Part Two of Two
By David Guy
Corporate civic responsibility and federal mandates have opened the boardroom doors to increasing numbers of discussions on sustainability. The American Hospital Association’s (AHA) Sustainable Roadmaps team, representing nearly 6,000 hospitals, has created tools and performance improvement metrics to aid facilities in the process of becoming “greener.” The AHA website explores the results of multiple surveys that illustrate the motivations for transitioning to greener practices, with corporate civic-mindedness and cost savings leading the way.
“Sustainability is not just a green initiative,” says Ron Pierce, founder and president of Waste2zero Solutions, a sustainability consulting management firm dedicated to working with healthcare facilities. “Sustainability in a healthcare facility exists on two levels: operational sustainability and environmental sustainability. Operational sustainability focuses on redesigning facility operations to consume the fewest resources and services. Reducing consumption of resources (including energy and consumable materials) and purchased services provided by vendors creates significant cost reduction benefits as healthcare facilities prepare to sustain their operations in an industry with downward pressure on reimbursement and operating margins. Environmental sustainability focuses on reducing the volume of materials discarded as waste, which also has economic benefits associated with reduction in purchased services for waste disposal.”
Janet Howard, EDAC director of facility engagement for Practice Green Health, offers a place for healthcare facilities to start in their journey to go green. “Many hospitals start on waste because it is highly visible — you see it, it’s there — and it’s expensive to manage and costs increase,” Howard says. “Closer scrutiny identifies waste as an opportunity due to the high cost of regulated medical waste and the knowledge that any hospital generating more than 10 percent [waste] is throwing dollars in the trash.”
Barriers to Going Green
Kermit the Frog may not have been thinking of sustainability when stating, “It’s not easy being green,” but it certainly applies there too. There are numerous challenges when it comes to moving from talk about sustainability to action, from the boardroom to the loading dock.
To begin with, people generally resist change. However, in the case of sustainability, change is necessary for survival, as global demand increases for scarce resources and as healthcare facilities experience declining operating margins.
While making the decision to develop waste reduction strategies is a good start, reducing waste volumes and disposal costs requires knowledge and capabilities that often are outside the core competencies found within healthcare facilities. Evaluating waste generation, segregation and reduction requires data analysis across the numerous waste categories, as well as benchmarking historical volumes and costs and a tracking and reporting capability to monitor progress against baselines.
Creating a Team to Reduce Barriers
Developing sustainability programs also requires organizational leadership, compliance and “buy in” within all departments. Sustainability programs often are initiated on a grassroots level within certain departments. However, sustainability programs are most successful when driven by senior institutional leadership to ensure broad organizational acceptance and compliance. There are several departments that can lead the change in waste reduction strategies, and coordination between departments minimizes conflict and facilitates organizational consistency.
Sustainability requires internal champions, who may work in various departments including environmental services, procurement, supply chain, engineering and so on. Sustainability coordinators can facilitate coordination of activities among departments.
Sustainability should be everyone’s responsibility, but it requires engaged advocates and staff resources to get a program running. Many hospitals have created sustainability and global environmental management system coordinators and are leveraging the knowledge and using the programs developed at partners, such as AHA’s Sustainable Roadmaps and Practice Green Health. These programs provide guidance to create a baseline for facilities, and offer tools to quantify where and how to implement the systems or technology needed to reduce waste. While some vendors tout the ability to reduce waste disposal costs by managing the problem from the outside in, it is important to understand that all waste reduction is created by changes in process and staff behavior inside the healthcare facility, necessitating an inside-out management capability that waste vendors simply don’t deliver.
Waste Program Design, Implementation and Management
Healthcare facilities are highly complex, generating many categories of waste across numerous departments. Although developing a strategy to reduce the volume and cost of a single waste stream has merit, developing a comprehensive sustainability program requires a programmatic approach to design, implementation and management.
“Developing a successful hospital waste reduction program is a four-phase process,” explains Pierce. “Sustainability is achieved by the successful transfer of specialized industry knowledge, process, technology and training within each healthcare facility. Phase One is Strategy, aligning waste sustainability objectives with the organization’s mission, values and objectives. Phase Two is Analysis, developing baseline data by quantifying the material volume and cost by waste category and vendors to identify opportunities for process change to reduce, reuse, recycle and recategorize waste. Phase Three is Design, developing and implementing actionable strategies (including installing technology processes or converting certain wastes on-site) and training staff to accomplish re-engineered facility operations to achieve waste reduction. Phase Four is Tracking and Reporting, auditing waste volumes, vendor service utilization and cost to monitor performance relative to the baseline data.”
Holistic Approach to Waste Reduction
Hospitals generate many different categories of waste materials that are serviced by an inefficient and fragmented waste industry. Typically, waste companies specialize in the collection and disposal of certain wastes, such as medical, solid, pharmaceutical, hazardous, HIPAA, etc. Consolidation of waste disposal services is occurring in the industry as vendors attempt to contract for multiple waste categories under a single service contract. The vendor’s objective is to maximize waste volume directed to its service infrastructure and minimize competition. Contracting with one company to dispose of numerous specialty waste categories does not ensure that costs or vendor service utilization will decrease, as virtually all waste companies rely on waste generation to sustain their revenue and profit growth.
The recurring theme in considering sustainability initiatives is the need to save green, in both the budget and the environment.
Sustainability is no longer an option: It is required to optimally utilize resources, but requires advocates and a team approach to be successful. Adopting new technologies, processes and systems may require changing behaviors and mindsets, but we have reached a point where this change is required. The best place to start is to measure your own sustainability and utilize the multitude of free resources available to determine your baseline and options to improve.