Environmental Impacts for Healthcare Sustainability

Jeffrey E Thompson, Pediatric Intensivist and Neonatologist, Gundersen Health System

Gundersen Health System is the first US healthcare organisation to achieve energy independence, producing more energy than it consumes. Gundersen’s Envision® programme saves the organisation millions of dollars each year, boosts the local economy and teaches organisations on how to become better environmental and fiscal stewards.

At Gundersen Health System, we define health of the populations we serve to include physical and mental health, social well-being, and the fiscal health of our communities. We are so convinced that this should be a part of responsible healthcare, and thus been embedded in our strategic plan and is a measured, integral part of how we accomplish our goals. That is, we pursue a broader purpose than just taking care of sick people who show up at the door. The purpose of the organisation expects us—indeed demands of us—that we see beyond our walls and look at our effect on the general health and well-being of our communities.

Furthermore, healthcare facilities, as a rule, are some of the most energy-intensive buildings in the commercial sector in the United States. According to the United States Department of Energy, hospitals are 2.5 times more energy-intensive than other commercial buildings.

The fact that we are more energy intensive and that the energy costs will continue to escalate, increases the urgency—if we are to hold down our costs—to address these issues.

Just as a reference, our organisation is a healthcare delivery system made up of five hospitals, 61 clinics, 7000 employees, 500 doctors, and 300 nurse practitioners and PAs. We teach, we conduct research, and we work with many partners to improve the health of the communities. We serve across 19 counties in three states.

Gundersen Health System didn’t set out to be the greenest health system in the country when we embarked on our plans to reduce our energy spending and improve our impact on the communities through, both, better health and improving the local economy.  However, in October last year, when we reached energy independence, we became the first in the country to reach that goal. To achieve success, we started by measuring our impact on regional environment. We found in 2008 that we were putting  48 million kilograms of carbon dioxide into the atmosphere, 1 kilogram of mercury and 197,000 kilograms of particulate matter.

For a healthcare organisation, we felt we could not continue on the same path. We had to be better for our patients and the communities we serve.

So how did we do it? We took a two-sided green approach to our efforts—green as in good for the environment and green as in financially sustainable—not programmes that would detract the financial performance of the organisation. We did not want to take any more money out of the community to pay for this activity. And we had to be conscious about not passing any unnecessary waste off on our patients through higher healthcare costs. Our goal, therefore, was to decrease our costs, decrease our negative impact on the environment and work to find ways to reduce our reliance on energy from outside our region. More specifically, since all of our energy comes from outside our region (coal from Wyoming for electricity and natural gas from Texas for heat), we felt developing local resources would improve that profile. Our approach was multi-pronged and looked to decrease waste in every part of the organisation with the same principles of decreasing pollution, improving the organisation’s finances, and improving the regional economy.

One of our earliest gains was to focus on recycling. We rapidly pushed our recycling rate above 35 per cent and held it there for five years. This gave us a financial start as we received payment for recycling plastics, cardboard and paper, bringing in tens of thousands of dollars. We also focused on food waste. In fact, over a five-year period, we reduced our food waste by 80 per cent. It kept 18 tons of food from going to the landfill each year and resulted in donations of thousands of meals through the Salvation Army. This saved money and served a community good at the same instance.

Other activities that resulted in substantial savings include remanufacturing of single-use devices—supplies from surgery, oxygen sensors from the intensive care units, and toner cartridges from printers across the organisation. All could be remanufactured and purchased back at remarkably low costs. This recycling of equipment saved US$400,000 – US$500,000 every year. The combined savings of recycling and reusing and remanufacturing of waste and equipment consistently, year over year, averaged savings in the US$500,000 per year range and easily paid for a coordinator and many of the projects we started. Other areas of significant waste occurred around bio-hazardous (blood-stained or body-fluid contaminated waste) and pharmaceutical waste. Disposal of contaminated and pharmaceutical waste has been historically expensive. A focused approach to carefully examine what exactly was in this waste and how to mitigate it had substantial savings. This was not easy work. It meant taking red bags of waste, carefully putting them out on large tables, sorting through them, and asking ourselves what is regarded as waste and what can be recycled. Then it meant going back and revising systems and using the LEAN methodology of careful examination, developing a plan, and re-working the flow. Bio-hazardous waste per patient visit has dropped by over 25 per cent and pharmaceutical waste has dropped by over 60 per cent and is saving us hundreds of thousands of dollars.

 

Author Bio

Jeffrey E Thompson

Jeffrey E Thompson is Executive Advisor and Chief Executive Officer, Emeritus at Gundersen Health System. Thompson is a trained pediatric intensivist and neonatologist, and served as Gundersen’s Chief Executive Officer from 2001 to 2015. After completing his professional training in 1984, Thompson came to Gundersen with a desire to care for patients and to teach. He was asked to serve on Gundersen’s boards beginning in 1992 and was chairman of the board from 2001 to 2014.

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