Published on : January 13, 2011

Case Study ~ Save Money, Go Green

Case Study ~ Save Money, Go Green

With healthcare costs on the rise, hospital sustainability is more important than ever. While the term “sustainability” can be interpreted in many ways, we define it as anything of, relating to, or being a method of harvesting/using a resource so that the reserve is not depleted or permanently damaged. Green medical centers across the nation have realized that it makes good financial sense to protect our environment and health through sustainability initiatives.

Tom Petersen, P.E. has more than 30 years of experience in environmental health and safety consulting and engineering. He is also the president of Environmental and Engineering Solutions, Inc. (EES), a consulting firm which helps organizations to achieve their sustainability goals, while complying with federal, state, and local environmental health and safety regulations. According to Petersen, there are a few steps hospitals can take to help preserve the environment while saving themselves big bucks.

Keep it Simple

The first step in any sustainability effort is to keep it simple. Start small and build from success. Hospitals must identify the initiatives that are easy to implement, cost little or nothing, and have substantial payback before tackling the more complicated issues. A Philadelphia hospital did just that and had enormous success.

The EPA and the AHA (American Hospital Association) had set a goal for all hospital medical devices to be mercury-free by 2005. This was an objective that the Philadelphia hospital had already accomplished, and rather than brushing it off, their “green team” used that benchmark as the first success story in their sustainability program. By pinpointing an existing success, the green team was able to increase confidence in the sustainability program and foster support for future endeavors.

Build From Success

Now that the green team had a stepping stone, they needed to find another simple, but effective, sustainability strategy. They were learning to consistently seek new sources of information on sustainability. This Philadelphia hospital found their next initiative through a Sustainable Healthcare Conference in 2004. The green team had learned about Di(2-ethylhexyl) phthalate (DEHP) (a vinyl plasticizer that was used to manufacture many IV bags and IV tubes). DEHP is a toxin known to cause reproductive changes in the organs of developing animals. After further research, it was determined that these animal studies were relevant to humans and that current exposure levels to critically ill infants, healthy infants and toddlers, and pregnant or lactating women were of specific concern.

Once equipped with this information, The Patient Safety Committee at the Philadelphia hospital agreed to phase out DEHP. They began with the neonatal intensive care unit (NICU), Pediatrics, Labor & Delivery and Maternity Units, where the potential risk to low weight developing infants and fetuses was believed greatest. After the successful phase out in select departments, the green team, in conjunction with The Patient Safety Committee, agreed to a complete phase out of DEHP at the hospital.

The decision to switch to Hospira’s new DEHP-free, VisIV containers paid off through increases in waste reduction, patient safety, and staff satisfaction. The new Hospira, VisIV containers were DEHP-free, latex-free, PVC-free, had specific design features to enhance patient and caregiver safety, as well as a longer shelf life than the previous DEHP product. Additionally, the Hospira product eliminated the protective cover wrap, which reduced waste by approximately ten tons per year and increased the ease of use for the pharmacist and caregiver.

Limit Unnecessary Waste/Expenses

While eliminating ten tons of waste per year was a huge success, all waste generated in patient rooms and restrooms was currently being treated as infectious waste, which costs $455 more per ton to process than municipal waste. Thus, a ten ton reduction simply wasn’t enough. With the cooperation of Epidemiology, Administration, Environmental Services and Nursing, the green team set a goal to reduce red bag waste (RBW) to less than 25 percent of the total waste stream.

The hospital purchased new step-on lidded red bag waste containers for all medical/surgical patients’ rooms, the Emergency Trauma Center (ETC), and the Labor and Delivery Floors. This allowed the staff to safely “source-separate” waste at the patient’s bedside. The hospital staff was trained to dispose of items soiled with blood as RBW, and labels were placed on top of the lidded containers informing staff of what constituted infectious waste. With the cooperation of staff and administration the hospital reached its goal to reduce RBW to less than 25 percent, and in time they even exceeded the goal.

Environmentally Preferable Purchasing

Through the previous sustainability initiatives one can see the importance product selection and packaging can have on waste. As a result, the green team focused its next efforts on environmentally preferable purchasing. The Purchasing Department and employees were encouraged by hospital administration to purchase the safest, least toxic, and most environmentally friendly products and services available.

The hospital convened local manufacturers, suppliers, group purchasing organizations, and Philadelphia-area hospital executives to leverage their influence and buying power. With the other organizations’ cooperation the green team was able to create a policy to reduce the consumption of resources, reuse materials, recycle or re-sell materials, and explore the use of alternative materials. Current suppliers were expected to comply with the policy or risk losing business.

The result was incredible. The hospital’s office supply partner now offers more than 3,000 environmentally friendly office products: facility supplies, recycled paper, rechargeable batteries, refillable ink cartridges, remanufactured toner cartridges, and Green Seal cleaning supplies. Most corrugated shipping boxes were made from 35 to 100 percent recycled products, and other vendors deliver their products in reusable totes.

One of the most significant money-saving initiatives for healthcare purchasing is the safe reprocessing (cleaning, testing/verifying, sterilizing, and packaging) and remanufacturing (disassembling, repairing) of “single-use” medical devices. After thorough scrutiny by the Infection Control Committee, the hospital now saves approximately $500,000 per year by safely reprocessing and reusing “single use” devices. Often the devices are reprocessed and reused many times versus discarding the devices after a single use. There is more than $1,000,000 in potential cost savings yet to be realized, and reprocessing saves approximately 7,000 pounds per year in waste.

Conserve Energy

The next objective for the green team was to conserve energy use throughout the hospital. They focused on everything from top to bottom. The hospital replaced more than 3,000 bedside incandescent lamps with LED lamps, which reduced electrical usage substantially; occupancy sensors were installed in conference rooms; exit signs were replaced with LED lamps; and four-foot fluorescent tubes were changed from T12 to T8, saving additional energy. The hospital was awarded a $3 million matching grant from the Pennsylvania Department of Environmental Protection for a natural gas powered electrical cogeneration plant, which is currently under construction, and will drastically reduce expenses and the hospital’s carbon footprint.

While this Philadelphia hospital took on some larger projects, the important thing to remember is where they started. The green team’s sustainability efforts started small and grew. By making environmentally conscious decisions, such as installing bike racks, offering public transportation discounts to employees, using integrated pest control, or creating a Blue Wrap (a polypropylene #5 plastic) recycling program, other hospitals can grow their sustainability programs while reducing their costs.

About the Author

Ms. Cummings is an alumnus of the Pennsylvania State University. She graduated with a bachelor’s degree in advertising/public relations and minors in psychology and environmental education. During her undergraduate career she interned at Dick Jones Communications, Inc., a higher education public relations firm, and created a public relations campaign for Cooperative Extension, an educational Pennsylvania non-profit. Prior to working at EES Ms. Cummings served as the marketing consultant for a small business in the Bucks County area. She specializes in higher education public relations, social media, and environmental education. At EES Ms. Cummings executes all in-house marketing tactics including, writing and editing blog entries; preparing proposals for potential projects; writing, targeting and pitching company articles; updating social media outlets; and attending networking events. Contact Heather at Heather@eesolutions.net.