report; CleanMed 2015



Sustainability at University of California San Francisco Health

• Diverted 34% waste from landfills (FY15)

• Saved $1.17 MM by reprocessing devices (FY16)

• Achieved 2020 goal of reducing water use

by 20% six years early!

• Switched to Green Seal certified cleaning

supplies

• Attained single occupancy vehicle

commuting rate of only 30% (FY’16)Source:http://sustainability.ucsf.edu/upload/sustainability/files/UCSF_FY16-sustainability-summary_healthFinal.pdf



Sustainability at Fairview Health Services

• Program saved $3.4 MM from 2013-2015

• 5 LEED certified buildings

• Average recycling rate of 28% (2015)

• Collected 20.6 tons blue wrap

• Composted 114 tons of food waste

• Implemented healthy food initiative

• More fruits & veggies, elimination of grease

fryers, wellness meals for patients & staff

• Implementing Healthier Hospital Initiative

Safer Chemicals goals Source: Fairview Sustainability brochure



Sustainability at Spectrum Health

• $4MM in energy savings since 2009

• Average recycling rate, system wide, is 30%

• Reusable sharps container program has

prevented 116,000 pounds of plastic sharps

containers from entering landfills

• Saved 52,000 pounds of single-use medical

devices by reprocessing

Source: http://www.spectrumhealth.org/about-us/corporate-social-responsibility/sustainability



Partners HealthCare Sustainability Efforts

• Founding member Healthier Hospitals Initiative

• Implemented Strategic Energy Master Plan• Reduced energy use by 25% from 2010-2015

• Earned LEED Certification on several buildings• Martha’s Vineyard Hospital (Gold)

• North Shore Medical Center Power Plant (Gold)

• Massachusetts General Lunder Building (Gold)

• Spaulding Rehab Hospital (Gold)

• Brigham and Women’s Hospital Shapiro Center (Silver)

• Represented on HCWH Climate Council

• Recognized on Becker’s Hospital Review list of

the 50 Greenest Hospitals in America (October 2015)

• 3 hospitals

http://www.modernhealthcare.com/article/20141108/MAGAZINE/311089981/hospitals-shift-from-fossil-fuel-to-

renewable-energy-sources

Sources: http://www.partners.org/Innovation-And-Leadership/Sustainability/Default.aspx



23

Sustainability Resources: Getting Started



Practice Greenhealth

The nation’s leading health care community that empowers its members to increase their efficiencies & environmental stewardship while improving patient safety & care through

tools, best practices and knowledge.

• Prevent, reduce and otherwise make less waste in the health care sector• Achieve carbon neutrality in health care• Reduce energy and water usage• Build, renovate and purchase responsibly• Demonstrate mission through respectful work environments• Engage community on environmental sustainability in design, construction, & operations• Lead the way in responsible buildings and operations• Increase recycling programs• Phase out hazardous substances and toxic chemicals

Goals

Mission

https://practicegreenhealth.org/



Polling Question #2

Is your hospital a member of Practice Greenhealth?

A. Yes

B. No

C. Not Sure



Sustainability Roadmap for Hospitals

http://www.sustainabilityroadmap.org/

AmericanHospitalAssociation



Health Care Without Harm Programs (International Coalition)

• Restorative Health Care

• Healthy Food in Health Care

• Toxic Materials

• Safer Chemicals

• Green Building & Energy

• Environmentally Preferable Purchasing

• Waste Management

• Climate & Health https://noharm.org/Sister organization to Practice Greenhealth

https://noharm.org/



Healthier Hospitals Initiative (HHI)

• 13 large US health systems worked with

• >1300 hospitals

• >$20 billion in purchasing power

• Three NGO’s

• Practice Greenhealth

• Health Care Without Harm

• The Center for Health Design

• To develop a guide for hospitals to

reduce energy and waste, choose

safer products, and purchase

and serve healthier foods.http://www.healthierhospitals.org/



HHI Challenge DetailsLess Waste (3 levels)

• Report a waste baseline for: solid waste, regulated medical waste, recycling and hazardous waste (for 1st two categories)

• Reduce Regulated Medical Waste to either <10% of total waste or <8 tons/OR/year

• Achieve a 15% recycling rate compared to total waste

• Implement a construction & demolition debris recycling program for major renovation & new construction to achieve at least 80% recycle/diversion

Safer Chemicals (4 Levels)

• Green Cleaning

• Purchase 90% Green Seal or UL ECOLOGO certified cleaning products in these 4 categories: carpet, window, all purpose & bathroom

• DEHP & PVC Reduction (2 product categories*)

• Healthy Interiors

• Ensure 30% of annual volume of freestanding furniture & medical furnishings* purchases based on $ eliminate the intentional use of flame retardants, PVC, formaldehyde, perfluorinatedcompounds, & anti-microbials (e.g. triclosan)

• Mercury Elimination*

Source: http://www.healthierhospitals.org/ *See website for more details



HHI Challenge Details (3 Levels/Goal)Leaner Energy

• All Levels: Input energy data to

ENERGY STAR® portfolio manager

to establish baseline and track energy

use and GHG emissions from

metered energy use.

• 3% energy reduction from baseline

• 5% energy reduction from baseline

• 10% energy reduction from base or if

facility is Energy Star Rated (>75)

Smarter Purchasing

• Review and reformulate (where

appropriate) at least 80% of total OR

kits.

• Collect and purchase 20%

reprocessed non-invasive devices

compared to total.

• Specify, purchase, and report

expenditures on greener electronics

with a goal of 80% EPEAT registered

devices

Source: http://www.healthierhospitals.org/



HHI Challenge Details (2 Levels/Goal)**Healthier Food*

• Less Meat: Reduce Meat purchases by 10%/yr OR achieve ultimate goal of an avg. 1.5 oz/meal served.

• Better Meat: Increase by 5%/year or achieve ultimate goal of 20% of meat & poultry purchases raised without the routine use of antibiotics

• Increase the % of local food purchases by 5% annually OR achieve ultimate goal of 20% of total**

• Increase the % of sustainable food purchases by 5% annually OR achieve ultimate goal of 20% of total.

Engaged Leadership• Level 1• Identify internal champions• Identify current stewardship processes• Develop sustainability proposal for

leadership

• Level 2• Implement 3 of the 5 Strengthening

Engagement Activities from the reference list. Examples:• Appoint Executive Owner • Identify Sustainability lead or internship• Appoint Clinical Champion• Commit to 2 or more HHI Challenges

Source: http://www.healthierhospitals.org/

**See website for more details

**Level 1 (Pick 1 category); Level 2 (commit to 2 categories)



Polling Question #3

Which facet of Sustainability is of most interest to you?

A.Energy Efficiency

B.Waste Reduction/Recycling

C.Sustainable Food Choices

D.Water Conservation

E.Use of Safer Chemicals/Env. Preferred Purchasing




34

Key Components of a Sustainability Program



Energy Conservation: How to Get Started

• Assess Operations•Determine Baseline

• Tool: EPA ENERGY STAR® Portfolio Manager®• www.energystar.gov/buildings/tools-and-resources

•Audits

•Does everything need to run 24/7?

•Heating/Cooling Systems

•Data Systems

•Lighting

• Consider Energy During Building/Renovation Processes• Certify to “Green Building Standards”

• Example: LEED® certification (by US Green Building Council)-

most countries have something equivalent

http://

http://www.energystar.gov/buildings/tools-and-resources



Reducing Waste

• Establish a baseline!

• Initiate/expand recycling programs

• Consider composting/organic recycling programs

• Reduce quantity of regulated medical waste via

education (right stuff into right bin)

• Initiate programs to divert construction debris from

landfill

• Capture pharmaceutical waste

• Look for ways to reduce waste at source

• Work with suppliers



Polling Question #4

What area of sustainability do you think your organization would be

most interested in working more on?

A. Energy efficiency

B. Recycling and waste reduction

C. Healthy Food

D. Safer chemicals

E. Supply chain

F. Water




Using Safer Chemicals/Environmentally Preferred Materials

• Strive to understand the science/evidence

• Chemicals some hospitals are monitoring

• Mercury

• Halogenated flame retardants

• DEHP/other phthalates

• PVC

• Triclosan

• Etc.

• Green cleaning options

• Resource renewable materials

• Recyclable materials



Sustainable Food Programs

•Purchase of locally produced food

•Purchase of healthy beverages

•Meat

•Antibiotics not used

•Reduced consumption (“Meatless Mondays”)

•Organic produce

•Dairy free of growth hormone rBGH

•Healthier cafeteria menus

•Farmer’s market for employees/visitors




Water Conservation: How to get Started

• Track and measure your usage

• EPA Energy Star® Portfolio Manager™ or similar tool

• Tools to develop improvement plans

• Water Sense (EPA partnership)

http://www.epa.gov/watersense/

• Practice Greenhealth• https://practicegreenhealth.org/topics/energy-water-

and-climate/water

• Various State Agencies. Example:

•Massachusetts Water Resources Authority http://www.mwra.com/comsupport/ici/hospitals.htm

http://www.epa.gov/watersense/

https://practicegreenhealth.org/topics/energy-water-and-climate/water

http://www.mwra.com/comsupport/ici/hospitals.htm



41

The Role of a Material Manager



Determine the Sustainability Priorities for Purchased Goods

• Determine your areas of focus/priorities• Safer Chemicals?

• Less Packaging/Packaging with Recycled Content?

• Green Building/Built Environment?

• EPEAT electronics?

• Improved air quality?

• Green Cleaning?

• Reprocessing of Single Use Devices?

• Reusable Items?

• Sustainable Food?

• Renewable Energy?

• Products that can reduce waste, energy, water

• Fleet?

• Develop an Environmentally Preferred Purchasing Policy



Other Considerations

• Alignment with your GPO/MindClick(Standardized Questionnaires)

• Contract templates

• Overall Environmental Stewardship of Supplier• Does supplier have Sustainability programs in their

manufacturing operations?

• Is the supplier publishing a Sustainability Report?

• Does the supplier have programs to reduce Packaging?

• System to track and report spend on environmentally preferred products

• Weighting system that considers more than price

• Training for Purchasing Team



Summary

• Hospitals have both mission based & financially based drivers to start Sustainability programs

• Hospital Sustainability efforts generally focus on

• Waste, water, and energy/GHG reduction

• Use of safer chemicals

• Environmentally preferred purchasing

• Sustainable food choices

• There are numerous resources/organizations available to help you on your journey!

• Shamelessly replicate success stories from other hospitals



Questions?


Presenter Contact InformationAnn Peddle Meitz

[email protected]

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