Sustainability, Environment

Do no harm. The underlying tenet in health care applies to all hospital operations, not just those that take place within hospital walls. Saving lives and promoting community health are commendable undertakings, but to fully realize those goals, hospitals must be good environmental stewards.

Hospitals face an unusual predicament: providing care generates considerable waste material — more than 6,500 tons per day nationwide — that jams landfills and creates environmental and health hazards. Environmental sustainability programs help hospitals significantly reduce their impact. They also can lower costs, improve organizational performance and enhance the patient and employee experience.

There are multiple opportunities to improve organizational sustainability, and a good place to start is by examining what comes out of the facility. Waste reduction involves diverting waste from landfills through recycling, source reduction, reuse, repurposing and composting. Eighty percent of hospital waste is solid waste, about 50 percent of which is recyclable. Focusing on waste disposal will provide some easy gains that can build support for more challenging sustainability efforts.

"Hospitals need to look at the amount of waste generated in the process of care and the associated costs," says Janet Brown, director of sustainable operations for Practice Greenhealth. Many hospitals do not know how much they spend because they have a variety of waste streams, such as solid, regulated medical, hazardous, pharmaceutical, universal and recycled waste, managed by different departments and vendors. Getting a handle on the totality of waste coming out of a facility will help establish a baseline, set goals and prioritize actions.

C-suite and board support is essential. "The more that leadership is involved, the better," says Sister Mary Ellen Leciejewski, ecology program coordinator for Catholic Healthcare West, San Francisco. Executives set the tone and garner support, while trustees help establish policy and set goals.

The next step is to establish teams to oversee implementation and evaluation of the organization's performance. Sustainability teams should include individuals and departments from throughout the organization. "Sustainability isn't just about saving money and the environment," Leciejewski says. "It's about relationship-building with employees and the community."

Leadership Responsibilities

Sustainability touches every aspect of the organization, from food and environmental services to materials management and front-line caregivers. It's important for senior leadership to set the tone and provide the oversight and resources necessary to become a truly sustainable organization.

Trustees: Trustees can play a central role in establishing policy, setting goals and priorities, identifying resources and overseeing progress.

Chief Executive Officer: The CEO sets the vision, leadership and accountability to make sustainability a success. The CEO participates in an assessment process to evaluate the organization's current practices and readiness to advance on a sustainability journey.

Chief Operating Officer: The COO plays a pivotal role in sustainability implementation, as well as monitoring its operational and performance benefits. Once the executive team has completed an initial evaluation of the organization's readiness, the COO should consider leveraging internal and external resources to conduct a complete sustainability assessment.

Chief Financial Officer: The CFO helps build the business case for sustainability, identifies financial resources, and monitors costs, savings and return on investment.

Chief Sustainability Officer: The CSO oversees the sustainability initiative, including its implementation by managers across the organization. The CSO provides technical expertise and oversees the formation and workings of sustainability teams.

Creating a Sustainability Plan

There are many opportunities for health care organizations to become sustainable. The best place to start is with a cohesive plan that will integrate sustainability into the organization's strategic framework.

Make a commitment: Senior leadership and the board must commit to sustainability and establish a comprehensive environmental policy. Senior leadership should establish the link between the organization's mission and sustainability.

Establish a baseline: Organizations must establish a baseline before embarking on a sustainability program. The best place to start is with a facilitywide audit of waste, energy consumption and water usage. Benchmarking data is available from Practice Greenhealth and the U.S. Environmental Protection Agency's Energy Star
Program, among others.

Create a Green Team: Establish a Green Team to oversee the sustainability initiative. The team should reflect a broad representation of the organization, including senior management, purchasing, food services, environmental services and nursing.

Identify Drivers and Barriers: Be clear about what's behind your organization's sustainability initiative. Whether it's cost savings or better environmental performance or improved community health, identifying the drivers — and barriers — will help set goals and increase the likelihood of the initiative's success.

Set Goals: It's important to set both short- and long-term goals. Set some initial, achievable goals to build momentum and support for the organization's sustainability initiative.

Assess Performance: Organizations should continually evaluate the organization's performance toward meeting sustainability goals.

Celebrate Achievements: The achievement of goals and milestones should be celebrated. It's important to share the organization's efforts
with the community as well.

Source: H&HN research, 2011

Sidebar - Sustainability Roadmap for Hospitals