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2018 Top 25 Environmental Excellence Award Honorees

The Top 25 Environmental Excellence Award is Practice Greenhealth’s highest honor for hospitals. Selected from the Greenhealth Partner for Change Award applicants, these 25 hospitals are leading the industry with innovation in sustainability, demonstrating superior programs, and illustrating how sustainability is entrenched in their culture.

Read this year’s press release announcing the winners

The Top 25 winners this year include:

Advocate Good Samaritan Hospital

Downers Grove, Ill.
287 beds, 17 ORs

Advocate Good Samaritan Hospital received Practice Greenhealth’s Top 25 Environmental Excellence Award for a fifth consecutive year. The hospital has a long history of working to reduce waste and increase recycling. In 2017 the hospital worked on employee engagement initiatives including paper and printing reduction, monthly “Energy Hours” to save energy and money, and Greening the OR activities such as waste audits and the implementation of clinical item recycling. Good Samaritan’s environmentally preferred purchasing efforts are tracked quarterly, and include the use of green cleaning chemicals, antibiotic-free meats, furniture without toxic chemicals, and more.

In 2017, Advocate Good Samaritan demonstrated its commitment to green building with the completion of a 200,000-square-foot vertical expansion of the hospital. The project, which added three floors and 96 new private rooms, achieved LEED Silver certification. The project’s sustainable design preserved green space and habitat, and its landscaping was designed with native plants to reduce irrigation needs. The building also features low-flow fixtures, improved energy performance, sustainable building materials, and other green features. This mirrors efforts taken across Advocate to ensure all major projects are built sustainably through the creation of the its Healthy Spaces Roadmap, which incorporates elements from the Green Guide for Healthcare, ASHRAE Advanced Energy Design Guides, LEED, and the Living Building Challenge.

Boston Medical Center

Boston, Mass.
397 beds, 24 ORs

The sky is the limit at Boston Medical Center: The hospital’s new 7,000-square-foot rooftop farm provides healthy produce for the hospital and community. The 5,200 pounds of produce harvested in its first year went directly to the hospital’s food service team for patient and patron meals. The farm also served as fertile ground to enhance the hospital’s nutrition and healthy food access education in their community teaching kitchen. It has reduced BMC’s carbon footprint by increasing green space, adding carbon-breathing plants, reducing the building’s energy use and runoff water. By producing food onsite, BMC is also decreasing the energy required to transport food. BMC also continues to partner with the Gloucester Fishermen Wives Association purchasing exclusively fresh fish caught by Gloucester fishermen and having this delivered daily thus supporting local economy and reducing the carbon footprint of fresh seafood to the BMC community.

In addition to their sustainable food focus, they have taken steps to become carbon neutral. As part of a clinical campus redesign, BMC has cut emissions by 50 percent through a solar power purchase agreement which is equivalent to 100 percent of BMC’s projected electricity consumption. They have also installed a combined heat and power plant system, through which BMC produces its own electricity from natural gas. The plant supplies more than 41 percent of BMC’s electricity and 20-25 percent of heat/cooling load in the winter and 100 percent in summer—a savings of about $1.5 million in electricity and heating costs per year.

Cleveland Clinic

Cleveland, Ohio
1,275 beds, 86 ORs

Cleveland Clinic has earned its reputation as a leader in climate and health. As a member of the Health Care Climate Council, the hospital recently announced plans to become carbon-neutral by 2027, and is committed to energy conservation and advanced green building standards. Cleveland Clinic demonstrates its leadership in part through education in the communities they serve. They have plans to increase green space and educate 5,000 people on the role of trees in climate and health. In 2017, they planted a four-acre park with high schools students and community members, and gave away 300 trees in partnership with the Arbor Day Foundation.

Cleveland Clinic also aims to create healthier buildings, and they adhere to both LEED and the WELL Building Standard for new construction. Sustainable design, access to natural daylight and views, avoiding a comprehensive list of chemicals of concern, energy and water conservation, and construction and demolition debris recycling have become a standard practice at Cleveland Clinic. In 2017, their new cancer center moved from design to fully operational, and a cross-functional team ensured that LEED was central to the project. A co-designed health education campus with Case Western Reserve University will result in teaching the next generation of medical professionals about the responsible use of resources while showcasing energy management.

Dartmouth-Hitchcock Medical Center

Lebanon, N.H.
396 beds, 34 ORs

While looking for new opportunities, Dartmouth-Hitchcock Medical Center continues to focus on foundational programs. A goal was established to increase composting and reduce the amount of food waste headed to landfills in an effort to meet ambitious greenhouse gas reduction goals. As a result, composting increased by 56 percent over the past two years to 170 tons composted annually.

As a member of Greenhealth Exchange, Dartmouth-Hitchcock is committed to environmentally preferred purchasing. In 2017, the waste management and purchasing departments partnered with Dartmouth College’s facilities department to complete an RFP for the responsible and transparent recycling of electronics waste and resale of functional computers. The process included criteria to ensure responsible equipment recycling and resulted in increased rebates for equipment resale. They have also made significant progress with resilient flooring. With rubber as the primary choice, 30 percent of flooring has been replaced--eliminating the waxing and stripping process, and resulting in improved air quality and chemical use reduction.

Hackensack Meridian Health Hackensack University Medical Center

Hackensack, N.J.
781 beds, 34 ORs

Hackensack Meridian Health uses its purchasing power to drive healthier foods, products, and materials. A strong environmentally preferred purchasing policy is the cornerstone of its effective program to reduce chemicals of concern--with the added benefit of increased communication within operations, maintenance, and patient care teams. Positive outcomes include 100 percent use of third-party certified safer alternatives for all five of Practice Greenhealth’s targeted cleaning chemical categories and 99 percent of all cleaning product lines. The network eliminated the controversial antimicrobials triclosan and triclocarban from hand hygiene products, and DEHP and PVC from six product lines. Eighty-seven percent of Hackensack’s procured furnishings met Practice Greenhealth’s healthy interiors criteria.

Hackensack Meridian Health is also a leader in antibiotic stewardship, with more than 75 percent of its purchased meat and poultry raised without the routine use of non-therapeutic antibiotics. The hospital also has zeroed in on serving less meat per meal and revamping plant-based options, focusing on taste and appeal of the menu items while driving patient satisfaction. Collaboration with The Deirdre Imus Environmental Health Center has been key to the hospital’s sustainability success.  In 2017, a partnership with students from multiple New Jersey colleges/universities helped reignite team member engagement across the campus.

Harborview Medical Center

Seattle, Wash.
413 beds, 26 ORs

Harborview Medical Center’s focus on food is paying off. As a part of UW Medicine, successful strategies include promotion and placement of healthier choices, pricing incentives, a seasonal menu, and education through regional conferences. As a result, 11 percent of the food and beverages are now sourced locally and 15 percent sustainably. Through a partnership with the University of Washington and the UW Medicine Department of Infectious Diseases, Harborview has also adopted the less meat, better meat philosophy. Patients have daily vegan and vegetarian menu options,  and 45 percent of their meat and poultry is free of routine, non-therapeutic antibiotics.

Harborview has focused as well on food insecurity screenings, food donation, and farm support. A facility-based farm stand is open two days a week, featuring locally grown, organic produce. The stand accepts SNAP/EBT payments from patients and community members and accepts fruit and vegetable prescription vouchers. Harborview dietitians also organize and host a biannual Nutrition Support Conference to highlight the innovative work done by staff to improve patient safety, reduce malnutrition, reduce food waste, and improve overall patient health.

Hudson Hospital & Clinic

Hudson, Wis.
25 beds, 3 ORs

Hudson Hospital & Clinic proves small hospitals can make a big difference. This repeat winner leverages positive change through the supply chain services and purchasing departments to create an annual work plan for sustainability goals. In 2017, all purchasing guidelines were updated to reflect the commitment to eliminating plastic-bottled beverages and Styrofoam. It also replaced all plain copy paper with a 30 percent recycled content paper, issued a comprehensive hazardous waste request for proposal that prioritized sustainability and waste minimization, and purchased three electric vehicles for their fleet. The vehicles have the potential to eliminate the equivalent of 44 metric tons of carbon dioxide annually.

Hudson also tackled a tricky waste metric issue in 2017. There are several tenants on the campus that contribute to the solid waste stream. As a result the campus waste data has appeared skewed toward the high end, especially when normalized. So, in 2017 Hudson took the initiative to weigh its waste one week of every quarter and to use that information to better reflect what waste is being generated from operations. The result: a waste metric that far exceeds the benchmark for award winning hospitals.

Kaiser Permanente San Jose Medical Center

San Jose, Calif.
216 beds, 14 ORs

Kaiser Permanente San Jose Medical Center enters the Top 25 for the first time this year, demonstrating the hospital is tailoring the system’s corporate sustainability goals to leverage site-specific strengths. To support their strong sustainability focus, the facility developed an environmental mission statement and charter for the green team, integrated sustainability into new employee orientation, utilized clinical champions to drive the work, and regularly reports progress on sustainability to the facility leadership team and National Environmental Program for Kaiser Permanente. Employee engagement was a key aspect to this hospital’s success. Green team members conducted rounds to educate frontline workers and identify departmental opportunities. Green team co-chairs presented at manager and physician meetings, who then shared the information with their department. The green team-sponsored Turn It Off Campaign encouraged staff to turn off lights and devices not being used.

Through Earth Day, Bike to Work Day, e-waste collection, and employee wellness events, the hospital informs and inspires staff and community to be green. A Patient Advisory Council, with an eye on environmental stewardship, captures community perspectives and concerns. A plant-based diet challenge featuring daily specials and samples, along with a physician educational lunch event, highlight how the hospital continues to embed this work into the fabric of the organization.

Lakeview Hospital

Stillwater, Minn.
68 beds, 8 ORs

Lakeview Hospital’s commitment to sustainability has landed the hospital a spot in the Top 25 Environmental Excellence Awards for the first time. Among its sustainability efforts are water-use reduction, Operating Room recycling, and solar energy use. While the initial water use reduction goal was 2 percent, thanks to a water use assessment and conservation efforts, the hospital has reduced water usage by 33 percent since 2015. Greening the Operating Room strategies have also flourished at Lakeview Hospital. An Operating Room employee champion helped secure colleague participation in recycling clinical plastics, reprocessing single-use devices, and shifting to 100 percent LED surgical lighting. Equipment and supplies were collected and donated through a facility mission project in Guatemala. An anesthetic gas evaluation team was developed to assess anesthesia use and identify opportunities for greenhouse gas reduction.

In 2017, Lakeview took part in a community solar program and purchased 969,000 kilowatt hours per year of solar power. This meant 31 percent of its energy came from renewable resources and 57 percent was carbon-free. The OR nursing champion created a competition among clinical departments to encourage environmental performance. Additionally, Lakeview Hospital is one of two pilot locations for the new Health Care Without Harm Nurse’s Climate Challenge. The organization is also making progress on transportation goals, including transitioning a portion of its fleet vehicles to alternative fuels and measuring greenhouse gas reduction as a result of increased telemedicine.

Memorial Sloan Kettering Cancer Center

New York, N.Y.
473 beds, 28 ORs

Memorial Sloan Kettering Cancer Center (MSK) is committed to avoiding the purchase of chemicals of concern. The Sustainability and Corporate Procurement staff have integrated environmentally preferred purchasing strategies into MSK’s purchasing processes through comprehensive guidelines that provide environmental criteria to inform purchasing decisions, while avoiding chemicals and substances of concern. Given their leadership on providing healthy interiors, MSK was invited to share their experiences with other Practice Greenhealth hospitals and product suppliers to make progress in addressing chemicals in flooring, fabric and furniture, as well as the reduction of DEHP and PVC in medical supplies.  

The Supply Chain staff is also working towards a data management strategy which will highlight repeat purchases to be reviewed and analyzed for attributes associated with the products. The Department of Design + Construction continues successful institution-wide efforts to eliminate PVC from interiors, including fabrics, wall coverings, and flooring for all new buildings and renovations. MSK uses hand soaps that are free of antimicrobials, safer cleaning products are selected, and ultraviolet radiation is used to support the disinfection of select patient rooms. Their emphasis on avoiding chemicals of concern, as well as their success with other sustainability initiatives has landed MSK in the Top 25 for four consecutive years.

Overlook Medical Center

Summit, N.J.
504 beds, 18 ORs

A new addition to the Top 25 this year, Atlantic Health System’s Overlook Medical Center began their sustainability journey by ensuring leadership was fully engaged in a strategy that includes measurable, improved performance. Their operating room initiatives include clinical plastic recycling, fluid management, medical device reprocessing, 100 percent OR kit reformulation, and energy-saving measures--demonstrating the value of Greening the Operating room as a strategic priority for maximizing cost savings and environmental improvement.

Overlook embraced the less meat, better meat goal with a 62 percent reduction in meat procurement with 0.11 pounds per meal served and 39 percent purchased without the use of non-therapeutic antibiotics or growth hormones. Twenty percent of food is purchased locally and the hospital even sells their own eggs and honey. Their community outreach is extensive with a community-supported agriculture program for employees, a teaching kitchen, a working garden that donates for food distribution, and a children-focused “Bee Healthy” program. Waste reduction efforts include reusable serviceware for cafe and takeout containers and state-of-the-art food waste management with off-site composting. The hospital has a detailed transportation plan and factors in the risk of climate-related events into their emergency planning matrix. In its diligence to demonstrate that every aspect counts, Overlook also invested in teleconferencing technology to decrease travel impacts for meetings.

Park Nicollet Methodist Hospital

St. Louis Park, Minn.
402 beds, 21 ORs

Park Nicollet Methodist Hospital is seeing success in its efforts to address food waste. With Practice Greenhealth’s Less Food to Landfill goal, they have put an emphasis on nourishing soil, avoiding landfill, reducing methane gas, and providing food to those in the community who are in need. 2017 marked the second year their food and nutrition department focused on food waste prevention. Through close monitoring, they identified several opportunities to reduce the amount of food that was wasted by 40 percent, mostly due to maintaining excessive inventory and overproduction. Last spring, they kicked off their organics recycling program with training for dish room and food prep staff, which resulted in 15 tons of food waste diverted from landfill to compost and soil nourishment in 2017. They also use reusable dishware for patients and staff and have both recyclable and compostable ware for take-out containers. Recycling was enhanced in food services, with increased collection of No. 10 steel cans, milk cartons, and other items that previously were sent to the landfill. Visual displays, posters, updated in-services, and ongoing audits maintain progress on this shared strategy.

Regions Hospital

St. Paul, Minn.
454 beds, 30 ORs

Regions Hospital continuously strives to use resources wisely and improve efficiencies in all that it does. In its efforts to avoid chemicals of concern, the hospital purchases hand soaps without triclosan and triclocarban, eliminated aerosol cans, and uses ultraviolet irradiation technology for surface disinfection and integrated pest management. Solvent distillation in the laboratory both reduced chemical use and the need to purchase virgin solvent for specimen processing.

In addition Supply Chain Services and purchasing departments completed an evaluation of the more than 170 vehicles owned by the HealthPartners organization. The team identified opportunities to purchase electric vehicles to deliver supplies that replaced traditional commercial cargo vans. The electric vehicles have the potential of driving 100,000 miles per year, with a calculated elimination of 44 metric tons of carbon dioxide (equivalents) annually. Regions Hospital submitted a BizRecycling grant application to Ramsey County and was awarded $9,000 to enhance recycling and waste operations. In 2017, Regions Hospital achieved a 20 percent reduction in its paper usage compared to the 2014 baseline, a savings of 6,746 reams or 3.3 million pieces of paper.

Seattle Children’s Hospital

Seattle, Wash.
348 beds, 14 ORs

Seattle Children’s Hospital drives progress by setting measurable goals and stretch goals for all of their target areas. The hospital achieved a 14 percent reduction in irrigation water--reducing irrigation water by nearly a million gallons in 2017--more than triple their initial stretch goal. The grounds crew achieved this significant reduction despite a hot summer by using high-efficiency irrigation equipment and implementing multiple process measures, including monthly calculations from irrigation meters to make sure consumption was on track, daily rounds on irrigation to check for overspray, and a team member devoted to fine-tuning the irrigation schedule for given conditions.

The facility also leads on climate issues, both nationally and regionally. Recognizing that anesthetic gases comprise 3 to 5 percent of the organization’s greenhouse gas emissions, the anesthesia department decreased its Desflurane usage by 31 percent in 2017. Seattle Children’s Hospital has been a leader on healthier transportation for many years, mentoring other facilities across the sector. Over the last two years they have decreased the staff drive-alone rate by 5 percent, supported by a bi-annual employee transportation survey. In 2017, they increased the daily pay incentive to $4.50 for employees that carpool, vanpool, bike, take transit, or walk to work. An active intranet commute calendar promotes gamification of transportation alternatives. Their bike program added a discount on electric bikes as a green employee benefit, and they continue to run the only on-site hospital bike shop in the United States.

The University of Vermont Medical Center

Burlington, Vt.
465 beds, 19 ORs

The University of Vermont Medical Center weaves sustainability through all aspects of hospital operations. With guidance from its Sustainability Council and support from its green-minded employees, they have developed a nationally recognized sustainability program and ambitious environmental goals. Committed to greening its facilities, the UVM Medical Center has completed a variety of energy and water efficiency projects. The organization has also adopted green design principles and achieved LEED Gold Certification for several building projects. Currently, the organization is constructing a 187,000 square foot inpatient building, with an aim of achieving LEED silver certification.

The UVM Medical Center continues to boast a robust waste reduction program. In 2017, the organization recycled eight tons of blue wrap and diverted over seven tons of single-use devices from the landfill. They also collaborated with their local waste hauler to identify additional waste reduction opportunities. The UVM Medical Center believes community partnerships are key to sustainability success. Last year, they collaborated with the Vermont Association of Hospitals and Health Systems to develop a video about sustainable food systems. The UVM Medical Center also joined the Vermont Climate Pledge Coalition, a statewide collaboration to uphold greenhouse gas emission reduction targets established by the Paris Climate Agreement.

U.S. Army, Carl R. Darnall Army Medical Center

Fort Hood, Texas
149 beds and 10 ORs

The Carl R. Darnall Army Medical Center is the second Army facility to achieve a Top 25 Environmental Excellence Award in the past five years--a beautiful complement to its LEED Gold certification for its nearly million square foot replacement hospital. Water conservation is a major focus for the Texas facility, which attained an 18.1 percent reduction in water use from its 2016 baseline. At 26 gallons per square foot, they are performing better than nearly 90 percent of Practice Greenhealth award-winning facilities. A hardscape and drainage system reduces runoff from rain and irrigation systems. Landscaping includes native trees, shrubs, and grass. The facility also has an innovative water reuse program featuring a 20,000-gallon tank for the reuse of processed chiller water and a 5,000-gallon steam collection tank--both used for landscape irrigation.

Energy efficiency was a priority for the replacement hospital, which achieved more than a 30% reduction in energy use beyond ASHRAE 90.1. Fort Hood--where the medical center is located-- is also home to the Army's first and largest hybrid renewable solar and wind energy project, with more than 40 percent of its annual power coming from renewable energy. The organization is on track to achieve a 34% reduction in greenhouse gas emissions from its 2008 baseline by 2020, and a more than 40% reduction by 2025.

University of Washington Medical Center

Seattle, Wash.
529 beds, 30 ORs

With its connection to the university, University of Washington Medical Center has a deep leadership commitment to its environmental stewardship program. The Environmental Stewardship Policy Statement has been incorporated into planning and decision-making, the impact of which can be seen in the climate action plan, specific goals, and their sustainability reporting structure. In addition, executive and clinical champions alike help ensure buy-in across the hospital.

The table is set for a healthy food offerings at the facility. Thirty-three percent of food is locally sourced, nearly 2.5 times higher than the 2016-2017 Practice Greenhealth median. Sustainable food procurement comes in at 18.9 percent, also more than twice the Practice Greenhealth median. Reduced pricing of the daily wellness meal helped introduce healthier foods to the community. Other strategies included meatless Mondays, smaller meat portion size, and education. They partnered with the Whole U, a University of Washington-based space for health, wellness, and community, for a healthy food lecture and cooking demonstration series that focused on encouraging plant-based foods and dietary changes that promote environmental sustainability in addition to positive health outcomes.

VHA 04 Erie VA Medical Center #562

Erie, Penn.
52 beds, 4 ORs

Erie VA Medical Center has a plan to further reduce its water use by 26 percent by 2020. The facility is already achieving an industry-leading 21.8 gallons per square foot--sitting in the 90th percentile amongst award-winning organizations. In support of the U.S.-Canada binational Great Lakes Water Quality Agreement to reduce pollutants and prevent harmful algal blooms in Lake Erie, the medical center designed and built two major storm water exfiltration facilities to prevent sediments and pollution coming from nearby structures and parking areas. A rain garden was established to remove sediment and pollutants from entering streams and the lake. The garden also provides a meditative place of respite for patients and visitors.

Nutrition and Food Services have teamed up the Second Harvest Food Bank of NWPA to co-host the Military Share Produce Express.  This mobile food pantry is scheduled regularly at our Erie campus as well as our Warren CBOC with plans to increase services this year. With the help of the Food Bank, the local VFW group, The Vet Center, and volunteers from local schools, they have provided fresh produce, along with other foods to more than 595 Veterans and their families to date. The dietitians use the mobile cooking cart to demonstrate healthy recipes using some of the foods the Veterans receive at each food distribution while the Veterans Miracle Center distributes warm clothing and toiletries to families in need.

VHA 04 James E. Van Zandt VA Medical Center #503

Altoona, Penn.
51 beds, 3 ORs

Renewable energy is on the rise at James E. Van Zandt VA Medical Center with 10.4 percent of their energy from renewable sources. The facility demonstrates its leadership through education, formal climate goals, a mitigation strategy, and a 2017 resilience assessment. More than 20 projects involving energy savings are included in their strategic capital investment planning. The medical center has transitioned to LED lighting throughout the facility and on its grounds. Community engagement is an important aspect of their sustainability efforts as well. An environmental fair is held at the facility periodically, ecological education programs are conducted on Take Your Child to Work Day and on Earth Day, and the green environmental management system program manager is a certified endangered species biologist, and speaks regularly at events in the community.

James E. Van Zandt VA Medical Center is the first VA hospital to inventory and transition to alternative fuel vehicles and in working with its supply chain partners, encourage EPA SmartWay partnerships for distributors. The hospital has also been recognized within the Veterans Health Administration for its extraordinary leadership and mentorship in engaging other VA hospitals to participate and excel at the Environmental Excellence Awards and has regularly won EPA Federal Green Challenge awards both regionally and nationally.

VHA 12 Clement J. Zablocki VA Medical Center #695

Milwaukee, Wis.
272 beds, 8 ORs

While the Veterans Health Administration follows executive orders to drive environmental health and safety as a coordinated system, Clement J. Zablocki VA Medical Center stands out for its individualized goal-setting. This first-time Top 25 recipient successfully implemented a controlled substance segregation process to reduce pharmaceuticals in waterways.

They also developed programs to reduce food waste. Pre-consumer food waste was reduced by 3 percent by closely observing bread and dairy inventory and modifying purchasing practices. A room service offering is under development to further impact both patient experience and food waste reduction, and the facility is developing a process to donate surplus food to on-site Veteran mental health programs. A focus on increasing local food procurement resulted in the center increasing local purchases to 9 percent, in line with the median range for Practice Greenhealth award winners. Access to tap water and reduction in sugar-sweetened beverage purchases demonstrates the facility’s commitment to health for patients. Other accomplishments include a hospital-wide recycling campaign, reducing hazardous chemical use, reducing energy and water use through recent facility upgrades, implementing reusable sharps containers, and hosting an annual electronic recycling event for the community.

VHA 21 VA Palo Alto Health Care System #640

Palo Alto, Calif.
274 beds, 8 ORs

Due largely in part to its “Greening the OR” program, the VA Palo Alto Health Care System has landed in the top 25 for the first time. Utilizing teamwork and the leadership of a clinical champion, the health care system’s surgical service staff members evaluate disposable items on a quarterly basis and identifies opportunities to reduce waste generation. All operating rooms have HVAC setback to reduce energy when not in use, and LED surgical lighting has resulted in $3,200 savings per operating room per year.

The VA Palo Alto Health Care System fastidiously tracks their materials and waste via the Greenhealth tracker, and they focus on best practices around pharmaceutical waste management through continuous training and tracking. As part of a joint effort between the pharmacy, nursing, and safety departments, VA Palo Alto’s pharmaceutical waste “train the trainer” program trained 160 nurses on proper waste segregation. This resulted in a 50 percent reduction in hazardous pharmaceutical waste. Other waste successes include reusable totes and composting. Kicking off in 2017, their composting efforts resulted in 226 tons of food waste diverted from landfills.

VHA 21 VA Southern Nevada Healthcare System #593

North Las Vegas, Nev.
210 beds, 8 ORs

Engaged leadership sets the tone at the VA Southern Nevada Healthcare System, where environmental stewardship activities are included in all job descriptions. Veterans are given a water bottle to be filled up and taken home for continued hydration and waste prevention. Their Greening the Operating Room strategies include strong recycling and red bag reduction, success with fluid management systems, full use of reusable sterilization containers, all OR kits reviewed for waste prevention, and all ORs set up for HVAC setback as an energy conservation strategy.

On the fluid management front, units were expanded throughout all OR suites, critical care, outpatient surgery, ER, and recovery areas both as cost saving strategies and for improved safety. This strategy reduced red bag waste by 70 percent in these areas. Recycling bins were added in each OR suite, training conducted, and all products were assessed for recycling eligibility. The effort further reduced both regulated medical waste and solid waste from the entire surgical service line. Paper use was reduced by 9.5 percent since last year through double-sided printing and copying and reduction in printed reports. Regulated medical waste is at 3 percent of total waste and recycling is at 50 percent.

VHA 23 Iowa City VA Medical Center #636A8

Iowa City, Iowa
73 beds, 7 ORs

The Iowa City VA Medical Center is making strides in greenhouse gas reduction. The purchase of 7.7 million kilowatt hours from off-site wind and another 1.7 million kilowatt hours through renewable energy credits bring the hospital to an impressive 29 percent renewable energy. The institution submeters energy-intensive equipment to look for opportunities for operational improvements, and in 2017 completed an air handling equipment upgrade and lighting retrofit as additional steps in their energy excellence journey. The lighting retrofit alone has been estimated to save $150,000 per year.

With a clinical champion in place, the hospital’s Greening the Operating Room efforts have realized numerous successes including installation of fluid management systems, with savings of more than $25,000 annually in regulated medical waste expenses. Success include 100 percent custom surgical pack review, HVAC setback, LED surgical lighting, and medical packaging and plastics recycling in the ORs. Continuous analysis of waste prevention opportunities resulted in reusable back table covers, surgical drapes, surgical gowns, towels, basins, trocars, endotracheal tubes, as well as reusable sterilization containers for medical instrumentation. The hospital estimates more than two tons of waste have been diverted, in addition to significant financial savings per year.

VHA 23 Minneapolis VA Health Care System #618

Minneapolis, Minn.
350 beds, 23 ORs

The Minnesota VA Health Care System leads by example in their region. Modeling healthy behavior, the hospital has installed 6 filtered tap water stations--serving over 265,000 liters of filtered water as a mechanism to drive down the purchase of single-use plastic water bottles. Additionally, the hospital achieved a 33 percent reduction in meat purchased and is supporting a movement toward procuring meat raised without the routine use of non-therapeutic antibiotics. The system has also emphasized a local and sustainable food system by establishing relationships with a local chicken processor and creamery. The system has also achieved success in its energy reduction and water conservation efforts. Sixteen percent of their offsite energy purchase comes from renewable sources, and they have an Energy Star score of 83, placing them in the top 17 percent in the country. At 47 gallons per square foot, water use intensity is lower than the Practice Greenhealth member median.

Clinician engagement is strong within the Minnesota VA Health Care System as well. A University of Minnesota medical student completed an extended internship with one of the chief surgeons with a focus on improving sustainability in the system’s operating room suites and associated facilities. As a result, Greening the OR work was expanded within the system, and those efforts were showcased in a session to the broader Practice Greenhealth community during CleanMed 2017.

VHA 23 St. Cloud VA Healthcare System #656

St. Cloud, Minn.
388 beds, 3 ORs

For the third year in a row, the St. Cloud VA Health Care System (SC VAHCS) has earned Top 25 distinction. The SC VAHCS prioritizes Lean management and green practices in day-to-day operations with a passionate commitment to stewardship and sustainability. The SC VAHCS is committed to fully integrating Lean management and green thinking into its culture at all organizational levels. Recycling, waste reduction, organics composting, paper conservation, green purchasing, laundry water reuse, LED lighting, renewable energy systems, electric utility vehicles, use of green space for healthy activities, and LEED and Green Globe Certified buildings all demonstrate SC VAHCS’s commitment to environmental excellence and its dedication to continuous improvement, systematically achieving small, incremental changes in processes in order to improve efficiency and quality.

Consistent with its commitment to be the best health care system anywhere, the SC VAHCS promotes a culture of respect for people and encourages health and wellness and green management with activities and programs that engage Veterans, staff, and the community in its sustainability journey.

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