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Dear Colleague:
We hope you enjoy this issue of GreenLink with news and tools on
green purchasing and healthcare practices. View the newsletter below OR download a
PDF version.
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Please visit our publicly accessible
Safety Institute Web site with thousands of pages of resources on patient, worker, and environmental safety and green healthcare.
Sincerely,
Gina Pugliese, editor
Vice President,
Premier Safety Institute™ and
GreenHealthy® program
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Case studies – Success stories on green purchasing and healthcare practices
Visit our
Green Corner Web site with more than 60 case studies of healthcare organizations and suppliers that are taking their environmental responsibility seriously – and sharing their success stories. Topics include:
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In one respect, it seems obvious that healthier environments promote healthier
patients. But as with other questions in healthcare, science is now being
applied in systematic ways to prove the correlation.
Growing numbers of hospitals are incorporating evidence-based design, the
practice of creating healthy environments based on research demonstrating how
the design may impact patient healing, primarily in new construction projects.
The bonus is that healing environments also benefit staff and visitors, and
often involve green principles.
Many contend that for institutions able and willing to make the investment in
green design, the paybacks in energy savings and community and patient health
are substantial. For example, use of natural light by installing energy-saving
glass permits healing-conducive views of nature, which can lead to a reduced
need for pain medication and possibly speedier recovery, while cutting electric
bills and reducing greenhouse gas emissions. Use of environmentally friendly
building materials such as low volatile organic compounds (VOC) paints and
carpeting improves air quality for all building occupants.
Efforts have been made to look at the literature retrospectively, identifying
measurable health outcomes using evidence-based design to determine how the
environment contributes to healing. One report
commissioned by the National Association of Children's Hospitals and Related
Institutions (NACHRI) engaged the Center for Healthcare Design (CHD) to apply
the literature findings to children's hospitals. The CHD authors concluded that
the physical environment inside the NICU, children's settings, and adolescent
settings affects the clinical, physiological, psychosocial and safety outcomes
of patients and families. Study authors cited such strategies as single-family
rooms, circadian lighting (light synched with patients' biorhythms), incubator
noise reduction and access to nature as positive steps that can be taken.
CHD published similar work as a 2009 White paper for the Institute for
Healthcare Improvement (IHI), describing basic elements believed to lead to
safer, less stressful, and more patient-centered healing environments. Both
reports include a literature review, design recommendations, a business case
supporting the recommendations, an implementation toolkit and checklists.
Following are just a few examples from Premier's Green Corner Web site of how
hospitals are using evidence-based design to create healthier environments:
- Lighting – Lexington Medical Center, West Columbia, SC, is building one
of the state's first "green certified" medical complexes, incorporating a
host of green features such as expansive use of natural lighting.
- Single patient rooms; natural settings – Evidence-based design
principles are being put into practice in Springfield, OR, where PeaceHealth's new RiverBend hospital is being built, and in nearby Eugene,
where McKenzie-Willamette Medical Center is trying to win approval for its
new DeltaRidge hospital. Both PeaceHealth's Sacred Heart Medical Center at
RiverBend and McKenzie-Willamette's proposed DeltaRidge hospital feature
single-patient rooms and stunning natural views.
- Patient-controlled climate settings – Sumner Regional Medical Center
incorporated sustainable elements to create a healthier, more
environmentally friendly building in its new patient tower in Gallatin, TN.
The 200,000-square-foot structure boasts a host of environmentally
sustainable features such as large expanses of natural light and modular
"wellness" rooms that incorporate everything from a host of
energy-conserving features such as patient-allowed lighting and climate
control.
Downloads and links
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Environmentalists have long been aware of the risks of chemicals in the
workplace, including cleaners, sanitizers and disinfectants in healthcare
settings. Healthcare organizations are moving to select safer chemicals – for
example, general cleaners that emit lower volatile organic compounds (VOCs). It
is easy to choose a “green” general purpose cleaner and many alternative
products are available with third party certifications, such as
Green Seal and the Canadian-based EcoLogo.
EPA-regulated hospital-use disinfectants cannot make a “green” claim
Currently the green certification process cannot be applied to "hospital-use"
antimicrobial sanitizers and disinfectants since these are classified and
regulated as pesticides by the EPA, and the EPA prohibits manufacturers from
making any claims of "green" or "environmentally preferable." Hospital-use
disinfectants (e.g., quaternary ammonium formulations known as "quats" or
phenolic compounds) are used to decontaminate environmental "high touch"
surfaces in patient rooms and the labels must show that at minimum, that the
product can kill at least S. aureus, P. aeruginosa and Salmonella cholerasuis.
EPA approach to 'green' may change
Given the need for EPA approval of hospital-use cleaners and disinfectants and
the plea for consideration of “green” claims and/or eco-labels, the EPA has
formed a Comparative Claims Workgroup to evaluate alternate claims and labeling. Such
a change would require a new EPA policy. See ASHKIN Press release
and EPA Design for the Environment. The workgroup agrees that effectiveness
remains the primary concern and currently approved products would be evaluated
first for environmental efficacy and safety.
In the meantime, the solution for environmental disinfection of surfaces in the
healthcare setting, particularly high touch surfaces in patient care areas and
regardless of the product used, is a careful monitoring strategy to ensure that
all surfaces are thoroughly cleaned, a practice that has been found to be
lacking in many hospitals.
Downloads and links
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Until recently, healthcare organizations had few options for disposing of
outdated medical equipment or unused supplies. Today, the estimated value of
such medical surplus is $6.25 billion per year.
Fueled by the green movement and increasing shortages of needed healthcare
supplies in impoverished or developing countries, new organizations are
providing bona fide repositories for used medical equipment and supplies. Many
operate large warehouses in major cities where donated items are inspected,
inventoried and shipped to countries around the world. Consider:
- Global Links This international nonprofit organization based
in Pittsburgh has recovered more than 3,000 tons of medical materials and
delivered more than $140 million worth of medical materials to hospitals and
clinics in more than 70 countries. Through its suture donation program,
hospitals around the world have received more than 1 million sutures, a
critical medical supply that is often lacking. Children’s Hospital of
Pittsburgh has a long history of donating much needed medical equipment.
After a recent change in the brand of sutures, all of the boxes that were
opened and therefore not returnable, were sent to Global Links and
redirected to 16 hospitals, including Linden Hospital in Guyana, one of the
poorest countries in the Western Hemisphere.
- AFYA Foundation This New York-based worldwide organization
partners with a growing network of donor hospitals, health organizations,
corporations, and individual households to collect medical and non-medical
supplies and equipment. AFYA (the Swahili term for "good health") stores and
sorts donations from a New York warehouse, loading containers bound for
health clinics in Africa and the Caribbean. For example,
St. John's
Riverside Hospital, a 407-bed community hospital located on the
banks of the Hudson River and part of Riverside Health Care System, has
donated more than 25 tons of furniture, medical equipment and supplies –
even toner cartridges – to AFYA and other charitable organizations and
equipment recovery firms.
Creative recovery
Some hospitals are even creating their own revenue streams from outdated medical
equipment or unused and expired supplies. After converting an existing
10,000-square-foot warehouse, staff inspect and refurbish the items, using an
eBay-like Web site to market them. Aurora Health Care, Milwaukee
expects to recover more than $1 million through its Asset Investment Recovery
program, a full integrated cradle-to-grave approach to maximize the remaining
value of unused or underutilized medical equipment.
Opportunity remains
Despite these efforts, U.S. hospitals each year still throw away an estimated
2,000 tons of unused surgical supplies worth more than $200 million. This still
useful material often ends up being landfilled or incinerated. Hospitals seeking
to reduce their carbon footprint and take an active role in environmental
stewardship have many options today to donate these items instead to
organizations that find homes for them in developing or third-world nations. The
Premier Safety Institute recently established a Web site dedicated to
information about medical equipment and supply donations. The site includes
resources and case studies.
Downloads and links
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Spurred by volatile energy prices, concerns over global warming and their desire
to adopt more environmentally sustainable practices, increasing numbers of
hospitals today are demonstrating they are savvy about energy.
Energy procurement with reverse auctions
In June 2008, Premier, in partnership with Practice Greenhealth and its
Healthcare Clean Energy Exchange (PGH-HCEE), launched the first large-scale,
Web-based healthcare reverse auction for energy
procurement. The reverse auctions are just one offering in Premier’s new energy
initiative, SPHERE™ (Securing Proven Healthcare Energy Reduction for the
Ecosystem), open to all healthcare facilities, with the goals of
helping hospitals reduce their energy usage and cost, as well as increase the
use of clean renewable energy, all to reduce their carbon footprint and the
related public health impact of their energy use. Premier’s SPHERE Web site
offers tools, resources, calculators and case studies to help hospitals achieve
these goals.
In partnership with PGH-HCEE, the reverse auction procurement process permits
energy providers to compete to supply healthcare facilities' energy needs with
renewable and traditional energy at the best possible price in those states that
are deregulated for energy procurement.
"The reverse auction for energy procurement outperforms any other procurement
method in obtaining the best pricing," noted Nicholas DeDominicis, director of
PGH-HCEE, adding that "the program is offered at no cost and without risk."
Through participation in the reverse auction, hospitals in states where
electricity or natural gas is deregulated have the opportunity to reduce their
costs. Such savings for hospitals in those states deregulated for electricity
can be applied to the purchase of renewable energy, priced higher than
traditional energy (fossil fuel-based). The savings can also be used to fund
energy efficiency initiatives and technologies, further reducing energy use and
generating even greater savings. So far, the results have been impressive.
- Covenant Health Systems in Lexington, MA, participated in the reverse auction and purchased electrical energy for seven facilities in Maine and Massachusetts – saving nearly $1.6 million over a traditional paper-based procurement process.
- Suburban Chicago-based Ingalls Health System saved $365,000 in electricity and was able to purchase 5 percent of its electricity from renewable, or green, energy sources at the same price as the traditional fossil-fuel energy, reducing carbon dioxide emissions by 10,299 tons over a three-year period. Ingalls also saved $465,000 for their annual purchase of 112,431 decatherms of natural gas when compared to a traditional paper-based procurement process and their annual budget.
More information on reverse auction
For more information on the reverse auction, including success stories from
Covenant and Ingalls, a list of deregulated states, and how to get started, go
to the SPHERE Web site.
Audioconferences on energy procurement and business case for efficiency
Premier’s
Energy Leadership Forum is a series of teleconferences for
healthcare leaders on the business case for energy procurement and efficiency as
part of the SPHERE energy program. This site provides a complete list of
upcoming programs and downloadable audio files and resources from prior
programs.
Downloads and links
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Healthy food initiatives may be doing as much for our planet's health as for the
health of hospital workers and patients. Organizations are building their own
organic gardens and buying food locally, as well as donating food to local
charities instead of paying for it to be hauled away by carbon dioxide-producing
trucks.
A few examples taken from Premier Safety Institute's Green Corner Web site:
- Catholic Healthcare West (CHW) – CHW developed its own "Food and Nutrition Vision Statement" to promote sustainable food transportation systems and, when appropriate, to source foods that are local and minimize transportation impacts.
- Aurora Health Care – When possible, Milwaukee, WI-based
Aurora Health Care buys locally to support the communities in which it
operates, but also to reduce its carbon footprint. For example, the decision
to recycle locally not only reduces landfill waste, but also reduces
greenhouse gases because less fuel is used to transport the material long
distances. The distance from farm to market has increased about 20 percent
in the last two decades, with much food traveling between 2,500 and 4,000
miles before it reaches the plate.
While the general public has dealt with recent isolated incidences of
salmonella-contaminated peanuts and pistachios, the U.S. healthcare industry is
grappling with other issues that have potential consequences for our nation's
food supply. Those issues include the use of synthetic hormones in livestock,
increasing use of antibiotics as food additives for animals, genetically
engineered vegetables and cloned-animal meat and dairy products. While data are
being gathered on potential adverse impacts on human health, we are seeing a
surge in the purchase of locally grown and organic foods, a call for federal
laws requiring disclosure of cloned foods on labels, and the need to increase
the number of FDA food inspectors.
A growing number of hospitals are also showing their commitment to healthy food
initiatives by signing the "Healthy Food in Health Care Pledge," (link below) a
Healthcare Without Harm sustainable food sourcing initiative introduced as a
means to "demonstrate to society at large healthcare's willingness and
commitment to build models for change."
Downloads and links
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Just a few years ago, it was little more than a novelty. But today, green is
going mainstream in healthcare, and nowhere is that more evident than in the
power plants and bricks and mortar of U.S. hospitals.
Increasing awareness about greenhouse gas emissions and an explosion of
environmentally friendly and energy efficient products and building materials
has escalated the greening of hospitals. The evidence is borne out in surveys
conducted by the American Society for Healthcare Engineering (ASHE). According
to ASHE's 2008 Green Design & Operations Survey, new and newly renovated
healthcare organizations, motivated by soaring energy costs and public concerns
about climate change, are embracing more energy efficiency and environmentally
friendly building practices.
ASHE found that 70 percent of survey respondents said they were specifying
environmentally friendly materials in some or all construction and renovation
projects. High percentages of respondents also said their hospitals had already,
or were in process of, installing systems to recycle or conserve energy –
particularly lighting controls, high-efficiency building controls,
high-efficiency HVACs, chiller plant optimization and building insulation.
Another 2008 ASHE survey found growing importance put on energy management
initiatives, noting that healthcare organizations could spend 8 percent of their
capital budgets and 6 percent of their operating budgets to conserve energy over
the coming year.
What's fueling it?
A key motivator is energy costs. Although there has been a downward turn in
energy prices in recent months, energy bills can take up to 3 percent of their
total operating budgets. Energy efficiency can also save money.
- Geisinger Health System – Despite increasing their 1.2 million-square-foot campus by 75 percent since 1988, they have maintained the same utility expense and electrical demand, saving them nearly $3 million annually. Al Neuner, Geisinger’s associate VP of facility operations, shared his journey in Premier’s Energy Leadership Forum teleconference series on energy efficiency. Download the program
audio file and slides
Many healthcare systems have learned that environmentally friendly building
programs and health go hand-in-hand—and planning is key.
- Catholic Healthcare West's "Healthy Building Initiative," the system's platform for sustainable design efforts, has set
long-range goals for reducing consumption of natural resources such as
energy, water, land and materials, improving energy efficiency, reducing
greenhouse gas emissions and incorporating energy efficiency and building
and land sustainability in all construction projects.
Current hospital construction projects also include the hospitality appeal
consumers demand, but include green design concepts shown to promote healing,
such as use of natural light and private rooms, as well as use of low or no
volatile organic compounds (VOCs). For example:
- PeaceHealth's new Sacred Heart Medical Center at RiverBend in Oregon.
Their design takes advantage of the stunning views of the McKenzie River,
Coburg Hills and the Willamette Valley, and nearby groves of towering firs.
Patient rooms have 6-foot by 8-foot windows, and the vast majority will
feature views that take advantage of the natural beauty surrounding the
hospital. Both Sacred Heart Medical Center at RiverBend and
McKenzie-Willamette's proposed DeltaRidge hospital in Eugene, OR, will have
single-patient rooms, a concept endorsed by the Center for
Health Design and the 2006 Guidelines for Design and Construction of
Healthcare Facilities which require single-patient rooms as minimum design
guidelines.
Return on investment
The return on investment on many environmentally oriented initiatives is getting
steadily better, and green building initiatives do not necessarily cost more
than traditional construction. According to the U.S. Green Building Council, an
added investment of 2 percent on top of normal construction costs yielded
life-cycle savings of more than 10 times the initial investment. The U.S. EPA
states that every dollar a nonprofit healthcare organization saves on energy is
equivalent to generating $20 in new revenues for hospitals or $10 for medical
offices.
More success stories
Visit the Premier Safety Institute’s GreenCorner™ Web site (last link below)
for more than 90 success stories on energy efficiency and other green healthcare
practices.
Downloads and links
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Disposing of electronic waste in a risk-free, safe manner continues to challenge
the nation's hospitals, as highlighted recently by critical reports from the
media and the GAO, Congress' investigative arm. Hospitals are receiving more
support from a coalition of manufacturers supporting an international pledge to
ban e-waste exports, effective guidance from the EPA and leading environmental
organizations, and a promise of stiffer EPA enforcement.
Scope of the problem
Well-established scientific evidence has shown that computers and other types of
electronics contain dangerous materials such as lead, mercury, brominated flame
retardants, cadmium and beryllium – materials that pose health risks and
long-term adverse environmental consequences when improperly discarded. Even as
hospitals believe they are disposing of their e-waste in a responsible manner,
they may be unwittingly handing it over to unscrupulous waste haulers and
recyclers. For example:
- Hong Kong late last year intercepted and returned 41 shipping containers
to U.S. ports because they carried tons of illegal electronics waste from
American homes and businesses, according to a USA Today
report.
- A 2008 GAO report found U.S. e-waste was often disposed of
unsafely in countries such as China and India.
"Unfortunately, these practices are still widespread," said Sarah O'Brien,
EPEAT Outreach director for the Green Electronics Council, (link below) which
administers EPEAT (the Electronic Product Environmental Assessment Tool), a
green rating system to help purchasers in the public and private sectors
evaluate, compare and select desktop computers, notebooks and monitors based on
their environmental attributes, including manufacturer takeback and recycling.
"If a waste handler offers to 'recycle' a healthcare organization's high-volume
e-waste at no cost, they should be extremely careful to investigate processes
throughout the vendor's recycling service chain..."
The good news is that there are organizations now monitoring such practices
such as:
- EPEAT which registered its 1,000th environmentally
preferable computer product in December. EPEAT covers 51 different
environmental attributes, including design for end of life and manufacturer
takeback and recycling for institutional purchasers.
- Basel Action Network (BAN) a watchdog group that monitors
the rapidly growing electronics recycling industry. More than 40 recyclers
have taken BAN's e-Steward pledge not to export to poorer countries.
- Electronics TakeBack Coalition works to promote sustainable
production and consumption of consumer electronics.
- Visit Premier’s Computers & Electronics Web site for
additional organizations and resources, including a link to the National
Recycler’s Coalition database to find recyclers near you.
New EPA guidelines for recyclers
The EPA, as part of a group of recycling stakeholders, recently developed the
"Responsible Recycling (R2) Practices for Use in Accredited Certification
Programs for Electronics Recyclers" to promote better
environmental, worker safety, and public health practices for electronics
recyclers and ensure safe and legal handling in the U.S. and abroad.
Getting tough on e-waste
Hospitals around the country are safely disposing of electronic waste through
aggressive, monitored recycling and donation programs. (For case studies, visit
the Green Corner Web site on computers/electronics). Premier Inc. is
among the companies that have led by example, safely disposing of and recycling
5 tons of computer equipment from its Charlotte-based corporate offices through CompuTel, a local electronics equipment recycler that has signed the BAN’s
recyclers pledge.
Downloads and links
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Government-sponsored reports from the United States, Canada and the European
Union have all concluded that exposures to di-2-ethylhexyl phthalate (DEHP) are
of concern to some patient populations and subsets of the general public.
Especially vulnerable are infants and toddlers, pregnant and lactating women,
and patients undergoing certain medical procedures. All reports point to the
need for action with the U.S. Food and Drug Administration (FDA) recommending
medical device manufacturers reformulate products to remove DEHP, and that
hospitals use alternatives to DEHP-containing products, whenever possible, for
high risk populations. These reports are summarized in a March 2009
publication from Health Care Without Harm (HCWH) titled The Weight of the
Evidence on DEHP: Exposures are a Cause for Concern, Especially during Medical
Care and include major conclusions from the U.S. National Toxicology Program’s
Center for Evaluation of Risks to Human Reproduction, the U.S. FDA, the Health
Canada Expert Advisory Panel, the Swedish National Chemicals Inspectorate (for
the European Union), the European Chemicals Agency, and California’s Office of
Environmental Health Hazard Assessment.
NICUs pledge to transition away from PVC/DEHP medical devices
HCWH has recently introduced the Neonatal Intensive Care Unit (NICU) Pledge to
transition away from PVC/DEHP medical devices – a move also encouraged in a 2006
resolution by the American Medical Association. The pledge also provides the
steps NICUs need to take for this transition.
Copies of the NICU Pledge and facilities currently signed on, copies of the
governmental reports, lists of alternative products, and additional resources
from Europe are available at HCWH's Web site.
Downloads and links
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Nearly 700 green healthcare proponents convened in Chicago May 18-20 for
CleanMed 2009, a global conference that inspires and activates
environmentally preferable practices in healthcare. Now in its sixth year, CleanMed serves as a comprehensive and energizing educational and networking
event for healthcare professionals, vendors, architects and others concerned
with sustainability.
"Sustainable healthcare practices are continuing to expand, even in these
challenging economic times," said Peter Diamond, CleanMed coordinator of Health
Care Without Harm (HCWH). "Healthcare leaders recognize the link
between human health and a healthier environment and are increasing efforts to
reduce their environmental footprint."
Community health promotion
One of the keynote speakers, Ray Baxter of Kaiser Permanente, placed the
conference sessions in the larger context of organization mission and the
promotion of health for communities. Baxter explained that "creating
environments conducive to health" is key to many healthcare organizations today.
One example he gave was the far-reaching impact on health and obesity when "fast
foods" and unhealthy foods may be the only or most readily available choice in
the community, such as the local convenience stores.
Growth out of a tragedy and celebrations of success
A moving moment of the conference was the screening of “A Healing Garden Grows
in Bhopal,” a new video that tells the story of the Sambhavna
Clinic, a nonprofit holistic health clinic in Bhopal, India, built to treat
those injured by the Union Carbide toxic gas release in 1984. Sambhavna Clinic
has gained a reputation for the research it is conducting on the long-range
impacts of chemical exposure and for building a model treatment program for
those exposed to toxic gas. Another highlight of the conference was the Practice
Greenhealth awards ceremony, where 182 healthcare organizations were winners of
the Environmental Excellence Awards and learned that 18,000 trees were being
planted in Haiti in their honor. (See Short Take: "18,200 Trees Planted in
Haiti")
Conference planners practiced what they preached when it came to healthy food
and nutrition. Attendees enjoyed delicious organic foods throughout the
conference provided from local farms.
Save the date
Next year’s conference will be May 11-13, 2010 in Baltimore.
Downloads and links
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Since launching a healthcare sector-wide collaboration in late 2007 to transform
the way the industry designs, builds and operates its facilities, the
Global
Health and Safety Initiative (GHSI) is well on its way to becoming
a major force in the environmental safety movement.
In the midst of developing a host of resources such as design databases and
ecological impact evaluation toolkits for hospitals, GHSI also has spearheaded
efforts to free up federal funds for healthcare energy efficiency and renewable
energy.
Marriage of safety and sustainability
At the time it was founded, GHSI hoped to harness the momentum building among a
growing number of hospitals and healthcare organizations, nonprofit
organizations, architectural and engineering firms, academia, industry and
governmental organizations working to improve the "three safeties" – patient
safety, workplace safety and environmental safety and sustainability. GHSI hoped
to build upon that by building a learning community through combining resources,
leveraging areas of expertise and sharing best practices from these entities.
Since its founding by seven leading healthcare systems and nonprofits Health
Care Without Harm, (HCWH) the Center for Health Design (CHD) and Practice
Greenhealth (PGH), GHSI has grown substantially to more than 60 organizations.
Major initiatives
In early February 2009, GHSI, joined by HCWH and PGH and a coalition of
supporters, proposed the "Renewable Energy and Green Healthcare Jobs Initiative"
to the Obama administration, which, if implemented, would create more than
57,000 new jobs, 26,800 of which will be new clean energy jobs. The initiative's
goal is to work with the federal government to make funds for healthcare energy
efficiency and renewable energy available. Other major initiatives underway
include:
- In conjunction with the CHD, "The Ripple Database for Better Built Environment Design" was developed as an open-source searchable database on innovative design experiences. It was populated with 170-plus Kaiser Permanente innovations, as well as design recommendations from the CHD's Pebble Projects and hospital projects that have incorporated the Green Guide for Health Care in their design and construction.
- Access to information on safer building materials including
Healthy Building Network's PHAROS database, a comprehensive resource that helps healthcare designers and architects select healthier building materials within a lifecycle perspective. It has also just released a new monograph: "Resilient flooring & chemical hazards: A comparative analysis of vinyl and other alternatives for healthcare."
- Eco-Health Footprint Toolkit for Health Care will soon be available,
which will enable hospitals to easily evaluate their energy and carbon
impacts, as well as other key environmental indicators such as waste, water
and toxic chemicals.
- Healthier purchasing through Environmentally Preferable Purchasing
Guidelines with model specifications, the culmination of inputs from group
purchasing organizations to drive a sustainability agenda.
- An innovative research collaborative to help establish priorities and
pool ideas and money from participating institutions to conduct timely
research that can help inform purchasing, design and operations decisions
that improve health, safety and sustainability.
- A public policy agenda and plan that will put the healthcare sector in a
leading position on issues affecting safety and sustainability, including
safer chemicals, climate protection and worker safety issues.
Downloads and links
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One of the most well-established healthcare environmental safety organizations
in the country continues to evolve from its humble beginnings in 1998, when it
was formed in the wake of a landmark agreement by the EPA and American Hospital
Association (AHA) to advance pollution prevention efforts in our nation's
healthcare facilities.
Hospitals for a Healthy Environment (H2E), a joint project of the AHA, EPA,
Healthcare Without Harm and the American Nurses Association, was launched as an
industry-wide collaborative effort to assist the healthcare industry with
mercury elimination and waste and toxicity reduction programs, and enhance
workplace safety and improve the environmental performance of the healthcare
field.
A decade later, H2E became Practice Greenhealth (PGH) when it joined
forces with the Green Guide for Health Care, the foremost green building
and operations tool for healthcare facilities, and the Healthcare Clean Energy
Exchange (HCEE), a program to reduce energy costs and healthcare's carbon
footprint. Then, as in 1998, the new organization remained resolute in its
mission to offer members a full range of tools, resources, forums, technical
assistance and networking opportunities to engage the healthcare design,
construction and operations sectors in creating safe, healthy healthcare
environments. Today, PGH is a leading membership and networking organization for
institutions in the healthcare community that have made a commitment to
sustainable, eco-friendly practices.
Recently, PGH announced two major developments designed to bolster its position
as a preeminent environmental safety organization, when it merged with a major
alternate care environmental education provider, Teleosis, and launched a
sustainability research and training program with one of the largest healthcare
companies in the world, Johnson & Johnson.
PGH offers information, best practices and solutions for greening the many
facets of the healthcare industry from facilities management, design and
construction and environmental purchasing to waste management, clean energy,
chemicals management and pest management.
PGH's suite of tools and resources continues to grow, and PGH will soon launch
the Greenhealth Tracker™, a new Web-based environmental data tracking system to
help organizations measure and monitor waste stream activity, analyze
opportunities to reduce costs associated with waste management and disposal, and
benchmark against hospital organizations nationally.
Other tools and resources include the Sustainability Coordinator training
course, which focuses on the practical aspects of "greening" healthcare through
presentations, case studies, exercises, discussion and networking and the
Energy
Impact Calculator, a tool that calculates the health impacts of a
facility's energy use.
Downloads and links
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Surgeons across the country are getting savvy about operating room waste. At the
University of Minnesota Medical Center-Fairview, Dr. Rafael Andrade has saved
his facility $2,000 and 80 pounds of waste annually through such practices as
eliminating needless, redundant supplies from surgical picks, minimizing
surgical prep waste, switching to reusable gowns and making prudent use of
sterile saline solutions (see Green Corner article, “Fairview reduces operating
room waste”). At Oregon Health and Science University (OHSU), Portland, surgeons
are recycling solid waste and conserving energy use in the operating room,
according to a report presented at the 2008 Clinical Congress of the American College of Surgeons. For
the past five years, surgeons at OHSU have been actively involved in waste
conservation and energy efficiency activities, and have contributed to the
university's campus-wide environmental sustainability programs, which recycled
nearly 1,100 tons of solid waste in 2007 and saved more than $85,000 in waste
management fees.
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A new comprehensive
guide on buying low-mercury lighting is the first resource
in the nation to list mercury levels of light bulbs by major manufacturers.
Published by the City of San Francisco, the guide helps institutional purchasers
of bulbs, tubes or ballasts: find more than 700 energy-efficient, lights that
have the least amount of toxic mercury; replace incandescent bulbs with light-emitting diodes (LEDs) or
compact fluorescent lights (CFLs) and save about $30 or more in electricity
costs over each CFL's lifetime; and safely dispose of lighting.
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Plastic beverage bottles made of polyethylene terephthalate (PET) have long been viewed as a culprit of global warming and mounting landfill waste. In February, Spartanburg, NC-based
United Resource Recovery Corporation opened a plant that will recycle billions of the bottles. A joint venture with Coca-Cola Co., the plant will initially recycle 56 million pounds of food-grade PET annually, with another 44 million pounds coming online by the end of this year or early 2010, when a second recycling line starts production. When completed, it is expected to be the largest PET recycling plant in the world that makes food-grade PET resin.
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Hospitals are measuring their energy performance with
Portfolio Manager, an
interactive energy tracking and benchmarking tool developed by the EPA's Energy
Star program, the industry standard for evaluating hospital energy performance.
Portfolio Manager allows a user to track and assess energy and water consumption
across their entire portfolio of buildings in a secure online environment.
Portfolio Manager allows users to set investment priorities, identify
under-performing buildings, verify efficiency improvements, and receive EPA
recognition for superior energy performance. According to Clark Reed, EPA
director of the healthcare facilities division for Energy Star, more than 2,200
acute care hospitals, representing more than 1.2 billion square feet, had
obtained Energy Star ratings within EPA's national energy performance rating
system in Portfolio Manager at the beginning of 2009. Reed said this represents
a market penetration of 63 percent for inpatient healthcare facilities, the
highest of any building type in the nation. EPA energy resources are available
on the Premier Safety Institute
Web site.
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Is your hospital interested in quantifying the public health impact of your
energy consumption? Based on EPA and other peer-reviewed data, the
Energy Impact
Calculator, developed by Practice Greenhealth's
Clean Energy Exchange, estimates the health impact of energy use, such as
premature deaths, chronic bronchitis, asthma attacks and hospital ER visits, on
a per kilowatt hour/year basis. The Energy Impact Calculator was created to
increase healthcare professionals' understanding of the health impacts and costs
of their facility's energy use, and to enable healthcare energy purchasers to
make business decisions on energy efficiency projects and renewable energy
purchases based on a fuller understanding of energy's true costs.
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Environmental issues were featured at the 2009 Premier Governance Conference with Gary Cohen, executive director, Health Care Without Harm, addressing the role of leaders in reducing the impact of healthcare on the environment, global warming, greenhouse gases, health, and disease. Clark Reed, the EPA’s director of healthcare facilities for Energy Star, offered a roadmap for leading the charge on one of the biggest challenges – reducing energy use and its impact on public health as well as the need for benchmarking to track achievements. These and other
presentations on the environment (audio and slides) are available free through the Premier Safety Store.
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Paint is one of the biggest contributors to indoor air pollution because of
volatile organic compounds (VOCs), chemicals that can have short- and long-term
health effects. Green Seal, an independent nonprofit organization whose "Eco”
labels" are known for promoting the manufacture, purchase and use of
environmentally responsible products and services, recently published a new
paint standard
that has increased the number of prohibited chemicals, reduces allowable levels
of VOCs for base paint and colorants, requires a more accurate test to measure
VOCs, and includes expanded consumer education criteria.
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Premier's Energy Leadership Forum teleconference offered at no charge, features
healthcare leaders sharing success in energy efficiency and cost savings of up
to $3 million annually. Audio archives, program materials and upcoming program
dates at www.premierinc.com/forum
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EPEAT (Electronic Product Environmental Assessment Tool),
a rating system for comparing and selecting desktop computers, notebooks and
monitors based on their environmental attributes, recently marked a significant
milestone (link to Computer module) when it registered its 1,000th
environmentally preferable computer product. This is the latest milestone in the
EPEAT system's explosive growth from its launch in July 2006 to its status as
today's most expansive and influential green IT product rating system. EPEAT
also provides a clear and consistent set of performance criteria for the design
of products, and provides an opportunity for manufacturers to secure market
recognition for efforts to reduce the environmental impact of its products.
Premier was one of the first national organizations to use EPEAT criteria in its
sourcing process in 2006 for computers and electronics.
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The EPA has released results of a study concluding that greenhouse gases (GHG)
contribute to air pollution that may endanger public health or welfare - a
timely report given President Obama's call for a low carbon economy and strong
leadership in Congress on clean energy and climate legislation. The report,
titled "Assessment of the Impacts of Global Change on Regional U. S. Air
Quality: A Synthesis of Climate Change Impacts on Ground-Level Ozone," is out
for public comment, the next step in a deliberative process before final
findings are issued and any changes are made under the Clean Air Act.
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Practice Greenhealth honored its top
performers at the Environmental Excellence Awards in May in Chicago at a dinner
ceremony during CleanMed 2009. Awards were presented in seven categories to 182
facilities. Through a partnership with Trees for the Future, Practice Greenhealth will sponsor the planting of 100 trees in Haiti for each
award presented. These competitive awards are given within the healthcare sector
to institutions for outstanding programs to reduce the facility’s environmental
footprint. Haiti is one of the most impoverished countries in the world with
very few trees left due to clear cutting of trees for income. The trees planted
on behalf of award winners will cover degraded hillsides and mountainsides. In
other areas, the trees will act as a windbreak and pest barrier for orchards,
prevent soil erosion, and provide shade, fruit, nuts and seeds to restore the
aquifers, habitat and income for families. We salute all the 2009 Practice
Greenhealth Environmental Excellence award winners. A listing of all winners can
be found on Practice Greenhealth's Web site.
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Editorial team
- Gina Pugliese, RN, MS, editor
- Judene Bartley, MS, MPH, CIC, associate editor
- John Hall, BSJ, contributor
- Laura K. Botwinick, MS, Contributor
- David Huntley, BA, Web master
About Premier Inc., 2006 Malcolm Baldrige National Quality Award recipient
Serving more than 2,000 U.S. hospitals and 50,000 other healthcare sites, the
Premier healthcare alliance and its members are transforming healthcare
together. Owned by not-for-profit hospitals, Premier operates one of the leading
healthcare purchasing networks and the nation's most comprehensive repository of
hospital clinical and financial information. Premier’s award winning
GreenHealthy® environmental leadership program is led by the Premier Safety
Institute™. Headquartered in San Diego, Premier has offices in Charlotte, N.C.,
Philadelphia and Washington.
GreenLink™ © 2009 Premier, Inc.
You may forward this newsletter to your colleagues. If you would like to reprint any of these stories, please cite the "GreenLink newsletter, Premier, Inc." as your source and send an email to
safety_institute@premierinc.com and alert us. Thank you.
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