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| Several of health care’s leading environmental organizations have joined forces to better serve the community at large. Operating under the banner Practice Greenhealth, the not-for-profit, member-supported organization offers a broad array of resources to help hospitals achieve environmental excellence. Many of these programs will be available to materials managers and procurement professionals. Read on to learn about opportunities that can help you lead your organization to improved environmental results. |
Ten years ago when I first started working with health care organizations on “greening” their procurement and contracting operations, the big focus was finding substitutes for mercury products. The U.S. Environmental Protection Agency (EPA) had recently announced that medical waste incinerators were major sources of mercury and dioxin to the environment, and university medical centers were experiencing something they had never seen before—EPA enforcement actions. Against this motivating backdrop, the American Hospital Association, American Nurses Association, EPA and Health Care Without Harm came together to create Hospitals for a Healthy Environment (H2E).
Over the last 10 years, H2E has become a central resource for the hundreds of health care facilities and allied organizations interested in increasing operational efficiency, eliminating mercury and creating an environmentally sustainable health care industry. By offering how-to guides, educational events and Web seminars, a waste tracking tool and other resources, H2E has helped health care facilities eliminate mercury and reduce waste volume.
More than 7,500 hospitals have participated in H2E’s Partners for Change Program and H2E top award winners have eliminated mercury from their facilities and reduced their solid waste by at least 25 percent.
As demand for its services has grown while EPA funding was eliminated, H2E evolved to meet the need. Last February, H2E, the Green Guide for Health Care (GGHC), and the Healthcare Clean Energy Exchange (HCEE) joined forces to become Practice Greenhealth, a new not-for-profit, member-supported organization offering a full range of tools, resources and strategies for achieving environmental excellence in health care.
Health care facilities, GPOs, suppliers, architects and designers, not-for-profit organizations and state agencies are all able to join Practice Greenhealth to enjoy the resources and tools offered. Many of these resources are of practical use to materials managers and procurement professionals, including educational Web seminars, the Waste Data Tracking Tool, the information exchange listserv, model environmental procurement specifications, the GGHC and the HCEE.
Web seminars
Practice Greenhealth offers three teleconference Web seminars every month, which allow members to access expert speakers and presentations from their own offices.
Every month offers a new topic in sustainable operations and design and construction. Upcoming Web seminars include Purchasing for Healthy Materials, Energy Savings and Electronics. Nonmembers also can sign up for a Web seminar subscription or register for a specific Web seminar at http://cms.h2e-online.org/tele conferences.
Waste Data Tracking Tool
If you’re not managing your waste, you’re wasting your resources. The Waste Data Tracking Tool (available to Practice Greenhealth members) helps your facility understand how hundreds of thousands of waste disposal dollars are being spent and organizes information by each type of waste. This information will allow you to see where to prioritize goals for waste minimization and justify addressing the specific contracts that contribute to particular waste streams.
In addition, many facilities do not audit or track their waste spending and do not realize how many surcharges or hidden charges are incorporated into waste management contracts. Pilot hospitals have experienced between $40,000 and $600,000 in savings in the first year of using this tool.
Information exchange
The Practice Greenhealth information exchange listserv has become an essential tool for health care facilities moving toward green procurement. If you want to either hear about the experiences of other hospitals or share information regarding such topics as reusable sharps containers or solvent recycling services, the listserv is the ideal place.
Just send an e-mail to the listserv and experienced members will post answers to your questions. It features a fully searchable archive and is monitored by Practice Greenhealth staff members who also answer questions and point members to available resources.
Ensuring EPP
GPOs and health care facilities can access specifications through the Practice Greenhealth Web site (www.practicegreenhealth.org) that can be copied and placed into an RFP to ensure availability and/or labeling of environmentally preferable products. For products where specifications are not available, procurement officials can use RFP/RFI questions to differentiate suppliers that are environmental leaders.
For instance, with the establishment of EPEAT, the environmental label for computers, most health care systems can easily ensure that the computers they use have reduced levels of many toxic chemicals commonly used in electronics, are energy-efficient and incorporate other environmental performance features.
Many health care facilities and GPOs, including Kaiser Permanente and Premier, have established contracts incorporating a requirement that their suppliers offer EPEAT-qualified computers. Also, many health care facilities and GPOs will find that EPEAT-qualified computers are available on their existing contracts.
When executing a computer purchase, facilities can ask their current supplier for a list of the EPEAT-qualified computers available to them, or can go to www.epeat.net to search for the type of computer they want (desktop, laptop, etc.), then request from their supplier the particular EPEAT-qualified model(s) they have chosen.
Capital equipment, medical electronic devices and office equipment also contain large numbers of different toxic and environmentally problematic chemicals that affect the environment through energy use and disposal, just as computers do. However, EPEAT has yet to establish standards for these types of products.
Progressive health care organizations identify medical electronics suppliers that incorporate environmentally friendly technologies by using a set of simple yes-or-no RFP questions such as:
• Does this product meet the threshold limits for specific chemicals stipulated in European Union Directive 2002/95/EC Restriction on Hazardous Substances (RoHS), even if the product category is exempt from RoHS compliance?
The European Union Restriction on Hazardous Substances (RoHS) Directive requires that electric and electronic products sold in the Europe Union (EU) meet strict thresholds for heavy metals and some toxic flame retardants. Responsible manufacturers have already begun to sell RoHS-compliant medical electronic devices in this country.
• Is this product free of intentionally added halogenated flame retardants (HFRs) in housings and external enclosures?
Most halogenated organic flame retardants are persistent, bioaccumulative and toxic. Effective alternatives are easily available for electronic housings and enclosures.
• Is this product free of intentionally added HFRs in all components, including the printed circuit board?
While many companies have stopped using HFRs in housings and external enclosures, addressed in the last question, environmental leaders are eliminating all HFRs in every component.
• Does the supplier or vendor offer a product takeback program qualified under the Pledge of True Stewardship for this product?
Product takeback programs encourage vendors to design products for easy upgrade and recycling. Recyclers that sign the pledge agree not to export hazardous waste or use prison labor and to adhere to other environmentally responsible practices.
Note the pledge is not a certification program and normal due diligence must be done to cover your liability. Practice Greenhealth makes available an Equipment End-of-Life Management Program Summary Form you can use to gather pricing, volume and other details about a particular vendor’s takeback program.
• What is the continuous (or “standby”) mode electrical energy consumption for this product, in kilowatts?
Lower standby power requirements result in less energy use, particularly for equipment that is constantly “on” but not constantly in use.
These questions can help you differentiate progressive suppliers of capital equipment, medical electronics devices and office equipment.
The preferred answer to all these questions is “yes,” except for the last question, where the preferred answer is the lowest number of kilowatts when evaluated against comparable equipment. Suppliers can be compared by tabulating the number of “yes” answers.
For instance, if product price and performance is equivalent, a supplier that answers “yes” to seven out of 10 questions would be preferable to a supplier that answers “yes” to only three questions.
One large health system used similar questions in an RFI for nurse call systems and was able to use the answers to help inform their product choice.
Step by step
The GGHC is a best practices guide for healthy and sustainable building design, construction and operations for the health care industry.
The operations section has recently been updated to expand and deepen the guidance on environmental purchasing initiatives. The credit structure of the GGHC provides step-by-step options showing how a facility can create an environmental purchasing (EP) program to reduce waste, identify responsible vendors and have more control over the potentially toxic and waste-creating materials and processes coming into the building.
“The GGHC environmental purchasing credits lay out not only what you can do but how you can reach your goals. By breaking the EP program down into credits, organizations can take on digestible steps, accomplishing one or two credits a year,” says Janet Brown, a member of the GGHC Steering Committee and director of sustainable operations for Practice Greenhealth.
For instance, the solid waste prevention through purchasing credit (GGHC EP Credit 1) requires a facility to reduce the creation of solid waste through procurement contract improvements.
One option to fulfill this credit is to upgrade mattresses to eliminate disposable “egg-crate” foam underlays. Legacy Good Samaritan Hospital in Portland, Ore., recouped the cost of the new mattresses in one year, then saved more than $80,000 each additional year and reduced annual waste by 16,350 pounds because they upgraded to decubitus-care mattresses, which virtually eliminated the need for egg-crate underlays. (See more examples at www.ciwmb.ca.gov/bizWaste/FactSheets/Hospital.htm.)
Materials managers are in a unique position to tabulate the cost data that could justify such a switch by figuring the simple payback time.
Divide the total cost of purchasing decubitus-care mattresses for all the affected beds in the hospital by the annual cost of purchasing disposable egg-crate underlays (multiply the quantity of egg-crate underlays purchased during the last 12 months by the unit cost).
This gives the number of years before the hospital recoups the cost of the new mattresses and starts to see the savings. The egg-crate underlay supplier should be able to provide the weight of the unit product, and multiplying this by the number of units purchased in the last 12 months will provide the annual waste reduction in pounds. Multiply that number by the current cost per pound to dispose of solid waste, which can be added to your annual savings projection.
Hospitals can download the GGHC and register a project to track its progress at www.gghc.org.
A healthy exchange
Inpatient health care facilities use approximately twice the energy as office buildings of the same size, second only to the food service industry in energy intensity. Major sources of energy in most markets, coal- and oil-fired power plants contribute to premature deaths, hospitalizations and asthma attacks, as well as to mercury emissions and other pollution.
As more health care facilities focus on reducing their climate impact and energy use to benefit their communities, changing energy sources is coming into focus as one way to significantly affect the greenhouse gas emissions attributable to health care. As fossil fuel costs rise, alternative energy sources look more attractive.
Energy costs can be reduced not only through energy efficiency measures, but also through energy procurement changes. Some estimate that billions of dollars are wasted annually because of ineffective energy procurement programs.
Practice Greenhealth’s Healthcare Clean Energy Exchange is a new national program that embodies a new, innovative approach to energy procurement for the U.S. health care industry.
Taking advantage of cost savings within the ever-changing landscape of energy market rules and regulations can represent a nearly impossible challenge without help.
The Healthcare Clean Energy Exchange (HCEE) available to Practice Greenhealth members can help health care facilities to significantly reduce energy costs and create the financial bandwidth to increase the percent of clean renewable energy facilities use while reducing the facilities’ carbon footprint. HCEE bypasses the paper-based bid process and uses a real-time, online auction process with multiple track price discovery research to drive energy and procurement process prices downward.
The platform powering the HCEE has enabled state and federal clients to win nine national awards, including the 2005 Outstanding Program Award for leadership and innovation awarded by the National Association of State Chief Administrators, Lexington, Ky.
Most importantly, the HCEE will allow all participating hospitals and health care facilities to aggressively pursue socially responsible, strategic energy plans. Health care facilities can call (866) 598-2160 to inquire about participating in the HCEE.
Practice Greenhealth has come a long way from its humble beginnings as a group of volunteer committees. As the impetus for environmental sustainability in health care has grown, Practice Greenhealth has become the home of next-generation tools and strategies for improving health care’s environmental and financial bottom line. Its members now have access to the tools needed to achieve leadership status and get ahead of the game.
Lara Sutherland is director of Environmental Purchasing Consulting FOR Practice Greenhealth, Denver.
This article first appeared in the August 2008 issue of Materials Management in Health Care.
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