Sustainability &Sustainability &Sustainability & HealthcareSustainability & HealthcareHealthcareHealthcare

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IntroductionIntroduction

Objectives for this session:– Sustainability 101– Sustainability and the Army– Sustainability Issues in Healthcare– Successful Sustainability Programs– Healthcare Sustainability Case Studies– Approaches for Implementing Sustainability– The MEDCOM Sustainability Planning Project

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S t i bilit 101Sustainability 101

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sus·tain·a·bil·ity noun

meeting the needs of the present without compromising the ability of future

generations to meet their own needs

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Mainstreaming of SustainabilityMainstreaming of Sustainability

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What does that mean?What does that mean?

SUSTAINABILITY IS NOT JUST “GREEN”Sometimes called “triple bottom line”Also referred to as 3-legged stool: fi i l i l & i t lfinancial, social, & environmental - orprofits, people, planetp , p p , pSimilar to Corporate Social Responsibility, but broader

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Conceptual FrameworkConceptual Framework

Sustainable

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SustainableGrowth

Nine Principles of SustainabilityNine Principles of Sustainability

EthicsGGovernanceTransparencyBusiness RelationshipsBusiness RelationshipsFinancial ReturnCommunity InvolvementCommunity InvolvementValue of Products/ServicesEmployment PracticesProtection of Environment

Source: Epstein & Roy (2003) “Improving Sustainability Performance”

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Sustainability Performance

A Global ProblemA Global Problem

Human activity is straining the Earth. y g

The ability of the planet to sustain future generations can no longer be taken for granted.

We need to be wiser in our use of natural assets.

Protection of these assets can no longer be seen asProtection of these assets can no longer be seen as optional.

Source: United Nations Millennium Assessment, 30 March 2005

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30 March 2005

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Shifting MindsetShifting Mindset

The key isn’t just reducing consumption of the Earth’s resourcesThe real key is shifting from finite resources t li itlto limitless resources

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Sustainability as a CornerstoneSustainability as a Cornerstone

“We believe our efforts in sustainabilityWe believe our efforts in sustainability enhance shareholder value by making Baxter a more competitive company.”p p yRobert L. Parkinson, Jr., Chairman and CEO

“Achieving strong and sustainable growth bl t h th t t iblenables us to have the greatest possible

impact on more patients’ lives worldwide. This is at the core of our mission ”

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This is at the core of our mission.Henri A. Termeer, President and CEO

A S t i bilitArmy Sustainability

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sus·tain·a·bil·ity noun

meeting the needs of the present without compromising the ability of future

generations to meet their own needs

For the military:Proactively planning for the future to ensure the long-term viability of the missionA shift from preventing pollution and compliance to sustaining our resources

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An Enduring VisionAn Enduring Vision

“Sustainable development has clearly matured to an end ring and in al able ision It is criticallenduring and invaluable vision. It is … critically important and achievable. Without it, worldwide stability and security will fail to exist and hence, no enduring peace. Our children and their children deserve a future of security, stability, sustainability, and peace. I don’t believe we can risk the pconsequences of a future that does not have these features. It is up to us, the doers in this life, to ensure that futuredoers in this life, to ensure that future generations receive that heritage.”

-- Lt. General Henry Hatch,

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Chief of Engineers, 1992

The Army Strategy for the EnvironmentThe Army Strategy for the Environment

Vision: – Secure the Future– Sustain the Mission

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The Army Strategy for the EnvironmentThe Army Strategy for the Environment

Mission:– Strengthen the Army contribution to joint

operational capability Meet current and future training testing and– Meet current and future training, testing, and other mission requirements

– Improve our ability to operate installations, to include growing joint interdependency

– Reduce costs and minimize impacts so the Army can do more and do it betterArmy can do more, and do it better

– Enhance human health, safety, and well-being – Be an active citizen within our communities,

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,as well as a good neighbor

The Army Strategy for the EnvironmentThe Army Strategy for the Environment

Goals:– Foster a sustainability ethic– Strengthen Army operations– Meet test, training, and mission requirements– Minimize impacts and total ownership costs – Enhance well-being – Drive innovation

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Army SustainabilityArmy Sustainability

“A t i bl A i th t i t d ’“A sustainable Army is one that wins today’s battles while laying the foundation for our future success. It connects today to tomorrow with sound business practices.

Sustainability enables today’s Army to empowerSustainability enables today s Army to empower the Future Force.”

-- Dr. Mario P. Fiori, Assistant Secretary of the Army (Installations &

Environment), 2003

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Pieces of the Sustainability PuzzlePieces of the Sustainability Puzzle

In its simplest form, sustainability is the it t ti th i i Thcapacity to continue the mission. The

programs that support sustainability include the following:the following:

Pollution PreventionGreen ProcurementSustainable Development Partnering with CommunitiesSafety and Occupational HealthSustainable OperationsNatural Resources Management

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Sustainability is the ability to operate into the future without decline in the mission or the systems that support it.

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The Bottom LineThe Bottom LineA sustainable Army wins today’s battles while

laying the foundation for our future success –laying the foundation for our future success and gives both these guys their best shot at a healthy, happy life.

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Sustainability Issues in

Healthcare

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First, Do No HarmFirst, Do No Harm

Human health requires a healthy global ecosystem 2 % f h l h bl i l i i i~25% of health problems are environmental in origin

Health care services depend significantly on and have consequences for global sustainabilityq g y

Issues such as:Use of toxics in healthcare Disposal of medical wasteFood and nutritionInfluence of building design on patient outcomesWater and energy consumption

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Water and energy consumption

Toxic Substances in Healthcare MaterialsToxic Substances in Healthcare Materials

Mercury– Neurotoxic heavy metal– Found throughout hospitals in

• Thermometers• Sphygmomanometers• Dilation and feeding tubesDilation and feeding tubes• Batteries• Fluorescent lamps

Thermostats• Thermostats

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PVC/DEHPPVC/DEHP

Most widely used plastic in medical devicesProblems:

– Dioxin, a known human carcinogeng– DEHP, a phthalate used to soften PVC plastic

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Medical WasteMedical Waste

Hospitals generate > 2,000,000 tons of waste per yearMajority of this waste is burned in i i tincineratorsMedical waste incinerators are leading

f di i d l d isource of dioxin, mercury, and lead air pollutants

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Healthy BuildingsHealthy BuildingsBenefits to the Bottom Line:

Si ifi t i f d d i ffi i i– Significant savings from energy and design efficiencies– Reduce costs with better waste management– Help attract and retain staffp– Reduce fossil fuel use and associated emissions

Benefits to Patients:– Reduced stress– Increased comfort

I d t– Improved outcomesPatients with views of nature go home an average of

¾ of a day sooner, have a $500 lower cost per case,

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used fewer heavy medications, and exhibited better emotional well being.

FoodFood

What and how we eat contributes to death, disease, and increased health care costsSustainable food procurement policies can:

– Provide nutritionally improved food for patients, staff, and visitors

– Create food systems which are ecologically sound, economically viable, and socially responsible p

By institutionalizing a policy to purchase foods

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produced, processed, and distributed locally, under local ownership, hospitals can support the socioeconomic health of the community. 27

Green PurchasingGreen Purchasing

Things to Consider:Does the product itself have possible toxic effects?Is the product reusable, recyclable or able to be composted?composted?Is it made from recycled materials?What are the environmental impacts from theWhat are the environmental impacts from the manufacturing of the product?Is it local or does it take a lot of fuel to get it here?gIs it more expensive than other, less harmful substitutes?

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What is the life cycle cost of the product?

Water/Energy ConservationWater/Energy Conservation

Healthcare facilities: – $6.5 billion spent on energy each year– Account for 11% of all commercial energy use– One of top consumers of water – Wastewater contains lab and cleaning

chemicals, pharmaceutical compounds

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Case Studies:Case Studies: S iSuccess in HealthcareHealthcare

SustainabilitySustainability

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Toxic Substances in Healthcare MaterialsKaiser Permanente

– Identified DEHP-containing materials in NICU, evaluated alternatives

– Switched to non-DEHP products for umbilical vessel catheters, PICC lines, and enteral feeding productseed g p oduc s

Evergreen Hospital Medical Center Children’s Services, Kirkland, WA, ,

– Over past three years, most of the DEHP-containing products have been replaced

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Medical WasteMedical Waste

Beth Israel Medical Center, New York CityRegulated medical waste disposal costs cut by 60%

Itasca Medical Center Grand Rapids MNItasca Medical Center, Grand Rapids, MNChanged to non-toxic "T2" chemistry for developing X-raysy

– Contains no hexavalent or trivalent chromium, no irritating fumes, and does not damage clothing 95% id f– 95% acid-free

– Improved worker safety and eliminated need to dispose of over 800 gallons of toxic waste per year

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FoodFood

On-Site Farmers’ Market Duke University Medical Center NCDuke University Medical Center, NCOperates April – September Held in a hospital parking lot every FridayHeld in a hospital parking lot every Friday from 11 a.m. – 2 p.m. Sells regionally-produced fruitsSells regionally produced fruits, vegetables, baked goodsHospital provides educational materials, p p ,blood pressure screenings, etc.So successful, there is a waiting list for new

d

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vendors

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FoodFood

St. Luke's Hospital, Duluth, MNOrganic foods provided in cafeteria and to patientsHospital coffee is Fair Trade certifiedPilot introduction of local, sustainably-grown produce

Dominican Hospital, Santa Cruz, CAPurchases produce from a nonprofit, community-based organic farm On site garden provides produce and flowers for theOn site garden provides produce and flowers for the facility

Kaiser Permanente Medical Facilities

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Farmers markets and produce stands provided on site

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Healthy BuildingsHealthy BuildingsBoulder Community Foothills Hospital

200 000 ft2 60 bed facility200,000 ft2, 60 bed facilityOpened Sept 2003Features include:

– Special parking spaces for recharging electric cars, bicycles, and car pool vehicles

– No VOC off-gassing from building materials– Windows open in patient rooms– Roof designed to bounce off sunlight, thus lowering A/C

costs– Built at precise angle so rooms get maximum natural

light– Sensors in rooms turn lights off when room is empty,

shut off A/C if window is open

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shut off A/C if window is open– Xeriscaping cut landscaping water usage by 50%

Healthy BuildingsHealthy Buildings

Continuum Center for Health and Healing,Beth Israel Medical Center Ne York NYBeth Israel Medical Center, New York, NYSelection of building materials and installation methods optimize indoor air quality andmethods optimize indoor air quality and environmental responsibilityMajority of flooring materials are cork and linoleum, b th t l d bi d d bl d tboth natural and biodegradable productsFabric selection focuses on recycled and compostable materialscompostable materials

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Energy/Water ConservationEnergy/Water Conservation

Modesto Medical Center, CAInstalled solar panel screens, which generate 55,000 kW/year of electricity

– $84,000 in cost versus ≤ $125,000 in renewable energy rebates

Porous paving instead of asphalt for all parking lots

Mercy Hospital, Valley City, NDImproved the efficiency of their heating, ventilation, and air conditioning systems

– Achieved energy reduction of 45.6%

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Green PurchasingGreen Purchasing

Winnipeg Health Science Center, CanadaPilot programs

– Product substitution trials– Packaging take-back programsg g p g– Application of life-cycle costing principles,– Contract language/purchasing tools development

Field testing– Field testing

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General Sustainable PracticesGeneral Sustainable Practices

2008 Environmental Leadership Award Winners:Northern Michigan Regional Hospital, Petoskey, MISacred Heart Hospital, Eau Claire, WI

“for outstanding achievements in reducing waste, eliminating mercury and improvingeliminating mercury, and improving environmental performance”

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Wh t’ W ki ?What’s Working?El t fElements of SuccessfulSuccessful

Sustainability yPrograms

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Successful ProgramsWhat’s Working

You are What You Buy:Green procurement supply chains are replacing regulatory

Successful Programs

– Green procurement supply chains are replacing regulatory requirements to motivate change

LEEDing the Way:M i ti l i b ildi t d d t– Many organizations are applying green building standards to new or existing buildings

Turn the Lights Down Low:– Stand-alone energy conservation programs are being implemented

Wind, Sun and Vegetable Oil:– There are successful renewable energy projects being implemented

including, wind and solar energy, and bio-diesel fuels

Green Thyself:– Increasing interest in the “greening” of internal day-to-day operations:

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g g g y y pRecycling, double-sided copying, telecommuting, mass transit

The MEDCOM Sustainability

S iStrategic Pl i P j tPlanning Project

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Mission & VisionMission & Vision

Develop and Implement Sustainability Strategic Plan to:– Sustain mission readiness– Improve quality of life for patients and

healthcare staffSt th it l ti hi– Strengthen community relationships

– Reduce total costs of operation and ownership

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Project PlanProject Plan

Phase I: PolicyPhase II:

– Benchmark – external healthcare facilities– Survey – MEDCOM facilities

Phase III: Sustainability Strategic Plan ase Susta ab ty St ateg c a

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Don’t be surprised to hear from us!

Conclusion

Sustainability will be a critical issue and driver in the 21st century as we all address:y

– Unprecedented growth– Diminishing resourcesg

New approaches and new ways of doing business that involve sustainable practicesbusiness that involve sustainable practices will be essential for success

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Together, we will create a more sustainable future45

About Weston

Weston has advocated t i bilit th h tsustainability throughout our

50 year history

For more information contact:–Mary.Strickert@WestonSolutions.com

–http://www.westonsolutions.com

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