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An early look at a new position: Sustainability manager

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March 1, 2010

An early look at a new position: Sustainability manager

Environmental duties begin to bring a need for direct responsibility

Many hospitals have created “green teams” of ecology-minded employees who strategize ways to reduce waste and energy consumption. At its best, such work enhances patient and employee safety and saves money.

Some medical centers have justified the cost, safety, and public relations boosts these green teams yield—so much so that they’re taking it a step further and creating a full-time position for the management of such initiatives, typically called a sustainability officer or sustainability manager.

The movement has spread far enough that several universities now offer degree programs specializing in sustainable business practices.

John Ebers, LEED AP, CEM, sustainable business officer at Metro Health Hospital in Wyoming, MI, graduated from such a program at Aquinas College in Grand Rapids, MI.

Denise Choiniere, RN, BSN, sustainability manager at the University of Maryland Medical Center (UMMC) in Baltimore, started out in healthcare as a nurse, albeit one with a passion for minimizing the ecological footprint of her facility. UMMC required a nurse for the position because the facility planned for the manager to help develop bedside clinical practice changes.

A trio of ultimate goals

Although they come from different backgrounds, Choiniere and Ebers speak of the same “triple bottom line” that is their goal: enriching patient care, increasing environmental benefits, and minimizing costs in the process.

“Sustainability within healthcare is important because of the impact that we have—healthcare being one of the largest consumers of energy and water—and we generate a huge amount of trash, which has a huge environmental impact,” Choiniere says. “Being conscious and aware of how we do business can have a huge impact environmentally and globally if we can pay attention to what we’re doing.”

Purchasing advantages become evident

Choiniere, who reports to the vice president of facilities and the chief nursing officer, says that when someone’s watching and tracking sustainability at the hospital, the payoffs can come in three main areas:

  • Energy conservation. Using less electricity, gas, oil, and water are probably the biggest ways to cut costs and lessen a facility’s ecological footprint. Water savings, in particular, can be gained inside buildings and outside, too, depending on current landscaping practices and the size of the hospital campus.
  • Waste reduction. Safety and facilities managers now take it upon themselves to analyze the ways the hospital generates waste. Sustainability officers have more time and bandwidth to help “sort the trash,” creating systems in which fewer truckloads of red bag waste get hauled away. There are also benefits from general trash reduction (e.g., recycling blue sterile wrap instead of tossing it out).
  • Purchasing practices. Smart purchasing can turn waste into recyclables and cut costs. At UMMC, the DEHP-free IV tubing Choiniere now orders not only removes those potentially unhealthy chemicals from patient care, but is recyclable, whereas the previous tubing wasn’t. Therefore, that tubing purchase incurs no disposal cost, saving about $8,000 per year.

Determining the time frame of success

Ebers, who reports to the vice president of property and construction management and the vice president of operations, says that, ideally, his facility would focus on long-term payoffs for sustainability measures. In other words, if the aim for the new Leadership in Energy and Environmental Design–certified facility on his campus is to keep it operational for 60–70 years, related sustainability measures could theoretically take decades or even longer to pay off.

But in these difficult economic times, Ebers typically must show an initiative will get in the black within one year for it to get a green light.

Sometimes Metro Health loosens up the reins and looks longer term on its sustainability issues, such as when it put in a vegetative roof for one of its buildings that used plants and not shingles.

Ebers says that project will pay off in 15 years and was part of several initiatives helping the facility earn a 2009 Practice Greenhealth Environmental Leadership Circle Award, the highest honor the ecologically oriented healthcare association gives (see the August 2009 Briefings on Hospital Safety for more about Metro Health’s award-winning ideas).

“You can’t just do anything for any amount of money. It has to have a payback,” Ebers says.

No compliance responsibilities—yet

Sustainability positions often have added benefits of partnering with other longtime activities in hospitals. For example, Choiniere’s purchasing decisions and other duties directly influence both patient safety and the EC, which has prompted her to work closely with nursing leadership and consult with the safety officer on a nearly daily basis.

Choiniere also sits on her hospital’s value analysis oversight committee, which reviews purchasing decisions and their implementation at UMMC.

Among his duties, Ebers sits on his hospital’s safety committee and influences the proposals and decisions its members make.

Although Ebers and Choiniere don’t have any direct compliance duties yet, they see a time when it might be part of their evolving job descriptions.

UMMC plans to update its hazardous drug handling and disposal policies, figuring that since the federal Resource Conservation and Recovery Act’s (RCRA) hazardous drug list is 34 years old, it’s going to be updated soon. As such, the facility wants to get a jump on its procedures to avoid potential enforcement actions when that change comes.

Beyond RCRA, however, auditing a hospital’s pharmaceutical stream is the responsible thing to do for the safety of employees, patients, and ecology, Choiniere says.

As sustainability managers further integrate into hospitals, it makes sense that they would take responsibilities for compliance with Joint Commission standards pertaining to their job duties, as well as related OSHA and Environmental Protection Agency rules.

Community response brings good vibes for green approach

Of all the benefits and cost savings a sustainability manager can theoretically bring to a hospital, the one that’s difficult to quantify is the PR benefit that comes from healthcare facilities being more conscientious corporate citizens.

The University of Maryland Medical Center in Baltimore (www.umm.edu/green) and Metro Health Hospital in Wyoming, MI, (www.metrohealth.net/locations/hospital/green-thinking) have set up Web sites discussing their green initiatives and have plugged into national group Practice Greenhealth’s initiatives.

Although the marketing efforts haven’t necessarily affected the bottom line, there is public awareness of green activities, says John Ebers, LEED AP, CEM, sustainable business officer at Metro Health.

While recently talking with some folks who didn’t know what Ebers did at Metro Health, they referred to his facility positively as “the green hospital.”

“They don’t know what I do, and they’re telling me that [compliment],” Ebers says. “I don’t know what that’s worth, but it’s worth something.”




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