Leading the Path to Sustainability in Healthcare

 Describe the forces that drove the adoption of sustainable practices at Christiana Care.  Outline the process of organizing a sustainability program.  Discuss the role of Purchasing, Contracting, Materials and Logistics in the implementation of sustainable practices.  Explain the business value of a successful sustainability program.  Describe how to measure and report on progress. Objectives

About Christiana Care Health System  One of the largest healthcare providers in the Mid-Atlantic Region.  Serves all of Delaware and seven counties bordering the states in Pennsylvania, New Jersey and Maryland.  More than 1,100 licensed hospital beds in two hospitals.  Over 10,000 employees.  Largest private employer in Delaware, 10 th largest in Philadelphia region.

Christiana Care Environmental Stewardship 2005

Forming the Green Team  Employee initiated.  Senior leadership champion.  Senior leadership support.  Combination of department leaders and employees who have a passion for the environment.

Where do we start?

Initial Goals FY 2005  Waste reduction project – recycling, reduce medical waste.  Organize and expand current sustainable practices.

Annual Goal Development Process  Subcommittee develops recommendations for goals and presents to Environmental Stewardship Committee.  Committee assigns responsible individuals for each goal.

Committee Membership  Environmental Services  External Affairs  Facilities Engineering  Food and Nutrition Services  Infection Control  Information Technology  Nursing  Occupational Safety  Pathology and Laboratory Medicine  Patient Escort Services  Pharmacy  Purchasing  Radiology

Committee Goals (cont.)

Major Sustainability Initiatives  Wind Power Purchase Agreement  Reduce Regulated Medical Waste  Recycling  Energy and Water Reduction  Pharmaceutical Waste Program

Wind Power Purchase Agreement Christiana Care began Purchasing 15% of the output of the Locust Ridge II wind power facility in central Pennsylvania in January 2010.

Wind Power Purchase Agreement (Cont.)  Nine (9) year agreement with Iberdrola Renewables Locust Ridge II Wind Farm in Pennsylvania.  Christiana Care pays a fixed cost per kwh with no escalation over the term of the contract.  Provides 40% of the electricity needs of Christiana Care facilities – approximately 40 million kWh per year.

Wind Power Purchase Agreement (Cont.)  Locust Ridge is a wholly owned subsidiary of Iberdrola Renewable Energies USA (Iberdrola).  Iberdrola is a subsidiary of Iberdrola S.A., the largest wind power company in the world.

Wind Power Purchase Agreement (Cont.) LSE Agreement  Iberdrola is not authorized nor are they interested in selling electricity directly to end users in the PJM region.  Christiana Care has contracted with Sempra Energy to serve as the Load Serving Entity (LSE).

Wind Power Purchase Agreement (Cont.) Benefits  Wind energy is clean and renewable, a natural fit with health service providers.  Stabilizes a large portion of Christiana Care electricity costs.  Long-term natural price hedge that is not dependent on the cost of fossil fuel  We are helping to drive the development of a clean, renewable energy source.

Wind Power Purchase Agreement (Cont.) Initial Investment Required – None Cost Savings – Currently cost neutral.

Reduce Regulated Medical Waste Vendor Contract  Reusable Sharps Containers Consultant Services  Reusable storage containers for red bag waste  Training

Reduce Regulated Medical Waste (Cont.) Initial Investment Required - $0 54% reduction in Medical Waste Cost Savings - $230,000 per year

Reduce Regulated Medical Waste (Cont.)

Recycling Program  Paper  Cardboard  Plastic Bottles  Glass Bottles  Cans  Fluorescent Lamps  Solvents (Xylene and Ethanol)  Motor/Lubricating Oil  Cooking Oil/Grease  Rechargeable Batteries  Electronics

Recycling Program (cont.)

Recycling Program (Cont.) Initial Investment Required $60,000 Recycling Cost Savings  Commingled Recycling/Cardboard - $33,000/yr  Solvents (Xylene and Alcohol) - $27,000/yr

Recycling Program (Cont.)

Energy and Water Conservation Consultant Services  Building energy assessment.  Water and energy conservation assessment and project development.

Energy and Water Conservation (Cont.) Recent Energy Reduction Initiatives  Replacement of original chillers and cooling towers.  Occupancy sensors for lighting.  Night/weekend setback controls.  Window replacement project at Wilmington Hospital.

Energy and Water Conservation (Cont.) Business Plan for Major Water and Energy Reduction Project  Replacement of toilets, retrofits of urinals, laminar flow restrictors on faucets.  Sterilizer condensate tempering systems.  Replacement of water cooled compressors on refrigeration systems.  LED lighting  Induction lighting systems.

Energy and Water Conservation (Cont.) Water and Energy Conservation Business Plan  Cost – $2 Million  Simple payback – 3.6 years  Will result in a reduction in water use of 20 million gallons/year.

Pharmaceutical Waste Program  Developed PARE program (Pharmaceutical Waste Reduction Effort).  Developed by subcommittee of the Environmental Stewardship Committee.  Cooperative effort among Occupational Safety, Pharmacy, Nursing, Environmental Services and others.

Pharmaceutical Waste Program (Cont.) Addresses the following:  EPA regulated substances.  Pharmaceuticals which we have determined should be treated as a regulated substance.  Expired pharmaceuticals that cannot be returned to the pharmacy for credit.

Pharmaceutical Waste Program (Cont.) Profile lists maintained at container.

Measuring Progress

Measuring Progress (Cont.)

Community Involvement Community Medication Take-back Events Action Taken – Hosted two medicine cabinet cleanout events for the community in cooperation with the Delaware Nurses Association Investment Required – Less than $1,000 per event

Community Involvement (Cont.)  Delaware Valley Green Building Council  City of Wilmington Energy Leaders Roundtable  One of the first businesses in the City of Wilmington to sign the Climate Change Pledge.

Employee Involvement Environmental Champions  50 volunteers representing nursing units and departments  Quarterly lunch meetings  The ambassadors for the Environmental Stewardship program

Employee Involvement (Cont.) Earth Day Activities  Local nurseries donated trees for the Christiana Hospital Campus which were planted by employees.  The Environmental Stewardship committee and Environmental Champions also planted a 3000 square foot employee vegetable garden.  Cafeterias served special “earth friendly” menus.

Employee Involvement (Cont.) Earth Day

Recognition  Practice Greenhealth Awards – Partners for Change with Distinction award.  Delaware Valley Green Building Council Business Leadership Award  EPA Region III Trailblazer award 2009.

Communications  Employee newsletter articles – Focus  Press release and media interviews on wind power purchase agreement.  Local newspaper article on green initiatives in hospitals.

Communications (Cont.) Marketing

Communications (Cont.) Annual Report

Current/Future Initiatives  Achieve a recycling rate greater than 25%.  Purchase safer and more sustainable products when economically feasible.  Initiate a composting program.  Pursue LEED certification for one or more buildings.  Promote environmental health literacy internally and through community programs.

Questions?