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University of Maryland Medical Center Going Green – What UMMC is Doing!

Victoria E. Stewart, MBA 04.02.2009

Objectives

• Describe the team approach used at UMMC to “Go Green”

• Describe how UMMC is incorporating sustainability principles into their current operations

• Describe how UMMC is evaluating sustainability alternatives

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The Beginning

•  The Green Team was formed in April 2007: •  The Green Team Oversight Group •  Patient Care Green Team •  Administrative Green Team •  Periop Green Team (subset of Patient Care Green Team)

•  We embarked on a cultural change to conserve, reduce, reuse, and recycle – 10 million lbs of waste (2006 data) @ $1.354 million dollars in waste disposal costs and $12 million in utility costs

•  Financial Goals Set: •  Operating Savings – 833K •  Capital Savings – 905K

Team Formation Self Selection Process

•  Driven by annual budgetary shortfall - $40 million every year for the last 10 + years.

•  VP’s, Directors & Pt Care Managers self selected on cost reduction teams that would meet for 16 hours a week for 4 weeks straight to identify opportunities

•  Sr. Leadership initially reluctant to start Green Team due to cost concerns…started at last minute as after thought. I had 2 minutes to form the team and get them organized.

•  People wanted to work on a new team, something that provided hope, that they could really put their heart into not the same supply chain, ADT, charge capture, etc…teams that form every year!

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•  Facilities Planning and Operations

•  Pastoral Care •  Perioperative

Services •  Nursing •  Central Sterile

Processing •  Emergency Planning •  Human Resources •  Women’s & Children’s

Services

•  Marketing and Planning

•  Strategic Planning •  Financial Planning •  Purchasing /

Contracts •  Materials

Management •  Environmental

Services •  Food Services •  Employee Health •  Food & Nutrition

Diverse Team Membership

Oversight Group Subgroups

•  New Construction

•  Renovation •  Communication •  Conservation

Management •  Procurement

•  Waste Disposal •  Cleaning •  Food •  Green Spaces •  Recycling

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UMMC Waste Tracking

THE GREEN TEAM FISCAL YEAR 2008

THE PLAN

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Financial Savings Targets Line # Description Operating

Savings Capital

Reduction Total R/N

1 Renegotiate waste contract and segregate waste

$200,000 $200,000 R

2 Resterilize open/unused supplies 125,000 125,000 R

3 Turn off PC’s/Monitors at nights and on weekends

125,000 125,000 R

4 Recycle Furniture at Reform 114,600 573,000 573,000 N

5 Reduce Energy Consumption by 1% 100,000 100,000 R

6 Reduce Blue Wrap usage in CSP 60,000 60,000 R

7 Reduce paper usage 20% 50,000 50,000 R

8 Purchase recycled furniture from BG&E

34,000 170,000 170,000 N

9 Reduce medical gas wastage 16,500 16,500 R

10 Recycle construction & demolition materials internally

8,100 162,000 162,000 R

Total $$833,200 $905,100 $1,581,500

THE GREEN TEAM FISCAL YEAR 2008

WHAT HAPPENED!

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Sharps Containers

•  Implemented pilot of recycled sharps containers in Periop, Lab and ICU. Will be rolled out house wide in FY09.

•  63,000 lbs to be diverted from the incinerator

•  $77,000 annual savings in containers, labor and disposal.

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Open / Unused Supplies

•  Resterilizing open / unused supplies in the OR, Cath Lab and EP lab

•  2 tons of supplies diverted from the incinerator

•  $50,000 annual savings

Cardboard Recycling

•  266,000 lbs of waste diverted from the incinerator •  $50,000 in waste disposal costs will now be

avoided once the incinerator contract amendment goes into effect.

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Isolation Supplies

•  Changed practice of isolation supply management – Minimize stocking in patient rooms

•  $134,000

Construction Management

•  Use recycled furniture on projects

•  Recycle demolition materials

•  Incorporate sustainable principles in construction contracts

•  $905,000 savings in construction costs

•  $156,000 savings in depreciation expense

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Utility Management •  Turn off business PC’s, printers, fax machines, monitors,

etc… at night and on weekends. 1% of energy consumption

•  Facilities management of utilities

•  Daily Code Red Alerts and adjustments to usage by individuals

•  6% - 9% reduction in energy costs depending on how evaluated (by bed, by patient day, etc…)

•  $500,000 savings

THE GREEN TEAM Utility Management

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THE GREEN TEAM Utility Management

Recycle Blue Wrap & other Plastics in the Operating Rooms

•  The Operating Rooms, ER & L&D are now recycling blue wrap, saline bottles, bunny suits and all other plastics.

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Line # Description Operating Savings

Capital Reduction

Total R/N

1 Recycle Sharps Containers $77,000 $77,000 R

2 Resterilize open/unused supplies 50,000 50,000 R

3 Utility Conservation 500,000 500,000 R

4 Recycle Furniture at Reform 114,600 573,000 573,000 N

5 Recycle Cardboard 50,000 $50,000 R

6 Isolation Supply Management 134,000 134,000 R

7 Purchase recycled furniture from BG&E

34,000 170,000 170,000 N

8 Recycle construction & demolition materials internally

8,100 162,000 162,000 R

Total $967,700 $905,000 $1,716,000

Annual Financial Savings

Evaluating Sustainable Alternatives

•  In addition to doing a clinical and financial analysis on new products, conduct an environmental analysis. UMMC has started to ask the following questions regarding new supplies:

1.  Will they take back the product it is replacing? 2.  What is the life cycle cost of the item? Purchase, Service, Energy, Parks,

Disposal 3.  Does it contain mercury, latex, PVC, etc… 4.  Can the packaging / product be easily recycled? 5.  Is the package/product made of recycled material? 6.  Can we reprocess the item? 7.  What is their history regarding upgrades? How often do they come out and to

they take back the old product? 8.  Is the company ISO certified 14001? 9.  What are their efforts to “green” their operations & distribution? 10.  Are they members of Hospital’s For A Healthier Environment?

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Evaluating Sustainable Alternatives - Response

•  The answers we receive indicate many vendor representatives do not know what sustainability means and are not aware of their company’s initiatives if they exist.

•  Most vendors representatives do not know what materials their products contain other than if it contains latex or mercury.

•  The Novation database does not contain enough information on sustainability so that individual member hospitals don’t have to ask every vendor these questions.

Evaluating Sustainable Alternatives - Next Steps

•  Contracts is modifying their standard contracts to include UMMC’s sustainability contracts.

•  Value Analysis – Development of a environmental product analysis template that is complementary to our clinical and financial analysis templates.

•  Novation has established a Sustainability Council effective 1/09.

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Preliminary FY09 Goals

•  Implement segregation of regulated and non-regulated waste. Implement recycling.

•  Pilot environmentally preferable purchasing, i.e. PVC free

•  Implement coordinated car pooling program with University

•  Implement farmer’s market •  Implement sustainability curriculum

FY09 Goals

•  Increase energy conservation initiatives •  Increase construction recycling and reuse programs •  Conduct Green Guide gap analysis and become

compliant with Green Guide •  Increase local food purchase and consumption in

cafeteria and patient care areas. •  Implement IT green practice standards •  Investigate environmental management systems

(per ISO 14001 or similar) for UMMC

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THE GREEN TEAM Links

•  http://www.premierinc.com/epp/ - Environmentally preferable purchasing (EPP)

•  http://www.sustainablehospitals.org/cgi-bin/DB_Index.cgi - Sustainable Hospitals

•  http://www.epa.gov/ - Environmental Protection Agency •  http://www.hospitalbuyer.com/ - Hospital Buyer •  http://www.h2e-online.org/ - Hospitals for a Healthy

Environment •  http://www.gghc.org/ - GREEN Guide for Health Care •  http://www.theGREENguide.com/ - National Geographic –

The GREEN Guide •  http://www.healthdesign.org/ - The Center for Health Design •  http://www.noharm.org/ - Health Care Without Harm

THE GREENE TEAM Contacts

•  Oversight Team –  Victoria Stewart, MBA, Co-chair, 410-328-2684 –  Jim Chang, Co-Chair, 410-328-6001 –  Harold Polk – Sustainable Development Coordinator,

410-328-6491 •  Chris Tamburo – Waste Manager, 410-328-0876 •  Administrative Green Team, Harold Polk, Chair •  Patient Care Green Team – Chair, Denise Choiniere,

RN, 410-328-5426 •  Periop Green Team

–  Marnie Kommalan, RN, GOR – 410-328-5910 –  Ann Cross, RN, STC OR – 410-328-6850

•  Joan Plisko – MD H2E, plisko@son.umaryland.edu