Because its decisions affect nearly every area of op-eration, supply chain has major potential for greening healthcare. But getting a sus-

tainability plan in place can be challenging. That’s why industry experts developed the Sustainability Roadmap for Hospitals.

The Sustainability Roadmap is a national clearinghouse of comprehensive informa-tion about healthcare sustainability geared specifically to healthcare professionals and

backed by industry and community leaders. Designed to help healthcare organizations recognize and act on the need to promote sus-tainability in their practices, the roadmap is a free online repository of resources, tools and information, and can be a great platform for sustainability efforts in all healthcare settings.

Framing the IssueWith such a significant carbon footprint,

the healthcare industry presents many op-portunities to green the system and make

a real impact on the health and environ-ment of local communities. Many supply chain professionals balk at making policy and product changes in the face of budget constraints, but sustainability efforts actu-ally can make for a healthier bottom line.

Hospitals consume 2.5 times the energy of other commercial buildings and spend more than $8.7 billion annually, according

to the EPA Energy Star pro-gram. The average hospital provider spends more than $72 million a year (one-third of its annual operating budget) on supply chain functions alone. Ultimately, the majority of materials consumed in healthcare set-

tings becomes waste, the disposal of which costs healthcare consumers $10 billion an-nually. Strategic source reduction and waste management afford supply chain profession-als the ability to realize cost reductions as high as 40 to 70 percent.

Using the Sustainability RoadmapAware that sustainability can be a daunt-

ing cause to champion, the American Society for Healthcare Engineering partnered with the Association for the Healthcare Environment and the Association for Healthcare Resource & Materials Management (AHRMM) of the American Hospital Association to develop the Sustainability Roadmap for Hospitals as a free, open-source online tool to help hospitals reduce costs and achieve envi-ronmental goals at the same time.

The website is organized so users can find tools, case studies and evidence-based infor-mation related to their specialties, including facilities, energy, water, waste, supply chain and chemicals. Information provided by the roadmap is product-neutral so users have access to reliable, unbiased resources. It in-cludes information on incentives and policy considerations, and provides tips for leading a sustainability initiative replete with check-lists and self-assessments that help hospitals get started or take next steps. The roadmap also provides the opportunity to participate in discussions on sustainability topics and report successes and experiences to others working toward greener healthcare settings.

“The roadmap is a starting place and a

Strides in SustainabilityFacilities can follow roadmap for greater hospital environmental sustainability

Cetacaine®

TOPICAL ANESTHETIC SPRAY

Brief Summary of the Prescribing Information

Active IngredientsBenzocaine ......................................................................14.0%Butamben ..........................................................................2.0%Tetracaine Hydrochloride ..................................................2.0%

ContainsBenzalkonium Chloride .....................................................0.5%Cetyl Dimethyl EthylAmmonium Bromide .....................................................0.005%In a bland water-soluble base.

ActionThe onset of Cetacaine-produced anesthesia is rapid (approximately 30 seconds) and the duration of anesthesia is typically 30-60 minutes, when used as directed.

IndicationsCetacaine is a topical anesthetic indicated for the production of anesthesia of all accessible mucous membrane except the eyes. Cetacaine is indicated to control pain and for use for surgical or endoscopic or other procedures in the ear, nose, mouth, pharynx, larynx, trachea, bronchi, and esophagus.

Dosage and AdministrationCetacaine Spray should be applied for approximately one second or less for normal anesthesia. Only a limited quantity of Cetacaine is required for anesthesia. Spray in excess of two seconds is contraindicted. Average expulsion rate of residue from spray, at normal temperatures, is 200 mg per second.

An appropriate pediatric dosage has not been established for Cetacaine Spray.

Dosages should be reduced in the debilitated elderly, acutely ill, and very young patients.

Tissue need not be dried prior to application of Cetacaine. Cetacaine should be applied directly to the site where pain control is required. Anesthesia is produced within one minute with an approximate duration of thirty minutes. Each 200 mg dose of Cetacaine Spray residue contains 28 mg of benzocaine, 4 mg of butamben and 4 mg of tetracaine HCl.

Adverse ReactionsHypersensitivity Reactions: Unpredictable adverse reactions (i.e. hypersensitivity, including anaphylaxis) are extremely rare. Localized allergic reactions may occur after prolonged or repeated use of any aminobenzoate anesthetic. The most common adverse reaction caused by local anesthetics is contact dermatitis characterized by erythema and pruritus that may progress to vesiculation and oozing. This occurs most commonly in patients following prolonged self-medication, which is contraindicated. If rash, urticaria, edema, or other manifestations of allergy develop during use, the drug should be discontinued. To minimize the possibility of a serious allergic reaction, Cetacaine preparations should not be applied for prolonged periods except under continual supervision. Dehydration of the epithelium or an escharotic effect may also result from prolonged contact.

Precaution: On rare occasions, methemoglobinemia has been reported in connection with the use of benzocaine-containing products. Care should be used not to exceed the maximum recommended dosage (see Dosage and Administration). If a patient becomes cyanotic, treat appropriately to counteract (such as with methylene blue, if medically indicated).

Use in Pregnancy: Safe use of Cetacaine has not been established with respect to possible adverse effects upon fetal development. Therefore, Cetacaine should not be used during early pregnancy, unless in the judgement of a physician, the potential benefits outweigh the unknown hazards. Routine precaution for the use of any topical anesthetic should be observed when Cetacaine is used.

ContraindicationsCetacaine is not suitable and should never be used for injection. Do not use on the eyes. To avoid excessive systemic absorption, Cetacaine should not be applied to large areas of denuded or inflamed tissue. Cetacaine should not be administered to patients who are hypersensitive to any of its ingredients or to patients known to have cholinesterase deficiencies. Tolerance may vary with the status of the patient. Cetacaine should not be used under dentures or cotton rolls, as retention of the active ingredients under a denture or cotton roll could possibly cause an escharotic effect. Routine precaution for the use of any topical anesthetic should be observed when using Cetacaine.

Rx Only. Made in U.S.A.

© 2013 Cetylite Industries, Inc. All rights reserved. Information is summary in nature and subject to change. Cetacaine and Cetylite are registered trademarks of Cetylite Industries, Inc. All other copyrights are the property of their respective owners.

REV 4/2012

13-CETY-032, Cetacaine Spray Sell Sheet_Gray FA.indd 2 6/17/13 3:01 PM

cetacaine.com 800-257-7740

13-CETY-076, Cetacaine Spray Ad 10-pack Health Trust FA Rev2.pdf 2 10/4/13 3:18 PM

Hospitals consume

2.5 TIMES the energy of other

commercial buildings and spend more than

$8.7 BILLION annually.

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Fourth Quarter 2013 | The Source 15

GREEN TRENDS SOURCEBOOK

SOURCEBOOK GREEN TRENDS

tool,” says Amanda Llewellyn, vice presi-dent of Global Supply Chain for Dimension Health System and chair of the Roadmap’s Sustainability Supply Chain Committee. Opportunities abound to make a positive impact—well beyond the blue recycling bin in the corner of the room, Llewellyn says. Supply chain professionals, in par-ticular, have a unique opportunity on the sustainability front because they affect most purchasing decisions in the hospital setting.

How to Get Your Bottom Line in the Green

Many healthcare professionals are put off by sustainability efforts before they even begin because they believe it’s too expen-sive and difficult to make those kinds of policy, procedure and purchasing changes. In reality, many green opportunities are low- to no-cost in nature and can reap im-mediate benefits, says Josh Miller, senior consultant at Mazzetti, the environmental consulting firm working with associations on the roadmap.

To get decision-makers on board with a new sustainability initiative, it’s important to focus on the big picture—meaning the triple bottom line of economic, social and environmental costs. Also, analyze a prod-uct’s total cost of ownership rather than just purchase cost when making a decision about whether to switch to a more sustainable

product or service, recommends Kimberly Smith, Mazzetti project coordinator.

The opportunities to make strides toward sustainability are plentiful, from minor changes like reprocessing single devices to major overhauls such as implementing more

environmentally friendly building materials.“Many of the opportunities to go green in

the supply chain are similar to what you’ll find in the home,” Llewellyn says. These include employing reusable bags and other products, sourcing locally to reduce trans-portation, choosing products with minimal packaging, and using more natural cleaning supplies and chemicals. Other areas that can make an environmental impact include

waste management, fluid management in operating rooms, and bed-changing and linen policies in patient rooms.

It’s also important to consider the use of post-consumer products that go beyond the operating room, such as recycled paper for mailings and health fair marketing mate-rials. Many healthcare organizations also are involving the IT department in their efforts and going paperless where possible. This not only reduces paper waste, but also saves money.

“Everyone these days is under economic pressures, and a lot of these measures are related to saving money,” Llewellyn says. “Reduce waste and you will automati-cally begin saving money. You can save 30 to 60 percent on reusable devices. Align sustainability efforts with your core mis-sion while doing something great for the environment.”

“HealthTrust supports the efforts of the American Hospital Association and its sub-organizations in the promotion of sustainable practices in the healthcare industry,” says J. Michael Jones, FACHE, director of Clinical Education and Sustainability at HealthTrust. Jones serves as a GPO

industry representative to the AHRMM Sustainability Task Force and has worked with the team from Mazzetti and AHRMM on the development of some of the roadmap resources. “We encourage our members to utilize the information and tools available from the roadmap as part of their overall sustainability program implementation.”

For more information on the roadmap, visit www.sustainabilityroadmap.org. •

“MANY OF THE OPPORTUNITIES TO GO GREEN IN THE SUPPLY CHAIN ARE SIMILAR TO WHAT YOU’LL FIND IN THE HOME. THESE INCLUDE EMPLOYING REUSABLE BAGS AND OTHER PRODUCTS, SOURCING LOCALLY TO REDUCE TRANSPORTATION, CHOOSING PRODUCTS WITH MINIMAL PACKAGING, AND USING MORE NATURAL CLEANING SUPPLIES AND CHEMICALS.” — Amanda Llewellyn

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18 The Source | Fourth Quarter 2013