Green hospital movement not about 'hugging trees,' White House panel says

July 26, 2012
by Brendon Nafziger, DOTmed News Associate Editor
Instead of throwing away all the disposable coverings that medical supplies come wrapped in, a large hospital system uses them for a unique event: a fashion show.

Inova Health System's "blue wrap fashion show" is meant to raise awareness on waste for staff at the system's half dozen hospitals in northern Virginia.

"Certain people really look great in blue fashions that come out of this," joked J. Knox Singleton, the president and CEO of Inova, at a panel discussion hosted at the White House on Tuesday.

Turning medical garbage into couture was just one "greening" suggestion that came up during two panel talks the White House Council on Environmental Quality convened to throw a spotlight on the Healthier Hospitals Initiative. This spring, the coalition of 11 large U.S. hospital systems and three non-profits launched a three-year plan to get U.S. health care facilities to provide healthier food, use less energy and waste, switch to safer chemicals, purchase environmentally friendly supplies and engage hospital leadership in green reforms.

Purchasing power

Hospitals could play a pivotal role in pushing for greener technologies, because of the industry's size, according to Gary Cohen, the president of Health Care Without Harm and the founder of the Healthier Hospitals Initiative. Already, health care accounts for 15 percent of the U.S. economy, but could soon grow to 20 or 25 percent, he said.

"Health care can be the driver toward green chemistry, toward renewable energy, toward sustainable agriculture," he said.

Kaiser Permanente, for instance, a massive consortium of hospitals and clinics, is helping to drive purchasing changes because of its desire to use safer plastics. Cohen said the hospital asked suppliers to move away from making IV systems with PVC plastics, which are usually treated with a softener called phthalate, and which many believe is a reproductive toxin that's especially harmful to babies and pregnant women.

"Because of their purchasing power and their mission, they were able to move away from PVC plastics," Cohen said.

Total cost of ownership

One push-back from buyers wary of green goods is that, item for item, they're often more expensive. However, Kathy Gerwig, the environmental stewardship officer with Kaiser, said while the price tag might be higher, often the total cost of ownership is lower.

She used the example of mercury-based thermometers, which her own health system replaced with slightly more expensive thermometers that didn't have mercury, a known neurotoxin. Although the mercury-free devices cost a bit more, she said hospitals wound up saving money overall by not having to clean up hazardous mercury spills, invest in spill kits, train staff to work with mercury or lose a room temporarily because of mercury contamination.

"It's a bargain -- safer for patients, safer for workers and obviously safer for the environment," she said.

"Not about hugging trees"

In fact, many of the nearly dozen panelists said the biggest challenge to instituting green reforms was almost always a personal one: convincing people at large institutions that the changes matter -- not just to protect the environment, but also to promote efficiency and even improve the bottom line.

"This is not about hugging trees," said Seema Wadhwa, director of sustainability with the Healthy Hospitals Initiative.

Christina Vernon, executive sustainability officer with Cleveland Clinic, said she had a hard time convincing the fleet manager of their buses to join a sustainability program. But once he was on board, he set aggressive fuel conservation goals, and his own drivers developed a plan to change how buses started in the morning, that ended up saving the system nearly $45,000 a year on fuel costs, she said.

Dr. Jeffrey Thompson, CEO of Gundersen Health System, agreed that people were the biggest challenge.

"The hardest problem is not actually solving the problem but getting people to believe they can solve the problem," he said.

Nonetheless, when planning the construction of a new hospital, despite the skepticism of his colleagues, he was able to get the contractors to use 98 percent recyclable or reused construction material, and also to drive down the projected energy usage from 250 or 260 kbtu per square foot per year, the standard for a U.S. hospital, to probably around 120 or 115 kbtu per square foot per year, when the hospital's finished.

"People have to believe you can get from where you're at, and have the discipline to make a plan, measure it, redo your plan, measure it again and stay at it," he said.