Going Green At The North Bronx Healthcare Network

Where were we?Where were we?

Where are we?Where are we?

Where are we going?Where are we going?

The Role of a Healthcare Environmental Services Manager

If you are an Environmental Services Manager, You: Are a Personnel Manager,Are a Personnel Manager, Are a Budget Analyst,Are a Budget Analyst, Are the Waste Guru,Are the Waste Guru, A Diplomat,A Diplomat, Project Expeditor,Project Expeditor, The ‘Expert’ when it comes to Cleaning,The ‘Expert’ when it comes to Cleaning, And a Number of other ‘Things!’ And a Number of other ‘Things!’

But When you Really Boil it Down, It’s about Service!

Providing a: SAFE – CLEAN – HYGENIC Providing a: SAFE – CLEAN – HYGENIC Environment for our PATIENTS, Environment for our PATIENTS, VISITORS and STAFF !VISITORS and STAFF !

North Central Bronx Healthcare Network

Jacobi Medical CenterJacobi Medical Center

&&

North Central Bronx HospitalNorth Central Bronx Hospital

Where were we as an E.S. Department with the Products in Use? Basically: a ‘State of Chaos’ existed!Basically: a ‘State of Chaos’ existed! Too many VendorsToo many Vendors Too many BrandsToo many Brands Too many ComplaintsToo many Complaints Too much VarianceToo much Variance Too much CostToo much Cost And Resulting Safety IssuesAnd Resulting Safety Issues

So, What Happened to ‘Spur’ this Change?

AdvocatesAdvocates

Management CommitmentManagement Commitment

Cost IssuesCost Issues

Advocates and Their Agendas

Dr. Ellen Crain – Pediatric Emergency Dr. Ellen Crain – Pediatric Emergency Services – Chief of Service.Services – Chief of Service.

Hospital Community.Hospital Community. Senior Administrative Support –Senior Administrative Support –

Arthur Wagner, V.P., NBHNArthur Wagner, V.P., NBHN

Herbert Dyer, A.E.D., NBHN Herbert Dyer, A.E.D., NBHN

Management Commitment:

New Network Director for Environmental New Network Director for Environmental Services.Services.

RE-ORGANIZATION and RE-RE-ORGANIZATION and RE-COMMITMENT of Department Objectives.COMMITMENT of Department Objectives.

(We lost sight of what our goals and (We lost sight of what our goals and objectives were as an Environmental objectives were as an Environmental Services Department.) Services Department.)

Cost Issues: Having to Maintain a Diverse Stock of Having to Maintain a Diverse Stock of

ProductsProducts Were we, as a Network inside the greater Were we, as a Network inside the greater

New York City Health & Hospitals New York City Health & Hospitals Corporation taking advantage of available Corporation taking advantage of available contracts and our Buying Power?contracts and our Buying Power?

Asthma, a few facts: In 2000, children in NYC were In 2000, children in NYC were twice as likely twice as likely to be hospitalized for to be hospitalized for

asthma as children in the United States as a whole.asthma as children in the United States as a whole. In 2000, children 0-4 years of age from low income areas were In 2000, children 0-4 years of age from low income areas were more more

than four times as likelythan four times as likely to be hospitalized than children from high to be hospitalized than children from high income areas.income areas.

Children from 4 - 5 years of age was Children from 4 - 5 years of age was more than twice as high.more than twice as high. One in eight adults in NYC report that they had been diagnosed with One in eight adults in NYC report that they had been diagnosed with

asthma at some time in their life.asthma at some time in their life. In recent years, In recent years, the Bronx the Bronx has been the New York City borough with has been the New York City borough with

the highest overall rates of asthma hospitalization, deaths and the highest overall rates of asthma hospitalization, deaths and prevalence among children as well as adults.prevalence among children as well as adults.

Costs in NYC for asthma treatment were almost a Costs in NYC for asthma treatment were almost a ¼ Billion dollars¼ Billion dollars in in 2000. 2000.

Asthma Facts, Second Edition/ Asthma Facts, Second Edition/

New York City Department of Health & Mental Hygiene New York City Department of Health & Mental Hygiene

Change EEK!

It’s NOT AS SCAREY AS YOU THINK! It’s NOT AS SCAREY AS YOU THINK! So get over it! So get over it!

Besides wouldn’t you rather take part in any Besides wouldn’t you rather take part in any ‘Change’ rather than having it forced on ‘Change’ rather than having it forced on you?you?

Greening the Cleaning

Our primary goal was to to find products Our primary goal was to to find products that would be safer to use. So in that would be safer to use. So in Consultation with the Deidre Imus Consultation with the Deidre Imus Foundation for Pediatric Oncology we Foundation for Pediatric Oncology we opted to test the product line offered opted to test the product line offered through their organization. through their organization.

Product Consolidation

We were able to swap out 9 Products in use We were able to swap out 9 Products in use for 3 Products – for 3 Products –

Glass CleanerGlass Cleaner All Purpose CleanerAll Purpose Cleaner Bathroom CleanerBathroom Cleaner

The ‘OLD 9’ contained:

Ammonium ChloridesAmmonium Chlorides Dodecylbenzene Sulfonic AcidsDodecylbenzene Sulfonic Acids Butoxy Ethoxy ProponolButoxy Ethoxy Proponol Ethylene GlycolEthylene Glycol TrichloroethaneTrichloroethane ButoxyethanolButoxyethanol XyleneXylene

Pilot Your Program

Find Champions to be your ‘test pilots’Find Champions to be your ‘test pilots’ Train – TRAIN –Train – TRAIN –

TRAIN!TRAIN!

Build on Success – No Matter How SmallBuild on Success – No Matter How Small

Roll Out

More Training!More Training! Purge the Facility of the old products, Purge the Facility of the old products,

while,while, Getting the new products in place.Getting the new products in place. Vigilance: when old products re-appear –Vigilance: when old products re-appear –

and they will re-appear - and they will re-appear - RemoveRemove them at them at once.once.

Be ReadyBe Ready…for the moaning and groaning!…for the moaning and groaning!

Moaning & Groaning!

It doesn’t work, or,It doesn’t work, or, It Doesn’t have a ‘smell’ to it, or,It Doesn’t have a ‘smell’ to it, or, It doesn’t It doesn’t looklook strong enough, or, strong enough, or, How do you expect me to work with this How do you expect me to work with this

stuff!stuff!

In the Trenches It’s one thing to train but you’ve got to It’s one thing to train but you’ve got to

follow up!follow up! Stick to your guns,Stick to your guns, Watch out for the Gremlins!!Watch out for the Gremlins!!

Staff Reality Check

With the Nay-Sayers we revisited some of With the Nay-Sayers we revisited some of their issues and some of the products that their issues and some of the products that were in use. were in use.

So Where are we going?

Green Seal CertificationGreen Seal Certification Enhanced / Better Dispensing OptionsEnhanced / Better Dispensing Options Germicides – Nano-Technology???Germicides – Nano-Technology???

Bio-Based???Bio-Based??? Paper Products – Percentage of Recycled materialPaper Products – Percentage of Recycled material Processes – Water – Waste Water MinimizationProcesses – Water – Waste Water Minimization Micro Fiber Cloth / ProductsMicro Fiber Cloth / Products

So Why Should You Put Yourself Through This!?! Lets Face It – When you Boil It Down, It’s Lets Face It – When you Boil It Down, It’s

just the right thing to do!just the right thing to do! It’s Coming…Do You Want to Manage It’s Coming…Do You Want to Manage

Change or Do You Want Change to Change or Do You Want Change to Manage YOU!?!?Manage YOU!?!?

In Some Cases ‘It’s” already here!!!!In Some Cases ‘It’s” already here!!!!

Governor George Pataki:

““This morning I signed an Executive This morning I signed an Executive Order requiring all state agencies and Order requiring all state agencies and authorities to begin using non-toxic authorities to begin using non-toxic cleaning products that are free of cleaning products that are free of harmful chemicals. And later this harmful chemicals. And later this session, I will submit legislation that session, I will submit legislation that requires all schools in the State to do requires all schools in the State to do the same.”the same.”

From His State of the State AddressFrom His State of the State Address

January 5, 2005.January 5, 2005.