Using Purchasing’s Power to “Green” Health Care

1. Using Purchasing’s Power to “Green” Health Care Opportunities for Environmental Services through Environmentally Preferable Purchasing ASHES CONFERENCE RENO, NEVADA September 2002

2. Objectives: • What is H2E? • Environmentally Preferable Purchasing • How can Environmental Services get involved? • Overcoming barriers --Getting started

3. So, who am I and why am I here? September 2002

4. Our concern is PBTs Alkyl-Lead Benzo(a)Pyrene DIOXINS/FURANS Hexachlorobenzene MERCURY AND COMPOUNDS Octachlorostyrene PCBs PESTICIDES Aldrin/Dieldrin, Chlordane Mirex,DDT(+DDD+DDE),Toxaphene September 2002

5. Mercury -- A Risk to Human Health • Mercury is well known for its toxic effects • Methyl Mercury is the most toxic form • Long term exposure can permanently damage brain, kidneys and developing fetus September 2002

6. Certain groups at higher risk • Women who are pregnant • Nursing infants • Young children September 2002

7. Why Healthcare? • Hospitals generate 6,600 tons of solid waste every day • Medical incinerators are the 3rd largest source of dioxin and 4th largest source of mercury emissions • Many PBTs used in and released from hospitals • Environmental awareness in hospitals growing

8. Thermometers Sphygmomanometers Esophageal dilators Cantor tubes Feeding tubes Lab chemicals Medical batteries Pharmaceutical preservatives Cleaning solutions Fluorescent lights Thermostats Pressure gauges Electric switches Medical Uses of Mercury September 2002

9. Hospitals’ waste per day is 15% higher than 1992 Landfills are consumed with waste, especially disposables. Landfills are the second highest source of greenhouse gas emissions in the U.S. Incinerated medical waste containing chlorine is the third largest contributor of dioxins. Waste incinerators contribute 69 percent of the dioxins in the global environment. Toxic Waste September 2002

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11. Pollution, Waste and Environmental Disturbances Goods and Services Natural Resources Life Cycle Impacts September 2002

12. What a WA$TE! • Waste is lost resources and money. • Solid waste comprises the largest portion of a healthcare facility's waste, about 70-80 percent. • About half of a hospital's solid waste stream is paper and cardboard (45 percent). These wastes can be easily reduced and recycled. • Healthcare institutions that have engaged in full-fledged waste reduction efforts have realized disposal cost savings of 40-70 percent. September 2002

13. Hospitals for a Healthy EnvironmentCollaborative Effort to Change the Culture of an Entire Industry…. • Community • ANA • HCWH • H2E • Champions • Partners • EPA • AHA • Healthcare Industry

14. H2E GOALS • Virtually eliminate mercury waste by year 2005 • Reduce total waste volume by 33% by year 2005, by 50% by 2010 • Identify and reduce PBT chemicals and other hazardous substances in hospitals through pollution prevention and waste reduction • Our key to success is your involvement!

15. “NO SPACE - NO TIME - NO MONEY” WHY H2E? WHY NOW? H2E is designed to help stretch limited resources by sharing information and providing you with the tools you will need to become environmental leaders in your communities while saving money… and more! September 2002

16. www.h2e-online.org “H2E – A Formula for Success” “Environmental programs in health care – Preventative medicine for human health and the environment…”

17. Children’s National Medical Center George Washington Medical Center John C. Lincoln Health Network Legacy Meridial park Hospital St. Rose Dominican Thomas Jefferson University Hospital California Hospital Medical Center Veteran’s Affairs Medical Center H2E: 321 partners representing ~1000 facilities and growing! September 2002

18. www.h2e-online.org “H2E – A Formula for Success” “Environmental programs in health care – Preventative medicine for human health and the environment…”

19. Aramark Service Master Facility Services Catholic Health East Catholic Healthcare West Consorta Inc. Sustainable Hospitals Project Kaiser Permanente Antos Environmental DC Department of Health Environmental Medical products, LLC Baxter Healthcare Sodexho Healthcare Services Thirty-one champions representing 3,000 Healthcare facilities and this number is growing! September 2002

20. www.h2e-online.org “H2E – A Formula for Success” “Environmental programs in health care – Preventative medicine for human health and the environment…”

21. Environmentally Preferable Products are: “products and services [that] have a lesser or reduced effect on human health and the environment when compared to other products and services that serve the same purpose.” This comparison may consider raw materials acquisition, production, manufacturing, packaging, distribution, reuse, operation, maintenance, or disposal of the product or service. —Executive Order 13101, Greening the Government Through Waste Prevention, Recycling, and Federal Acquisition, September 16, 1998. September 2002

22. Develop demand for greener products and services Reduce hospitals’ “environmental footprint” Help meet environmental goals through markets rather than mandates Why Green Purchasing? September 2002

23. Why Green Purchasing? • Recycled aluminum cans require 95% less energy to manufacture than virgin aluminum cans • Using 1 ton of 100% recycled-content paper saves 17 trees and 7,000 gallons of water • 100 Energy Star computers and monitors can save $10,000 in energy costs over 5 years September 2002

24. Why Green purchasing?Consider the full cost • Purchase Price • Disposal Cost • Occupational Health Costs • Liability • Environmental Consequences • Total Cost September 2002

25. Why Green Purchasing?Costs Increase Downstream Cost Per Sphyg September 2002

26. Why Green Purchasing?Consider the cost savings • One hospital saved $280 per sink per year by installing $12 flow reduction device in sinks. • One hospital saved $20,000 per year by re-circulating heating/AC water • One hospital saved $42,000 per year by installing Ultra Low Flush Toilets • Energy Efficient equipment can save $100K or more per year, with 2-3 year paybacks September 2002

27. Opportunities for EPP in Environmental Services • Carpets/Greening Meetings and Conferences • http://www.epa.gov/oppt/epp/documents/pfs.htm# • Green Cleaning Products – H2E • http://www.h2e-online.org/tools/chem-clean.htm • Green Buildings – H2E • http://www.h2e-online.org/tools/GreenBuildings.htm • Waste Management • http://www.h2e-online.org/tools/waste.htm • Disposable vs. Reusable

28. Developing a sustainable EPP Program: • Commitment to EPP principles. • Product focus. Developing a set of criteria or definitions for environmentally preferable products. Working with suppliers, GPOs, vendors • Process oriented. Developing specific steps your department will implement to actually make different purchasing options available. • Education!

29. Sample Product Selection Criteria • Mercury free • Non-toxic (or minimize toxicity) • PVC Plastics or DEHP free • Disposal Implications: Recyclable Product and Packaging, hazardous material disposal… • Recycled content (post-consumer) • Minimal packaging • Energy Efficient • Can be reprocessed or reused • Take-back provisions

30. Focusing on specific products and services MORE FACT SHEETS – http://www.epa.gov/cpg/factshts.htm September 2002

31. Why Green Your Cleaning Products Environmental & Health Concerns Benefits of Buying Green Magnitude of Potential Exposure What you Can Do Natural Resource Use Manufacture/Product Content Product Use and Disposal Success Stories Contacts and Resources Greening Your Purchase of Cleaning Products September 2002

32. Sample GPO EPP Program’s Websites • Broadlane http://www.broadlane.com/broadlane/screen/CommunityPrograms.do?article=communityProgramsEnvResp • Premier(click on different sections in upper righthand box) http://www.premierinc.com/frames/index.jsp?pagelocation=/all/ safety/resources • Consorta http://www.consorta.com/Wings/resource_mgmt/epp/default.asp

33. Providing Tools EPP Database Identify and compare environmental attributes for key products and services from various information sources, both domestic and foreign www.epa.gov/oppt/epp/database.htm September 2002

34. Providing Tools “Promising Practices” 20 case studies incorporating environmental factors into product and service contracts Links directly to contract language, worksheets, evaluation criteria, etc. September 2002

35. www.h2e-online.org “H2E – A Formula for Success” “Environmental programs in health care – Preventative medicine for human health and the environment…”

36. Environmental Services – Let’s Talk Trash • Isn’t it to our advantage to make less of it? • Don’t we have healthier staff (patients, visitors, and community) if we are choosing less toxic materials? • We don’t have to clean up toxic spills if we don’t have toxic materials! • Housekeepers make THE difference!!! September 2002

37. H2E is all about P2 and P2 is all about Behavioral Change • We are all stewards for the environment • H2E shows that we can meld environmental and healthcare considerations • Changing behavior is a challenge September 2002

38. But, when we work together ... • Almost anything is possible! • Write down this URL • www.h2e-online.org • H2E September 2002

39. LAURA BRANNEN, HCWH (603) 643-6700 h2e@valley.net SUSAN WILBURN, ANA (202) 651-7130 swilburn@ana.org TOM MURRAY, EPA (202) 564-8829 Murray.Tom-HQ@epa.gov Debbie Sprindzunas AHRMM/AHA (312) 422-3842 dsprindzunas@aha.org H2E Program ContactsToll Free Hotline: 800-727-4179www.h2e-online.org