Slowly but surely, hospitals and health systems are making progress on their strategies to recycle waste, use energy more efficiently and generally act as better stewards of the environment.
“The trajectory of change has been over the last 18 years or so,” Gary Cohen, president and founder of Health Care Without Harm and Practice Greenhealth, told Healthcare Dive, adding that almost all of hospital/health systems' “go-green” efforts have been voluntary. Cohen's national association of healthcare organizations aims to increase “green initiatives” while improving patient safety and care.
“Hospitals started with simple things, where they had a very significant environmental imprint,” Cohen said. In the mid-1990's, hospitals were seen as being the largest source of dioxins from burning medical waste with plastics, he said, and hospitals also were responsible for about 10% of mercury emissions.
According to Cohen, a focus on getting U.S. hospitals to close medical-waste incinerators decreased the number of incinerators from about 4,500 to 60 and hospitals learned to reduce their volume of medical waste. The industry adopted efforts to eliminate mercury in thermometers and blood-pressure devices to the point where that issue has been mostly addressed, he added.
Now the issues are broader as hospitals work to reduce their climate impact with more efficient energy use, Cohen said. And over the past several years, at an accelerating pace, hospitals are working to improve their food practices, using more local food-supply sources and sustainable food systems.
Nationwide, about 1,000 hospitals now are participating in Practice Greenhealth's “Healthier Hospitals” initiative, Cohen said. A report on hospitals' efforts in 2013 isn't due out until July. But Cohen told Healthcare Dive that hospitals in general saw “a lot more savings” year-over-year, especially in waste and energy reduction and some device reprocessing categories: strategies helping to clean the environment and address population health issues under the Affordable Health Act.
However, while hospitals have come a long way in addressing environmental issues, Cohen said, “There's still a long way [to go] in detoxifying their supply chain and leading our society toward a cleaner energy future.”
Here are highlights of “green” initiatives by several health systems and hospitals recognized recently as being in the forefront of national efforts:
Mayo Clinic's main campus in Rochester, Minn., officially began a recycling program in 1991, recycling just over 1,500 tons of materials (mostly cans and cardboard) that first year. Since then, the health system has continually expanded its recycling efforts, adding such items as fluorescent light bulbs, computer parts, appliances, batteries, box-board paper as well as corrugated paper, magazines, x-ray film, toner and ink-jet cartridges. Most recently its recycling expanded to include polystyrene foam in 2013.
As a result, Mayo Clinic's Rochester campus recycled just over 4,500 tons – adding up to more than 35% – of its overall waste in 2013, Amanda Holloway, Mayo Clinic's section head of facilities operations in waste management and environmental services, told Healthcare Dive. Including scrap metal from construction and demolition projects on campus, that annual recycling figure increases to more than 5,600 tons, she said.
Mayo Clinic is retro-commissioning older buildings on its main campus to increase energy efficiency, changing to more efficient lighting, heating and cooling, said Holloway, who chairs Mayo Clinic’s Rochester Green Committee. Surplus food is donated to local hunger relief efforts, and almost 700 tons of food waste was diverted to a local farm in 2013 alone.
Mayo Clinic Health System based in Eau Claire, Wisc., recycled more than 24 tons of glass, plastic and aluminum and 252 tons of paper across its five hospitals. Across its regional network, the reusable sharps program diverted 22,214 pounds of plastic from the landfill and eliminated the use of 1,716 pounds of cardboard in 2013.
“These [recycling numbers] are going to get better as we find more companies willing to take the plastics and other materials we want to recycle,” Gordy Howie, director of facilities and construction services for Mayo's Wisconsin network, told Healthcare Dive. “The operating room has lots of plastics I can't recycle now.” Differing local waste-management policies make it challenging for a system that includes four critical-access hospitals and 13 clinics spanning a 100-mile service area in northwestern Wisconsin, he said.
The system began using a standardized data collection during first-quarter 2014. “Obviously, if you can't measure it, you can't improve...We have a solid baseline now,” he said. The aim is to reduce waste and energy by 20% by 2020, he said, adding that while saving money is “clearly a good thing, our overall goals are a reduction in consumption” – and a cleaner environment.
Ridgeview Medical Center in Waconia, Minn., adopted sustainability as part of its mission in May of 2001, said Todd Wilkening, director of facilities. The hospital partnered with the Minnesota Office of Environmental Assistance to launch the program, and by 2003 it won the governor’s award for pollution prevention “for successfully incorporating sustainable practices into its core business,” he said.
In comparison to its baseline, Ridgeview has reduced electrical use by 23%, dependency on natural gas by 20%, and water consumption by 28%, he said. As for waste reduction, he cited a strategy minimizing single-use devices in operating rooms that saves up to $111,175 annually.
Beaumont Hospital in Royal Oak, Mich., “decreased water consumption by more than 12 million gallons from 2010 to 2013....[and] we recycle 3.4 million pounds of waster annually,” Kay Winokur, Beaumont's vice president of quality and professional services, told Healthcare Dive. And that's only the tip of the iceberg: “For waste, we earn about $53,000 a year in recycling rebates and we avoid $80,000 in landfill costs annually,” she said, adding that plumbing improvements such as replacing inefficient sinks and toilets have also saved the facility $43,000 annually in water.
Across its three-hospital system, Beaumont received $500,000 in energy rebates for 2012 and 2013 combined, Winokur said. That has occurred since the system began an energy conservation initiative that reduced consumption by 10% annually.
To accomplish all of this, Beaumont trained 700 “green officers” in a program for front-line staff, including doctors, nurses, housekeepers, dietary staff, engineers and plumbers. They seek opportunities in their departments to conserve energy and water, increase recycling, and so on, said Winokur, who chairs a “green team” committee of 20 key executives to further the effort.
Workers are buying into Beaumont's “green” efforts in other ways. “Our doctors and employees bike more than 22,500 miles a year to work...[and] we have 150 employees that carpool,” she said.