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Sustainable procurement: The true cost of products and services
HEARRT- December 13, 2019
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Beth Eckl Director, Environmental Purchasing Program Practice Greenhealth
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Objectives 01 03 Understand the importance of sustainable procurement and the role it plays in health care Recognize what is being done to transform markets to increase sustainable products 02 04 Recognize the true cost of products and services and learn of opportunities to find cost savings Know key resources to support sustainable procurement
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Remember mercury thermometers?
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Sustainable procurement is “preventative medicine”
Looks at three considerations to reduce harm/impact: Environment (Planet) Waste reduction Air and water consumption, quality Toxic chemicals Energy Social (People) Fair trade Employee welfare Human rights Economic (Markets) Use of local and diverse suppliers Life cycle cost/ Total cost of ownership
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Why sustainable procurement?
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Reduces environmental impacts of healthcare practices
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Minimizes chemical exposures
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Reduces chemical footprint of products commonly used in Pediatric departments
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We are ALL exposed Center for Disease Control’s ongoing analysis of over 200 environmental chemicals in blood and urine of representative sample of U.S. population Biomonitoring of 20 healthcare workers showed PBDEs, mercury, PFCs, phthalates, Triclosan, BPA
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Multiple routes of exposure
Inhalation Dermal Ingestion Cross placenta transfer Breast feeding Multiple routes of exposure
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Reduces contributors to disease (link to environmental exposure rising)
Asthma 1 in 12 Americans Childhood leukemia 55% increase between and 2010 Thyroid cancer 3.6% increase every year between 1974 and 2013 Developmental disability 7% of children ages 3 to 17 years Breast cancer Increased 0.4% each year between 2009 and 2013
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Health care’s climate footprint report - Findings
Health care is a major contributor to the climate crisis More than half of health care’s footprint comes from energy use Decarbonizing health care’s supply chain is critical (Scope 3 is 71%) Fossil fuel combustion is at the heart of health care’s climate footprint Health care spending and the sector’s growth is an important factor in emissions Source: Health Care’s climate footprint, Health Care Without Harm, 2019
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Scope 3 defined Purchased goods or services
Transportation and distribution of products Processing of sold products End of life treatment of sold products Disposal of waste generated in operations Fuel and energy-related activities (not in 1 or 2) Capital goods Leased Assets Employee business travel, commute
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NHS Report on reducing the use of natural resources
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Market Transformation Group | Safer Chemicals Priorities
Priority categories Furniture and other furnishings Medical beds/mattresses Medical products Cleaning chemicals Flooring (resilient) Carpet
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Health interiors criteria and goal
Healthy Interiors criteria Furniture and furnishings do not contain the following chemicals and materials: Flame Retardants Formaldehyde Perfluorinated Compounds Antimicrobials PVC or Vinyl Healthy Interiors goal Hospitals ensure that 30 percent of their annual volume of furnishings and furniture purchases eliminate the use of the targeted chemicals of concern.
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Healthy Interiors | Outcomes
Cleveland Clinic: Over 80% of furnishings purchased in 2017 meet Healthy Interiors criteria 2007 2012 2017 Over 140 health care organizations purchase furniture and furnishings using the healthy interiors criteria For more information, visit
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Sustainable procurement can result in cost savings Examples from the operating room
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Price Total cost of ownership: looking beyond the purchase price
Submerged costs
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What are the submerged costs?
Energy, Fuel Water Cleaning Waste, Recycling Maintenance Labor Health and safety = Total costs to hospital
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Use the Greenhealth Cost of Ownership (GCO) calculator
Gain transparency on the “hidden costs” associated with the use and disposal of products Empower smarter purchasing decisions Lower costs Reduce human health and environmental impacts
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Greenhealth Cost of Ownership (GCO) Calculator – Step by Step Instructions
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Types of Products to Consider
Durable Good Alternative Durable Good Lab Freezer Lab Freezer – Energy efficient Computer Computer – Energy efficient, etc. Faucet Faucet – Water efficient KEY: Selected products should have a differentiator during use or disposal (waste, energy, water, fuel, etc.) Consumable/Disposable Good Reusable Good Trocar – Disposable Trocar - Reusable Patient gowns – Disposable Patient gowns - Reusable Sterilization container – Blue wrap (disposable) Sterilization container – Reusable metal container
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Total cost of ownership identifies true cost
-80 Laboratory Freezer TCO project (115 freezers) Energy Efficient Freezer Traditional Freezer Power- $8,500 HVAC- $2,500 Price -$13,500 Power- $5,900 HVAC- $1,700 Price- $14,000 Total- $21,600 Total- $24,500
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Surgical Light Fixtures: CFL vs LED
Results TCO YEAR 1 TCO OVER 20 YEARS TCO AVERAGE PER YEAR
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Reusable and Disposable Trocars
Reusable trocar = $300
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Disposable vs Reusable Trocars – Cumulative Costs
Disposable trocar
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TCO Toolkit TCO Tool Step by Step Illustration TCO User Guide
Training Webinars Guidance on Product Selection Data Collection Templates (members only)
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Coming in 2020
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Where to Start: Sample of Practice Greenhealth purchasing challenges
Safer Chemicals Furnishings Janitorial Cleaners PVC/DEHP Reduction Mercury Elimination Hand Hygiene Flooring Carpet Purchasing Greener Electronics Single Use Device Reprocessing Review Custom Kits Food Local and sustainable food Less meat, better meat Healthy beverages Waste Recycling of construction and demolition debris Transportation EPA SmartWay Partners Fleet vehicles Energy EPA ENERGY STAR Water EPA WaterSense
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Practice Greenhealth procurement resources
Sustainable Procurement Toolkit, Greenhealth Cost of Ownership Calculator,
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The health of the environment is connected to the health of people and wildlife. What we buy matters. © Practice Greenhealth All Rights Reserved.
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Director, Environmental Purchasing Program
Questions? Beth Eckl Director, Environmental Purchasing Program
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