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Building on Paris: 4 ways hospitals can go green

By Ned Pagliarulo | January 4, 2016 

http://www.healthcaredive.com/news/building-on-paris-4-ways-hospitals-can-go-green/411431/

Meeting in Paris at the United Nation’s Conference on Climate Change, 195 countries last month reached a landmark climate agreement, pledging to keep global temperature increases this century well below 2 degrees Celsius. On the sidelines of those negotiations, the international coalition Health Care Without Harm announced 67 organizations, representing 8,200 hospitals and health centers from 16 countries, had pledged to reduce carbon emissions against individual targets by 2020. 

Hospitals are large consumers of water and energy as well as major sources of waste. Overall, healthcare accounts for 8% of the United States’ carbon emissions, according to a 2009 estimate. Adopting sustainable, energy-saving practices could save the industry up to $15 billion over 10 years, making green initiatives an important source of cost savings for hospitals.

As the world takes encouragement from the Paris agreement, hospitals and healthcare networks can further boost their sustainability to reduce waste, and increase savings. Here are four approaches (among many), hospitals can take to go green: 

1.) Ensuring appropriate targets are set in order to make tracking meaningful. 

While 69% of hospitals surveyed tracked energy use, only 37% included performance metrics as part of that tracking, according to the 2015 Health Facilities Management Sustainable Operations Survey. Less than half set and monitored energy use targets. 

Furthermore, the survey identified a need for increased senior management engagement in hospitals’ sustainability initiatives. Nearly 60% of responses indicated no C-suite representative on sustainability teams, and only 29% had designated a sustainability manager to oversee their programs. 

Without performance targets and metrics, hospitals may have a harder time realizing energy savings and increasing efficiency. This task becomes even harder without senior management involvement and centralized decision-making. By improving goal setting and strategy, hospitals may by able to gain more benefit from their green investments without much additional cost. 

2.) Improved energy efficiency

The Commonwealth Fund, a private foundation, estimates energy costs at 1% to 3% of a typical hospital’s operating budget. 

Upgrading older buildings’ lighting and HVAC systems can realize substantial in annual savings costs. Cogenerating heat and electricity from the same source can reduce energy costs by 25-40%, according to the Advisory Board Company. These green capital investments typically have clear return on investments and, as a bonus, require little change in staff behavior - making them easy to implement. In the same analysis, the Advisory Board pegs potential savings at $600,000 - $1.8 million from energy upgrades. 

However, with many competing budget priorities, it can be difficult to pay for large capital upgrades. As a first step, hospitals are instead turning to retrocommissioning, a process where a building’s existing energy systems are analyzed and optimized for most efficient use. A respondent to the Health Facilities Management survey reported $600,000 in steam and $250,000 in electricity savings from several retrocommissioned buildings. Only 42% of respondents reported implementation or planning for retrocomissioning - indicating untapped savings potential.

3.) Reducing waste generation, especially biohazard waste

In addition to consuming large amounts of energy, hospitals generate significant amounts of waste, including costly-to-process biohazard waste. Each day, hospitals in the U.S. produce 6,600 tons of waste. 

Medical waste, disposed of through special red bags, costs 13 times as much to dispose of compared to regular waste. Identifying misuse of red bags and ensuring proper sorting by staff can reduce overall volume, significantly reducing disposal costs. For example, Inova Fairfax Hospital in Virginiasaved $200,000 annually by reducing red bag waste. 

In a separate study, the Commonwealth Fund collected data on four hospitals which had implemented new waste management interventions. The Fund found the five-year average net cost savings to be roughly 40 cents per adjusted patient day. If hospitals throughout the country adopted the same practices, the five-year net savings would climb to $700 million. 

4.) Looking small as well as big

“Going green” conveys images of LED lighting, solar panels, and other similarly high-cost capital investments. However, tactical level initiatives aimed at reducing equipment use can yield efficiency gains as well. 

"Operating room packs" are kits loaded with equipment and supplies to be used in surgeries. Any unused equipment must be disposed following surgery, as it will no longer be sterile. Reformulating the packs to better reflect what will actually be used in a given surgery reduces unnecessary waste, often of expensive medical supplies. This could save the healthcare system hundreds of millions over five years, if extrapolated across all hospitals and procedures. 

While any individual hospital may not see dramatic savings from reformulating OR packs, combining many small initiatives such as this may be easier to implement out of the gate than larger projects. 

Leading the way

Last year, Gundersen Health System in Wisconsin became the first health system in the nation to produce more energy than it consumed. Despite expanding its footprint, Gundersen saved $2 million a year from improving overall energy efficiency by 40%. 

As more hospitals and health systems follow the lead of earlier adopters like Gundersen, the industry as a whole could see significant cost savings while improving environmental health.


Top Image Credit: Flickr; U.S. Department of Agriculture

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