The Business Case for Sustainability

Virginia Energy and Sustainability ConferenceFebruary 11th 2014

Joan Plisko, PhD, Technical DirectorMaryland Hospitals for a Healthy Environment

Stephen J. Huebner, FACHE, CMRPVice President, Materiel Operations-VirginiaBon Secours Health System

Richard MorganSenior Director, Facilities and Real EstateAtSite inc

Environmental Sustainability and Health Care

Joan Plisko, PhDTechnical Director

Maryland Hospitals for a Healthy Environmentjplisko@som.umaryland.edu

410.706.2107

Community health

Patient health

Worker health

First, Do No Harm

Why be Sustainable?

• Climate change resilience• Cost savings• Community benefit• Employee engagement• Environmental compliance• Environmental protection• Operational efficiency• Patient safety • Quality of Care• Social responsibility

Energy Usage in Hospitals

• Accounts for 8% of all U.S. greenhouse gas emissions

• $10 billion on energy/year• 836 trillion BTUs of

energy/year • > 2.5 times the energy intensity

and CO2 emissions of

commercial office buildings• Historical reliance on non-

renewable sources

Hospital Waste > 6,600 Tons/Day

BIOHAZARD

Solid waste

Medical

waste, sharps

Recyclable

Radioactive

waste

Trace chemo &

pathology

waste

$ Cost to dispose

Hazardous

Waste,

Chemotherapy

Waste

Toxic Chemicals in the Hospital?• Brominated flame retardants (BFRs)• Building Materials• Cleaning Chemicals• Di-2-ethylhexyl phthalate (DEHP) in medical devices• Electronics• Glutaraldehyde• Lab Chemicals• Mercury• Pesticides• RCRA Hazardous Pharmaceuticals• Solvents

Water

• One of top ten consumers in community• 40 – 350 gallons per capita per day• Large U.S. hospitals consume 133 billion gallons of

water, totaling $615 million in water expenditures • Water and sewer costs are on the rise• Toxic wastewaster and stormwater due to:

• Cleaning chemicals• Laboratory waste• Laundry chemicals• Landscape and pest control• Pharmaceuticals

Food System

FIRE

HEAT WAVE

WEST NILE VIRUS

HURRI-CANE

SMOGFLOODING

Resiliency

The capacity to absorb, respond, and recover from vulnerabilities and to develop capabilities that help

the community:

• Basement• Environmental services• Facilities management• All front line workers…

• Bedside• Nurses, nurses, nurses• Physicians, clinicians• Dietitians, therapists and

more…• Management

• EVS, capital improvement• Purchasing, food services• Nursing, pharmacy and

more…

MD H2E: It Takes a Village

• Boardroom• Executives• Leadership• Board members

• Community• Neighbors• Suppliers• Builders• Local/State government• Non-profits organizations• Visitors

Creating a culture of environmental health and sustainability in Maryland’s health care community

MD H2E Mission

• Audits• Awards• Case Studies/Pilot

Projects• Educational Material • Listserv• Meetings/Conferences

• Newsletters• Partnerships and

Collaborations• Site Visits• Vendor and Peer

Connections/Networking• Website

Through networking, education, technical assistance, and recognition, MD H2E supports Maryland hospitals and health care providers in becoming

leaders in environmental health and sustainability

www.mdh2e.org

MD Health Care Sustainability Leadership Council (HCSLC)

Mission: To foster environmentally conscious health care facilities that engage, educate, inspire and advocate for social responsibility in their leaders, employees, patients, and the wider community.

2014 Leadership:Chair: Michael Forthman, GBMCVice Chair: Rachel DeMunda, Johns Hopkins Bayview Medical CenterSecretary, Lisa Grubb, Johns Hopkins Bayview Medical Center

Working GroupsEducationGovernance/AdvocacyKnowledge BaseMembership/Networking

www.healthierhospitals.org

Sponsoring Health Systems

Includes former Vanguard facilities

HHI Challenge Areas

HHI Tools and Resources

• Calendar of Events• Case Studies• How To Guides• Newsletter• Regional Maps• Webinars

Jessica Wolff, MSN, MBAjwolff@healthierhospitals.org

Engaged Leadership

University of Maryland Medical Center, Baltimore, MD

Engaged Leadership

Bon Secours Health System, Marriotsville, MD (HQ)

Ecological Stewardship PlanGoals for 2013-2015

1. Expand ecology visibility internally and externally2. Conduct evaluation process3. Build upon level of excellence in waste, recycling4. Advance cost savings opportunities especially related to energy5. Foster a culture of sustainability6. Identify greening efforts that directly link to improvements in

population health

Leaner Energy

1. Lighting upgrade2. Lighting Occupancy Controls3. Vending Machine Controls4. Water Conservation5. Chilled Water Loop Repiping6. Insulation Blankets7. Steam Trap Replacement8. Cooling Tower Repiping

First Year Savings:Electric – 630,390 kWh saved (15% savings)

Fuel oil – 17,835 gallons saved (16% savings)Water – 1,612 kGals saved (40% savings)

CO2 emissions reduction of 460,190 pounds

9. Air Handler Unit Retooling10. Hot Water Reheat Valve

Replacements11. Boiler Room Ventilation12. Cooling Tower Variable

Frequency Drives (VFD)13. Controls Upgrades14. OR Humidifiers15. Night Setbacks

Atlantic General Hospital, Berlin, MD

Leaner Energy

Adventist Health Care, Rockville, MD (HQ)

Safer Chemicals

Roller Shades – Vinyl-free

Millwork – Formaldehyde-free substrates

Wall Protection – Vinyl-free

Sealants / Adhesives – Low VOC

Floor Base – Vinyl-free rubber

Flooring – Vinyl-free flooring and Low VOC adhesives (Linoleum flooring)

Painting – Zero VOC paint

Sinai Hospital Pediatric Hematology/Oncology Clinic, Baltimore, MD

Less Waste

Logs and tracks items on a database

MedStar Union Memorial Hospital, Baltimore, MD

Smarter Purchasing

University of Maryland Midtown Hospital, Baltimore, MD

Reprocessing/Remanufacturing Single Use Devices• Operating room: bits, trocars, foreceps, drills• Nursing units: compression devices, pulse oximeters, cuffs• Approximate savings = $100,000/month or ~$364/bed/month

Healthier Food

• Local, grass-fed beef – no routine antibiotics

• Certified organic produce from local farmer

• Local, sustainable “Grocers’ section” in cafeteria

• On-site composting of coffee grounds

• Launched herb garden

Union Hospital, Elkton, MD

www.mdh2e.org

Joan Plisko, PhDTechnical Director, MD H2E

jplisko@som.umaryland.edu, 410.706.2107

“We need to protect the environment not

because we love trees, but because we love

people”.- R.F. Kennedy Jr.

The Business Case for SustainabilityPanel Discussion

Stephen J. Huebner, FACHE, CMRPVice President, Materiel Operations-VirginiaBon Secours Health SystemStephen_Huebner@bshsi.org

Richard MorganSenior Director, Facilities and Real EstateAtSite incrmorgan@atsiteinc.com