1. HOUSEKEEPING AT DHMC GREEN CLEANING

2. In an effort to promote healthier communities both locally and globally, Dartmouth-Hitchcock Medical Center (DHMC) is committed to improving environmental management throughout the organization. DHMC will manage its operations in a manner demonstrably protective of environmental and human health. DHMC will constantly seek new and innovative ways to meet its environmental goals through conservation, reduction, re-use and recycling programs, and through partnering with others in the community to safeguard the environment. DHMC will apply these principles to achieve optimal environmental standards consistent with institutional goals and financial considerations. In an effort to respect and protect the earth’s resources, and to minimize environmental damage, DHMC will: Dartmouth-Hitchcock Medical Center Statement of Environmental Principles

3. Manage, minimize, and eliminate, whenever possible, the use of hazardous materials. Use renewable natural resources and conserve non-renewable natural resources through cost efficient use and careful planning. Use pollution prevention initiatives to reduce negative environmental impacts. Minimize the generation of waste through source reduction, re-use, and recycling programs. Conserve energy and improve the energy efficiency of our operations and make every effort to use and promote environmentally safe, cost effective, and sustainable energy sources. Ensure the health and safety of our employees by promoting safe work practices, reducing exposures, using safe technologies, and implementing effective emergency preparedness programs. Provide employees with safety and environmental information through training and education programs in order for them to make work/practice decisions in support of these principles. Statement of Environmental Principles continued

4. Track off mats Micro-fiber mops Green cleaning chemicals & techniques Vacuums Floor finish Integrated Pest Management Program Green Supplies New technologies HOW DO WE DO THIS?

5. Track off mats are the first line of defense in keeping dirt from entering your building! Track off mats are installed at every door that leads to an outside entrance and at the base of stairwells that are located beside these outside doors. These mats can significantly reduce the amount of dirt and debris that is tracked throughout the facility. Thereby reducing the cost of cleaning it up (labor) and the use of chemicals that have a negative impact on indoor air quality. Boot Scrapers are also used at entrances in the winter time TRACK OFF MATS

6. Track off matting

7. Boot Scrapper

8. Micro –fiber mops are more cost effective as well as generating less waste for the facility. Micro-fiber uses up to 95% less water and chemical. They can be re-used (hundreds of washes) before having to be replaced. 60 % lifetime cost savings. These mops are easier for staff to use, tools are 75 % lighter and will reduce the amount of back related (repetitive movement) injuries (up to 20%) that result from floor mopping. These mops are also better for the patients as they are replaced in each room with a new mop head, thus reducing the possibility for cross-contamination. Shown to reduce bacteria levels as much as 99%. The micro-fiber mops should be used with a charging bucket to maintain the proper amount of moisture to the floor. Training needs to be on-going to ensure staff are following the correct procedure. Micro-fiber mops

9. Microfiber & Charging Bucket

10. Microfiber cleaning cloth

11. Spartan Green Seal Certified Products 104 Carpet cleaner 105 Industrial Cleaner 102 Glass Cleaner Citric Acid Toilet cleaner Clean by Peroxy These chemicals are safer for the staff to use and are better for the environment. They have a lower health risk (long term use) when used appropriately and this helps to maintain a better indoor air quality. These chemicals are also required to be produced with less environmental impact. Green Chemicals

12. Reduce the use of hand sprayers for most chemicals, especially the disinfectant. Use a squeeze top pourer to dispense your chemicals. Apply them on a cloth to clean. This keeps the aerosolized chemicals out of our lungs. Floor cleaning applicators keep the wash solution contained in the mop handle. No heavy mop buckets. Safer ways to use Chemicals

13. Pour Top Bottle & Pulse Mop

14. Vacuum cleaners have a significant impact on the overall appearance of the facility and in the overall air quality. The housekeeping department is always looking for vacuums that are a good value and clean the carpets well and that they provide us with the best HEPA filters in critical areas. Filters help to ensure that irritants aren’t made airborne during the process of cleaning the carpet. Maintaining this equipment is vital to overall effectiveness of program Using wide area vacuums with a HEPA filter for large areas, (even hard floors) do a much better job than traditional floor sweepers that only capture the surface dirt. VACUUMS

15. Go-Cart Vacuum and Wide Area Vacuum

16. Re-finishing floors in the hospital is always a challenge due to the potential for VOC’s (volatile organic compounds) these irritants cause concerns for people that have respiratory issues. (off gases) We have been using the product, “G-Force” floor finish. This product has very little “odor’ and has been received well by both the staff and patients. It does require more coats. This finish comes in a small box and uses an applicator, by far the best way to apply finishes. No open mop buckets and everything is contained. FLOOR FINISH

17. Back Pack Finish Applicator

18. Self contained wand waxing system

19. We have also been trying a hybrid 2 part finish called Ecomax. A small amount of hardener is added at use. The use solution has almost no odor, and dries quickly. ( 20 minutes). With the hardener, it has a “1” health rating. It is also applied with an applicator. (back pack style) No open mop buckets, virtually no odors. This product has held up very well in patient rooms, where it is very difficult to gain access. More on Floor Finish

20. We have purchased a number of orbital floor machines, that will allow us to strip and re-finish larger areas of floor with less floor stripper and less labor/time. These machines result in cost savings for the hospital as well as an increase in productivity for staff and an opportunity to provide a cleaner environment for some of our more challenging areas to get floor work done. (i.e., ICU) These machines also use a new pad technology that assist in this process. In addition we also use a floor machine, “Foam machine” that saves on water and chemical by using a different process in applying chemical. EQUIPMENT

21. Orbital Floor Scrubber

22. Steam Cleaner

23. The housekeeping department has a contract with Waltham Services, Inc. They come 4 times a month to address any pest control problems. (Mondays) Identifying pests before treating is imperative. We/they use less harmful methods of pest control like, “Cluster Busters” for the cluster flies that visit us each year. (This is a trap that the flies go into and get “stuck” and die.) “Fly lights” are also used throughout the complex. These lights are chemical free. We also use bait for ants instead of spraying and traps for mice instead of poison. We do occasionally have to spray for pests, but it is very limited. INTEGRATED PEST MANAGEMENT PROGRAM

24. Cluster Buster & Fly Light

25. Plastic liners are a necessity. Use the thinnest ones possible. Most bathroom and office trash is very light. Liners with recycled content are available. Consider them, as they are getting better. Closed loop systems are starting to be more common in plastics. Your vendor might collect your blue wrap, shrink wrap, and used liners. Supplies and Sustainability

26. Coreless toilet paper saves on the cardboard core Consider wrapped packaging rather than cardboard boxes. Paper towels offer recycled content in many varieties. Closed loop paper opportunities are being offered by your vendors. More on Supplies

27. 100% recycled content Sustainability Forestry Initiative

28. Coreless Toilet Paper

29. Consider flooring that doesn’t require stripping & finish. That is our standard now, although we have not found the perfect flooring yet. New technology in hand dryers helps keep bathroom clutter down. We are trying some. Entrance matting is constantly evolving. We are trying a rubber scrapper tile in an entrance. Develop a green team or just a group of advocates. The Future!!

30. Rubber and Marmoleum

31. Urethane Treated Vinyl