January 2006
Dear Colleague:
Welcome to Premier's new Green Link newsletter. All issues of this free newsletter will be archived on our Safety Institute Web site. Each Green Link will bring you the latest news, resources, and cost-saving success stories in green purchasing and healthcare practices, including energy efficiency, waste reduction, green cleaning, green buildings, and recycling of lab chemicals and computers and more.
Please share Green Link with your colleagues and encourage them to subscribe. You can unsubscribe at any time.
Visit Premier's Safety Institute Web site for more resources on green purchasing and healthcare practices at www.premierinc.com/safety and call us at 704.733.5865 to share your successes with us for future issues. You may also download a PDF version of this issue.
Sincerely,
Gina Pugliese, editor
Vice President, Premier Safety Institute
News
- Greening of healthcare: hospitals making a difference
- How green is your facility? A quick assessment tool
- Catholic Healthcare West switches to PVC/DEHP-free products
- Premier safely disposes two tons of IT equipment
- CleanMed: Industry's leading EPP conference
- Order a free CD of speakers and case studies from programs on "green" healthcare practices
- Luminary Project lights the way for nurses to share green successes
- Premier cited for environmental leadership
- Premier Safety Institute resources: Visit Web site for in-depth green resources and news
- Quick Stats
Green corner
A look at environmental success stories from around the country, "Green corner" stories in this issue are adapted from case studies on Hospitals for a Healthy Environment (H2E) Web site at www.h2e-online.org.
- Lab chemical waste recycling saves $1.7 million
- EtO-free sterilization reduces risk and improves
air quality - Safer and cost-effective pest control
- Green cleaning program cuts cost by 75 percent
- University hospital safely disposes old computers
- Oregon hospitals recycle bulbs
- On-site autoclave for waste saves $250,000
- New flooring materials improve indoor air quality; reduce maintenance cost
- Medical center saves big by being smarter about water
- New program cuts hazardous waste in half
Greening of healthcare: hospitals making a difference
One of the most under-reported yet significant trends of the 21st century is the greening of healthcare. Since the turn of the century, increasing numbers of hospitals and other organizations have heeded the calls for environmental safety by implementing programs to minimize and manage waste, recycle, eliminate or seek alternatives to harmful toxic chemicals, and conserve renewable resources.
Hospitals for a Healthy Environment (H2E) was launched in 1998 as a joint project of the American Hospital Association, the Environmental Protection Agency, Healthcare Without Harm, and the American Nurses Association. The voluntary program is designed to help hospitals enhance workplace safety and promote environmentally friendly practices.
H2E was born out of a landmark Memorandum of Understanding between the Environmental Protection Agency and the American Hospital Association. The agreement advances pollution prevention efforts in our nation's healthcare facilities and was intended to address the growing environmental problems of hazardous materials, including mercury, in our nation's waste system as well as the overall issue of medical waste.
Since its formation, H2E has fostered a national movement for environmental sustainability in healthcare. The primary goals of H2E are:
- Virtually eliminating mercury-containing waste from healthcare facilities' waste streams. Today, that goal has been achieved, with 97 percent of all U.S. hospitals today labeling mercury-containing devices and phasing out their purchases in favor of safer, equally effective alternatives;
- Reducing the volume and toxicity of healthcare waste both through reduction of materials at the source and through recycling and other waste minimization activities; and
- Identifying hazardous substances for pollution prevention and waste reduction opportunities, including hazardous chemicals and persistent, bioaccumulative, and toxic pollutants.
Guided by these important goals, H2E today is taking on even broader roles as a promoter and national information clearinghouse of environmental health and safety, allowing healthcare organizations to share their successes.
For more information, visit the H2E Web site
How green is your facility? A quick assessment tool
Does your chief executive need an easy way to gauge how green your organization is? A short assessment tool for CEOs to rate their organizations' pollution prevention, material purchasing, and waste management/reduction programs is available on the Safety Institute Web site.
Premier developed this valuable tool in collaboration with Hospitals for a Healthy Environment (H2E) and Health Care Without Harm (HCWH), to help healthcare organization leaders perform a high level assessment on environmental initiatives, including green buying practices, waste reduction and pollution prevention initiatives.
As a supplement to the CEO scorecard, Hospitals for a Healthy Environment has prepared a 28-page comprehensive environmental assessment tool to help healthcare facilities conduct a complete assessment of their environmental program's status and develop goals and action plans to reduce waste, eliminate the use of mercury, and reduce other types of healthcare related pollution.
Download the CEO scorecard (.pdf) (62 KB)
Download the comprehensive environmental assessment tool (.pdf) (963 KB)
Catholic Healthcare West switches to PVC/DEHP-free products
Catholic Healthcare West (CHW) recently announced its plan to convert to polyvinyl chloride (PVC)/di-2-ethylhexyl phthalate (DEHP)-free intravenous (IV) bags, solutions and tubing in all of its 40 hospitals in California, Arizona, and Nevada. This represents one of CHW's ongoing efforts to ensure that products used in the hospital setting are safe for patients, employees, and the environment.
"The care and safety of our patients is our first priority," said Lloyd H. Dean, CHW president/chief executive officer. "We have been actively advocating for PVC/DEHP-free supplies from our vendors since 1997. B. Braun has stepped up to the challenge as the first supplier with the capacity to deliver PVC- and DEHP-free supplies to all 40 of our hospitals."
By using PVC/DEHP-free products, CHW is eliminating approximately 840 tons of PVC/DEHP IV containers from both the patient care setting and the waste stream. Due to the lighter weight of materials, CHW is also reducing overall waste by 250 tons during the five-year course of the contract. Together, PVC and DEHP may represent long-term hazards to the health of patients as well as the environment, as the destruction of PVC results in the release of dioxins, a potent carcinogen.
The transition to PVC/DEHP-free products is one of many environmental and patient safety policies CHW has in place. In 1996, CHW endorsed the CERES Principles for environmental protection and accountability and agreed to conduct regular audits of its environmental impacts and develop action plans for improvement.
In 2001 CHW adopted a mercury elimination policy. Since 2003, CHW has been engaged in a program of sustainable design. Several of the system's hospitals have undergone energy retrofits that have resulted in a savings of 11.6 million kWh of electricity and 833,000 therms of natural gas per year.
CERES Principles for environmental protection and accountability
Premier safely disposes two tons of IT equipment
Premier recently launched a comprehensive Web-based resource to assist healthcare organizations in the environmentally friendly selection, recycling and disposal of computers and electronics.
While the resource was designed with medical facilities in mind, Premier's own Corporate Information Technology Services operations team found that the Premier Safety Institute's Computers and Electronics in Healthcare Web site at has applications beyond hospitals.
Guided by the site's searchable database, Premier was able to recycle and safely dispose of more than two tons of excess IT equipment to organizations within the Charlotte area at no cost. In the midst of a major office move, Premier found that much of its older IT equipment slated for disposal could not be removed through the company's normal garbage pick-up process - a challenge faced by medical facilities across the country.
While some disposal companies wanted $150 per barrelful of discarded uninterruptible power supply (UPS) devices, Premier ultimately found a local company that would accept them all at no cost. Moreover, the IT team located a local business that not only removed a truckload of old PCs, laptops and other equipment, but actually paid Premier to do it.
Premier Safety Institute's Computers and Electronics in HealthCare Web site
CleanMed: Industry's leading EPP conference
Healthcare providers are recognizing that products can impact our health and the environment and are seeking opportunities to improve the environment, occupational health, and patient safety by choosing safer, cleaner, more sustainable products and practices.
Now in its fourth year, CleanMed is the healthcare industry's leading conference on environmentally preferable products and green buildings.
Conference participants have included healthcare purchasing and facility executives, architects, designers and engineers, environmental health and safety leaders, university researchers and nursing and clinical leaders.
Educational sessions have covered issues such as design and operation of green buildings, environmentally preferable healthcare products, reducing waste and toxicity, greener cleaners, computer recovery, and latex elimination.
CleanMed 2006 is scheduled for April 19-20 at The Westin Hotel in Seattle. On April 18, Hospitals for a Healthy Environment will host its Annual Awards Luncheon and Workshop.
Premier is a CleanMed sponsor. For more information, visit the CleanMed Web site at www.cleanmed.org or call 617.524.6018.
Order a free CD of speakers and case studies from programs on "green" healthcare practices
Premier's Safety Institute has captured a wealth of information and resources from two Premier-sponsored conferences on environmentally preferable purchasing and healthcare practices, including audio recordings of speakers and handout materials. A four-CD collection and a downloadable audiofile are available for free from the Premier Safety Store (link below)
Keeping Our Environment Health: Green Products and Practices - 60 minute program
This program featured Sarah O'Brien from Hospitals for a Health Environment (H2E) and Gina Pugliese of Premier's Safety Institute. The speakers discussed how to maximize the results from "green teams" or committees to coordinate environmental agendas, strategies for waste reduction, solvent recovery, energy savings, green cleaning programs, and community outreach activities. This program was one in a series of Premier Advisor Live programs to discuss supply chain issues in healthcare and an audio recording of the program .All handouts can be downloaded from the Premier Safety Store.
Environmentally Preferable Purchasing and Healthcare Practices - half-day program
The Safety Institute offers a special four-CD collection of the audio recordings of all speakers, PowerPoint™ presentations, and resource materials from this half-day conference co-sponsored by Premier, Beth Israel Deaconess Medical Center, Health Care Without Harm, and Hospitals for a Healthy Environment.
The conference included presentations and cases studies on:
- Mercury pollution prevention
- Green buildings
- Energy efficiency
- Solvent recovery
- Waste management
Some success story highlights
- Beth Israel Deaconess Medical Center, Boston
- Energy efficient lighting upgrades saved $166,000
- Energy savings estimated at 25 to 75 percent
- Water efficiency measures saved 40 million gallons a year with savings in excess of $350,000
- Bronson Healthcare Group, Kalamazoo, MI
- Now recycling more than one-third of total waste stream
- Virtually eliminated EtO and glutaraldehyde
- Use less harsh chemicals in place of xylene, formalin, and alcohol
- University of Michigan Hospitals & Health Centers, Ann Arbor
- Recycled more than 4,000 tons of material
- Conserved more than 16,000 cubic yards of landfill space
- Saved more than 110,000 trees, 33 million gallons of water
Luminary Project lights the way for nurses to share green successes
The Luminary Project: Nurses Lighting the Way to Environmental Health is a new Web-based effort to capture the illuminating stories of nurses' activities to improve the health of the environment. Their stories show how nurses are creatively addressing environmental problems and illuminating the way toward safe hospitals, communities with clean air, land and water. Here are two luminaries:
- Charlotte Brody, R.N., former executive director, Health Care Without Harm and current executive director, Commonweal, Health Care Without Harm, helped build the bridge between environmental activists and healthcare professionals, and was instrumental in educating both about the dangers of dioxin and the availability of safer alternatives for waste disposal.
- Bettie Kettell, R.N., OR staff nurse, Mid Coast Hospital, Brunswick, Maine, led efforts to establish an active hospital environmental committee that identified internal waste streams and coordinated a successful hospital recycling program.
Premier cited for environmental leadership
Premier and its shareholder Catholic Healthcare West have been recognized as "Champions for Change" by Hospitals for a Healthy Environment (H2E).
Premier was the first hospital group purchasing organization to earn the award (in 2003), and in 2005 became the first GPO to be honored three consecutive years. The award recognizes organizations for their national leadership in helping healthcare facilities with their environmental efforts, including waste minimization and the elimination of the use of mercury.
Dozens of other Premier healthcare organizations have also earned distinction as honorees for other H2E awards, recognizing efforts in waste reduction, pollution prevention and mercury elimination.
For more information, call H2E at 800.727.4179 or visit the H2E Web site. (link below)
News about Premier's environmental leadership efforts
Premier Safety Institute resources: Visit Web site for in-depth green resources and news
The Premier Safety Institute offers a comprehensive selection of tools, resources and news on environmental safety on its Web site. Here are samples:
- Environmentally preferable purchasing (EPP) tools and resources, including product/services lists;
- News about federal and healthcare industry initiatives;
- Information about hazardous chemicals and safer cleaners and pesticides;
- E-waste management and disposal;
- Pharmaceutical waste management;
- Mercury pollution prevention strategies;
- Latex allergy resources;
- Current topics about reuse of single-use devices;
- A CD collection of presentations from the Environmentally Preferable Purchasing and Healthcare Practices Conference in Boston; and
- An assessment tool for CEOs to rate their organizations' pollution prevention, material purchasing, and waste management/reduction programs.
In addition, news on environmental safety and EPP trends is covered regularly by the Safety Institute's monthly e-mail newsletter, Safety Share.
Pharmaceuticals and mercury lists
Premier supports efforts related to the identification and use of environmentally preferable products and packaging that are less toxic, minimize pollution, more energy efficient, and safer and healthier for patients, workers, and the environment.
As part of its commitment, Premier has a comprehensive collection of mercury pollution prevention news, resources and tools on its Web site.
Among these are lists of mercury-free products under contract with Premier and pharmaceuticals containing mercury, which Premier prepared to assist in the identification, management, and/or disposal of these drugs as potentially hazardous waste.
Premier Safety Institute's Web site featuring tools, resources and news on environmental safety
Collection of mercury pollution prevention news, resources and tools
List of mercury-free products under contract with Premier
List of pharmaceuticals containing mercury
Quick Stats
- Hospitals generate 6,600 tons of solid waste every day, 2 million tons annually.
- Solid waste is 70-80 percent of a facility's waste.
- Half of a hospital's solid waste stream is paper and cardboard.
- Full-fledged waste reduction efforts cut disposal costs up to 70 percent.
- Incinerated medical waste containing chlorine is third largest contributor of dioxins.
- E-waste is the fastest growing portion of our waste stream.
- Ninety five percent of discarded computers end up in landfills or incinerators.
Green corner
A look at environmental success stories from around the country, "Green corner" stories in this issue are adapted from case studies on Hospitals for a Healthy Environment (H2E) Web site at www.h2e-online.org.
Lab chemical waste recycling saves $1.7 million
Each year since 1995, Albany Medical Center has been successfully recovering more than 50 percent of its regulated chemical waste by operating a chemical reclamation facility. Since its inception, the center has also avoided $1.7 million in removal costs and reclaimed 147 tons of chemicals for laboratory use, at a value of more than $1 million. The program paid for itself in about six months.
The reclamation facility cost $150,000 to build, including $75,000 in equipment and $75,000 in renovations to a decommissioned incinerator room. Albany Medical College received a letter from the EPA commending its efforts in hazardous waste minimization and assuring compliance with the agency's RCRA standard.
EtO-free sterilization reduces risk and improves
air quality
The material processing center at St. Elizabeth Hospital, Edgewood, Ky., switched to a low-temperature hydrogen peroxide gas plasma system to improve air quality and reduce hazards from exposure to ethylene oxide (EtO) in its material processing area. The hospital also reduced daily sterilization loads from six per day (EtO) to partial loads once or twice a week.
Cost, safety and environmental concerns are prompting many facilities to consider EtO and glutaraldehyde alternatives for sterilization and high-level disinfection. EtO is a known human carcinogen and requires special handling, air monitoring and safety practices. Glutaraldehyde is a sensitizer, can induce asthma, cause skin dermatitis and irritate mucous membranes.
The Centers for Disease Control and Prevention has developed guidelines to help facilities classify reusable instruments and determine whether they need to be high level disinfected or sterilized.
Safer and cost-effective pest control
Since Baystate Health System in Western Massachusetts implemented an in-house integrated pest management (IPM) program in April 2003, it has learned that hiring one individual to focus on an issue leads to an effective, cost efficient and safer program for patients, communities and staff.
The IPM coordinator educates department heads, physicians and nurses in the hospital system's three facilities in order to help them understand IPM and its goal of prevention rather than treatment. Integrated Pest Management only employs toxic chemicals as a last resort and is a long-term program to inspect, prevent, monitor and educate to reduce the need for killing pests.
Green cleaning program cuts cost by 75 percent
Hackensack (NJ) University Medical Center converted its entire cleaning system to an environmentally-friendly green cleaning program. The center uses the least toxic alternatives. The program reduces toxicity, waste, storage space and cleaning costs. Facilities that have implemented the program have saved as much as 75 percent.
Green cleaning programs endeavor to eliminate all cleaning agents containing hazardous ingredients and replacing them with environmentally friendly, non-toxic products that utilize natural or naturally derived ingredients. Because effective EPA approved natural substitutes for disinfectants and sanitizers do not yet exist, the hospital uses the least toxic alternatives.
University hospital safely disposes old computers
Thomas Jefferson University Hospital, Philadelphia, has been successfully recycling electronics since 2001. Retired computers and electronics are removed and stored by information services or the housekeeping department, cleaned of confidential information per HIPAA regulations, and then safely disposed.
Support services and housekeeping staffs prepare the equipment by placing it on pallets. A contracted vendor then removes the discarded equipment and separates it into its various glass, metal and plastic components. The hospital ensures that the material is broken down into raw material for recycling and that the vendor has established reliable, safe and environmentally responsible outlets for recycling raw material that's sold internationally.
Oregon hospitals recycle bulbs
Pricing barriers were dissuading many Oregon hospitals from recycling their fluorescent bulbs. To turn things around, the Oregon Health Care Without Harm Campaign, Oregon Center for Environmental Health and Oregon State Department of Environmental Quality worked together to negotiate a discounted rate with a local bulb recycling vendor. In the first year, the 16 participants successfully diverted 67,000 lamps.
The cost to recycle the lamps represents just 1-2 percent of the lifetime cost of the bulbs, which includes purchase price plus energy costs. The Oregon Department of Environmental Quality estimates that only 20 percent of lamps in the state are recycled, making fluorescent light bulbs one of the largest sources of mercury in Oregon's waste stream.
On-site autoclave for waste saves $250,000
Since dismantling its incinerator in 1995, Dartmouth Hitchcock Medical Center, Lebanon, N.H., has saved about $250,000 annually by autoclaving and landfilling instead of shipping its general infectious waste through a vendor.
The hospital made the decision after being convinced of the environmental, financial and operational advantages of autoclaving over incineration or outsourcing. The hospital also saved money by reducing the amount of regulated medical waste it generates. The facility averages between six and seven autoclave loads per day, representing nearly 1,500 pounds of general infectious waste.
New flooring materials improve indoor air quality; reduce maintenance cost
St. Joseph Hospital, Orange, Calif., switched to an environmentally friendly floor material to improve worker and patient safety. The flooring, which is chlorine-free and low in volatile organic chemicals, has improved indoor air quality and reduced maintenance costs.
In addition, the chosen flooring material does not require waxing and stripping. Although the material appeared at first to be more expensive than other flooring material currently in use at St. Joseph, a full life cycle analysis proved that the true cost of the material was comparable - with some important health benefits.
Medical center saves big by being smarter about water
Since 2001, Ridgeview Medical Center, Waconia, Minn., has been perfecting a plan to manage or remove harmful contaminates from its discharge water. The hospital removed toxic chemicals from its waste stream, added a laboratory chemical recycler, and began seeking safer alternative products. Many alternative products did not increase costs.
Water savings, in terms of both conservation and financial numbers, are a virtually untapped resource. While water may be only 1-3 percent of a typical facility's operating budget, there are still very cost effective water projects.
New program cuts hazardous waste in half
North Broward Hospital District's Coral Springs Medical Center recently implemented a biomedical waste reduction program that has cut the amount of its hazardous waste generation by more than half.
Coral Springs was able to reduce its monthly poundage of biohazardous waste from 30,000 pounds to slightly more than 12,000 pounds per month.
The facility also reduced the size and number of infectious waste containers in its soiled utility rooms, patient rooms and restrooms. Other measures included increasing the size and number of regular trash cans in patient rooms and bathrooms.
Editorial team
- Gina Pugliese, RN, MS, editor
- Judene Bartley, MS, MPH, CIC, associate editor
- John Hall, BSJ, writer, designer
- Judith Luca, RN, BSN, contributor
- Derek Kleckner, BA, Web master
About Premier's EPP program
Premier's Environmentally Preferable Purchasing (EPP) program, a collaboration of its Safety Institute and Group Purchasing Program, supports the efforts of members and the industry at large to enhance the safety and health of patients, healthcare workers and the environment. Through its EPP program, Premier provides publicly available resources and tools to assist hospitals with their environmental safety agenda and offers environmentally friendly products, packaging, and services to members as part of its group purchasing contracts in collaboration with suppliers that share Premier's environmental commitment.
Green Link © 2006 Premier, Inc.
You may forward this newsletter to your colleagues. If you would like to reprint any of these stories, please cite the "Green Link newsletter, Premier, Inc." as your source and send an email to safety_institute@premierinc.com and alert us. Thank you.
