Going Green

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When it comes to “green” issues, Kent Miller approaches his job with a strong dose of Midwestern pragmatism. “I am not an environmentalist,” says Miller, director of environmental services at Mercy Medical Center in Cedar Rapids, IA. “But I am environmentally concerned. I am not a ‘tree hugger,’ but I understand what waste does to the environment.”

In the healthcare setting, Miller has plenty to contend with. Not only are hospitals major energy consumers, but they produce inordinate amounts of waste, much of which winds up in a landfill or at the incinerator. Under Miller’s leadership, Mercy has tackled the question of environmental stewardship head on. In May 2007, Mercy won recognition for its mercury reduction effort from Hospitals for a Healthy Environment, a Lyme, NH-based nonprofit that promotes earth-friendly business practices in the healthcare setting. “It is a continuous effort,” Miller says. That is a major understatement, considering that Mercy, like all hospitals, is swimming in waste—sometimes hazardous, such as infectious materials, and sometimes merely voluminous, such as cafeteria byproducts.

Mercy is not alone in its efforts to reduce the waste stream, however; it is among a handful of hospitals that have made major environmental strides. Like Mercy these hospitals may not promote themselves by waving green flags. Rather, they are quietly becoming organizations that consume less energy, recycle more materials and rethink how hospitals are built and how they operate.

Technology is ingrained in these efforts, as it is both part of the problem and the cure. For one thing, environmental leaders are rethinking their use of electronics by recycling computers and medical devices. They are also addressing building infrastructure and rooting out hazardous—and widespread—substances like mercury. Still others are mounting educational campaigns to raise the awareness of staff members who may occasionally pitch an empty soda can into the wrong container.

One healthcare organization with an innovative approach to electronics recycling is the University of Texas Health Science Center in San Antonio. First, the facility sorts through used computers, offering them to university employees for use at work. Then, twice a year, the center ships a truckload of obsolete computers and related equipment to Texas Correctional Industries. The prison system puts inmates to work sifting through the computers for reusable parts. “Laptops have plastic and heavy metals as components,” says Mike Gilmer, environmental protection manager at the center. “It is becoming a national problem as people throw them into the garbage. They will accumulate in landfills,” with the waste potentially making its way into the water supply, he says.

Affinity Health System in Appleton, WI, also recycles computers and other medical equipment, says Gary Kusnierz, director of development and construction. Some used equipment is either auctioned off or given away, Kusnierz says. Other equipment is broken down into recyclable components as part of an inhouse program run by the health system’s biomedical department.

Running three hospitals and 25 clinics, Affinity goes through a considerable amount of equipment. During a three-year period ending in 2006, Affinity diverted 116,000 lbs of medical equipment and computers from the waste stream, Kusnierz says. Buying more environmentally friendly computer equipment is also part of the environmental equation at Mercy Medical Center. “We are switching to LCD flat-screen monitors,” says Miller. “They use less energy and contain less hazardous waste” than their CRT forbears.

Adapting a building’s technological infrastructure can also lead to more environmentally friendly operations. The University of Texas Health Science Center replaced scores of old light switches that included a mercury component that would conduct electricity, says Gilmer. To reduce its energy consumption, Mercy is remodeling patient rooms with newer lighting technology that uses far less electricity. And Affinity installed a state-of-the-art heating and ventilation system, notes Kusnierz. As it builds new clinics, Affinity is looking to use natural light as much as possible by adding skylights. Natural light means less glare off computer screens, says Kusnierz.

Despite such steps, the industry has a long way to go in becoming more environmentally conscious, according to Kusnierz. “Only a few health systems are doing this,” he says. “People think it will cost more money.”

Kusnierz disputes that conventional economic wisdom. An Affinity clinic that opened in 2005 is “LEED-certified” (leadership in energy and environmental design), a designation offered by the U.S. Green Building Council. The LEED designation is reserved for buildings that meet lighting and construction requirements. Building the green clinic only added an additional1 percent to the construction budget, Kusnierz says. The clinic uses rubber flooring in procedure rooms that costs more per square foot but has better durability resulting in significant cost savings. Affinity also diverted 70 percent of the construction waste from a recent addition to its main hospital—about 60 tons total.

Affinity’s green efforts are driven by the health system’s mission, Kusnierz says. As a faith-based institution, Affinity upholds a “stewardship value” as one of six key organizational tenets. “It means we make wise use of our resources, both financial and environmental,” he says.

As Miller points out, upholding any green mission requires cooperation from staff at all levels. To raise staff awareness, Miller’s crew mounted a display in Mercy Medical Center’s cafeteria. It showed all the inappropriate items that wound up in hazardous medical waste containers, which costs the hospital considerably more to recycle than regular garbage. “We found pia boxes and soda pop cans,” he says.

Medical device users have been educated at Mercy, as well. After starting a battery recycling program in 2006, Mercy is now capturing some 250 lbs of batteries every month that once would have gone to landfill. The batteries come from the defibrillators, patient monitors, pagers and numerous other devices commonly used in the hospital setting. It’s a real step toward a green operation, but Miller the pragmatist shrugs it off. “We pay by the pound to get rid of that stuff in the trash.”

Gary Baldwin is technology editor of HealthLeaders magazine. He can be reached at gbaldwin@healthleadersmedia.com.

Waste, Waste Everywhere

When it comes to managing waste, Mike Gilmer has his hands full, so to speak. Gilmer serves as environmental protection manager at the University of Texas Health Science Center in San Antonio, a teaching facility for medical, nursing, dental and allied health professionals that houses 650 labs and employs some 5,000 staff. Like many environmental managers, he’s very down to earth. “My job is waste stream management,” Gilmer says.

And quite the stream it is. The scope of waste generated at the center demonstrates the environmental challenge facing healthcare institutions. Gilmer must contend with four major sources of waste:
  • Hazardous chemicals, including paints, oils and solvents used in lab research.
  • Radioactive materials and chemicals generated by radiological studies.
  • Regulated medical waste, which covers a host of materials, such as scalpels, infectious materials from test tubes, and tubing. “Any material with a bloodborne pathogen,” he says.
  • Electronics, including lab equipment and computers.




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