Q&A with executive director for Practice Greenhealth
January 30, 2014
by Sean Ruck, Contributing Editor
Gone are the days when being ecofriendly or business-friendly were mutually exclusive. In fact, in the current world of health care, it’s often quite the opposite. Doing a little bit of homework and intelligently greening your health care offerings can have a positive impact on your bottom line. DOTmed Health Care Business News recently spoke with Practice Greenhealth’s executive director, Laura Wenger, to find out more about the association and about going “green.”
HCBN: Can you tell me how and why Practice Greenhealth was formed?
LW: It started officially through a grant as Hospitals for a Healthy Environment. A decision was made to create an implementation arm and the best way to do that was to create a membership association. So since Practice Greenhealth’s beginnings in 2008 with 50 hospitals, we’ve grown to 1,300 hospitals among our members today. And our membership has been growing at a rate of about 15 percent year-over-year for the past couple of years while maintaining greater than 90 percent retention.
We also have about 80 business members of Practice Greenhealth as well.
HCBN: What do you feel has been the association’s biggest accomplishment?
LW: I think it has been the broad increase of awareness and the broad uptake of sustainability in hospitals — really changing the mindset. We’re doing the best for health care, helping the bottom line, but also helping the environment so that everyone’s a winner. It’s taken time to get that message across, but they’re finally making the connection.
Another achievement is our awards program — we literally have several hundred questions to complete for the application, including uploading files, documents, images. It really shows across the country who our top performers are and what they can achieve. Also, with the metrics we have developed for this program we find that they use those metrics to set their own facility level goals for the year.
This coming year, we’re launching a new awards application and tracking system that should be more user-friendly and should allow for better data. With the new tracking system we’ll be able to identify the top 25 sustainable hospitals in the country.
Each different award category looks at key performance indicators and weighs questions, based upon 10 categories for health care;
HCBN: How do you consider performance in regards to climate change?
LW: For climate change we consider mitigation strategies. For instance, having a program in place to encourage staff to bicycle to work, or working with anesthesiologists to use different anesthetic gases than some of the traditional choices, since some gases can be more than 2,000 times more potent than CO2.
HCBN: It seems nearly every company has introduced “green” or “eco-friendly” solutions. What should health care facilities look for in order to verify those claims?
LW: They should look for third party verification like Green Seal or EnergyStar, for example. We have also worked with (group purchasing organizations) to clarify the information about contracted products. We sat down with the five largest GPOs in the country and got them to standardize the formats of their RFPs as it relates to environmental disclosure. They now ask environmental disclosure questions for medical products so that hospitals would have a chance to see what was in the products they were considering for purchase off of the GPO contracts.
Overall, from a Practice Greenhealth view though, we won’t endorse something as a “green” product simply because there’s still a lot of research that needs to be done. So we try to focus our efforts on the environmental attributes of products. We don’t want to say something is the safest option and then have news two years down the line come out showing that it’s just as bad or worse than the product it was replacing.
HCBN: What’s the number one piece of advice you would give to a hospital considering eco-friendly options?
LW: If someone’s new to sustainability work, I think the biggest thing they should do is do an audit. We offer an eco checklist that shows where there are opportunities and things they might not have thought of yet. And it doesn’t have to be financially daunting to take the first step. There are a lot of projects that can be implemented for minimal to no cost, but still have a big payback.
HCBN: What reasons do facilities give for not going green?
LW: Cost and staff. Some people think all green initiatives require a lot of capital. They are thinking too big to start. Our role is to try to help educate them and work within a level of action they’re comfortable with in staff training or technology updates.
For staff, one of the first things they might look at is education about red bag versus regular waste. Red bag waste costs facilities up to ten times more than regular waste to dispose of, yet there’s a tendency to use it even for trash that isn’t regulated medical waste.
Other things, like kit reformulation, can also save money and be an environmentally responsible practice. If a kit has 50 items, but you only need 20, what are you doing with the rest of it? It’s not sterile anymore, so you can’t store it for the next patient. However, if you work with your kit packer, you can cut costs and cut unnecessary waste.
With health care reform and the way things are going, reimbursement isn’t going up. In the past, hospitals used to just up their prices to cover expenses. But that’s not happening anymore. So now, it’s a matter of being more efficient and decreasing their operational costs in order to still keep serving their community. But it takes time and energy to work on those initiatives.
HCBN: What are some of the benefits of being more environmentally friendly?
LW: One benefit is the positive impact on staff health. In the July 2007 issue of , research was published showing nurses have a very high level of occupational asthma — higher than carpenters, higher than cleaning staff, more than twice that of office workers. They’re constantly exposed to bromides, formaldehyde, harsh cleaning supplies, latex, and flame retardants. So, reducing use of those types of chemicals can lead to healthier staff, less sick time, greater employee job satisfaction and lower employee turnover. And reducing employee turnover can mean savings of tens of thousands of dollars, just with the reduction of training time alone
HCBN: How much might a hospital expect to save with moderate greening efforts?
LW: That will widely vary, but among our Top Performers, the top 200 award winners in 2013, there was a savings of more than 16.8 million dollars in recycling programs alone. That amount was calculated by figuring out the amount of tons of waste that was diverted from a landfill to a recycling program — over 64 thousand tons of waste.
The same group saved over $30 million in electricity savings. They accomplished that by renovating facilities, switching to LED lighting, and other various energy initiatives.
Our hospitals also saved $18.3 million by utilizing reprocessing services for both invasive and non-invasive products. The reprocessors take them back and clean, sterilize and sell back to facilities at 50 percent of cost on average of what the purchase price would be for the same OEM device. This practice also diverted 330 tons of waste.
HCBN: Are there any initiatives on the state or federal level that would help to encourage facilities to be more environmentally conscious?
LW: There are some – I will tell you that there are some things that are regional and some that are state-focused. Waste disposal can differ from state to state. EPA has been very active in their various EPA regions across the country. At the federal level, there are executives order around decreasing waste and environmentally preferred procurement that directly impacts our VA hospitals as another example.
HCBN: Does Practice Greenhealth have any lobbying efforts at the Federal level?
LW: No. One, it’s too political — being a membership organization, you’re trying to be all-inclusive to membership. Two, some organizations have very specific codes of ethics —if any of our membership dollars go toward lobbying they cannot join. Our focus is on providing members with the tools, education and how to guide them to implement their sustainability programs.
HCBN: Can you tell me how and why Practice Greenhealth was formed?
LW: It started officially through a grant as Hospitals for a Healthy Environment. A decision was made to create an implementation arm and the best way to do that was to create a membership association. So since Practice Greenhealth’s beginnings in 2008 with 50 hospitals, we’ve grown to 1,300 hospitals among our members today. And our membership has been growing at a rate of about 15 percent year-over-year for the past couple of years while maintaining greater than 90 percent retention.
We also have about 80 business members of Practice Greenhealth as well.
HCBN: What do you feel has been the association’s biggest accomplishment?
LW: I think it has been the broad increase of awareness and the broad uptake of sustainability in hospitals — really changing the mindset. We’re doing the best for health care, helping the bottom line, but also helping the environment so that everyone’s a winner. It’s taken time to get that message across, but they’re finally making the connection.
Another achievement is our awards program — we literally have several hundred questions to complete for the application, including uploading files, documents, images. It really shows across the country who our top performers are and what they can achieve. Also, with the metrics we have developed for this program we find that they use those metrics to set their own facility level goals for the year.
This coming year, we’re launching a new awards application and tracking system that should be more user-friendly and should allow for better data. With the new tracking system we’ll be able to identify the top 25 sustainable hospitals in the country.
Each different award category looks at key performance indicators and weighs questions, based upon 10 categories for health care;
- Leadership
- Waste
- Chemicals
- Greening the OR
- EPP
- Food
- Energy
- Water
- Climate
- Green Building
HCBN: How do you consider performance in regards to climate change?
LW: For climate change we consider mitigation strategies. For instance, having a program in place to encourage staff to bicycle to work, or working with anesthesiologists to use different anesthetic gases than some of the traditional choices, since some gases can be more than 2,000 times more potent than CO2.
HCBN: It seems nearly every company has introduced “green” or “eco-friendly” solutions. What should health care facilities look for in order to verify those claims?
LW: They should look for third party verification like Green Seal or EnergyStar, for example. We have also worked with (group purchasing organizations) to clarify the information about contracted products. We sat down with the five largest GPOs in the country and got them to standardize the formats of their RFPs as it relates to environmental disclosure. They now ask environmental disclosure questions for medical products so that hospitals would have a chance to see what was in the products they were considering for purchase off of the GPO contracts.
Overall, from a Practice Greenhealth view though, we won’t endorse something as a “green” product simply because there’s still a lot of research that needs to be done. So we try to focus our efforts on the environmental attributes of products. We don’t want to say something is the safest option and then have news two years down the line come out showing that it’s just as bad or worse than the product it was replacing.
HCBN: What’s the number one piece of advice you would give to a hospital considering eco-friendly options?
LW: If someone’s new to sustainability work, I think the biggest thing they should do is do an audit. We offer an eco checklist that shows where there are opportunities and things they might not have thought of yet. And it doesn’t have to be financially daunting to take the first step. There are a lot of projects that can be implemented for minimal to no cost, but still have a big payback.
HCBN: What reasons do facilities give for not going green?
LW: Cost and staff. Some people think all green initiatives require a lot of capital. They are thinking too big to start. Our role is to try to help educate them and work within a level of action they’re comfortable with in staff training or technology updates.
For staff, one of the first things they might look at is education about red bag versus regular waste. Red bag waste costs facilities up to ten times more than regular waste to dispose of, yet there’s a tendency to use it even for trash that isn’t regulated medical waste.
Other things, like kit reformulation, can also save money and be an environmentally responsible practice. If a kit has 50 items, but you only need 20, what are you doing with the rest of it? It’s not sterile anymore, so you can’t store it for the next patient. However, if you work with your kit packer, you can cut costs and cut unnecessary waste.
With health care reform and the way things are going, reimbursement isn’t going up. In the past, hospitals used to just up their prices to cover expenses. But that’s not happening anymore. So now, it’s a matter of being more efficient and decreasing their operational costs in order to still keep serving their community. But it takes time and energy to work on those initiatives.
HCBN: What are some of the benefits of being more environmentally friendly?
LW: One benefit is the positive impact on staff health. In the July 2007 issue of , research was published showing nurses have a very high level of occupational asthma — higher than carpenters, higher than cleaning staff, more than twice that of office workers. They’re constantly exposed to bromides, formaldehyde, harsh cleaning supplies, latex, and flame retardants. So, reducing use of those types of chemicals can lead to healthier staff, less sick time, greater employee job satisfaction and lower employee turnover. And reducing employee turnover can mean savings of tens of thousands of dollars, just with the reduction of training time alone
HCBN: How much might a hospital expect to save with moderate greening efforts?
LW: That will widely vary, but among our Top Performers, the top 200 award winners in 2013, there was a savings of more than 16.8 million dollars in recycling programs alone. That amount was calculated by figuring out the amount of tons of waste that was diverted from a landfill to a recycling program — over 64 thousand tons of waste.
The same group saved over $30 million in electricity savings. They accomplished that by renovating facilities, switching to LED lighting, and other various energy initiatives.
Our hospitals also saved $18.3 million by utilizing reprocessing services for both invasive and non-invasive products. The reprocessors take them back and clean, sterilize and sell back to facilities at 50 percent of cost on average of what the purchase price would be for the same OEM device. This practice also diverted 330 tons of waste.
HCBN: Are there any initiatives on the state or federal level that would help to encourage facilities to be more environmentally conscious?
LW: There are some – I will tell you that there are some things that are regional and some that are state-focused. Waste disposal can differ from state to state. EPA has been very active in their various EPA regions across the country. At the federal level, there are executives order around decreasing waste and environmentally preferred procurement that directly impacts our VA hospitals as another example.
HCBN: Does Practice Greenhealth have any lobbying efforts at the Federal level?
LW: No. One, it’s too political — being a membership organization, you’re trying to be all-inclusive to membership. Two, some organizations have very specific codes of ethics —if any of our membership dollars go toward lobbying they cannot join. Our focus is on providing members with the tools, education and how to guide them to implement their sustainability programs.