When it comes to implementing environmentally-sound practices in healthcare, there is philosophy and there is reality. Philosophically, proponents believe that recycling, reusing and reducing emissions are the right things to do. In reality, implementing environmentally-friendly practices can be expensive, difficult and subject to pushback.
Despite whatever challenges exist, however, management at most hospitals across the country appear to be making some kind of effort to initiate "green" policies at their facilities, says Al Neuner, associate vice president of facility operations for Danville, Pa.-based Geisinger Health System.
"A lot of facilities have hopped aboard the green bandwagon - especially from an energy perspective," he said. "That makes the most sense because energy is the only thing that impacts the bottom line and the triple bottom line of people, planet and profit. When you do something more energy efficient, you save energy dollars; but when you reduce usage, you are reducing pollution (planet) and if there is less pollution you improve health (people)."
Neuner says recycling, composting and buying green products are "all great," but that "there is very little dollar value in that." It is in the energy domain where hospitals can make the most impact, he said, citing several statistics:
- Hospitals are the second largest energy consumer in the U.S. According to the Environmental Protection Agency, inpatient healthcare is the second-most energy intensive industry in the United States (behind just foodservice), consuming more than twice as much energy per square foot as non-healthcare facilities.
- Hospitals' $5 billion per year energy bill keeps rising. The Department of Energy reports that hospital energy costs rose 56 percent from $3.89 per square foot in 2003 to $6.07 per square foot in 2008, and those costs are continuing to rise.
- Energy demand is soaring unabated. A recent American Society for Healthcare Engineering (ASHE) survey found that electricity demand in the U.S. alone will grow by at least 40 percent over the next 25 years.
- Negative impact on the environment and public health is growing. Healthcare alone accounts for nearly one-tenth of the nation's emissions of carbon dioxide. One average-sized U.S. hospital annually produces approximately 18,000 tons of carbon dioxide, which has been linked to a host of illnesses, including premature mortality, chronic bronchitis, asthma attacks and various respiratory symptoms.
As a facilities director, Neuner says his main focus with environmental (or "sustainability") issues is how they can impact the hospital's return on investment. For example, last year Geisinger installed a cogeneration power unit that generates five megawatts of power, "which cut our carbon footprint in half," Neuner said.
The internal power plant operates at 80 percent efficiency, which is extremely effective compared to a public utility power plant, which typically operates at 30 percent efficiency, he said. Moreover, a newly installed air chiller will provide cooling to the facility in the summer without relying on any outside electricity.
"This has a benefit to society in that during peak electrical demand on a hot summer day, we will not be contributing to that load," he said.
Dialing back noise
Matt Perkins, chief technology officer for San Diego-based Awarepoint, says noise pollution is another environmental problem that hospitals need to combat. The biggest offender, he says, is the proliferation of wireless mobile devices inside facilities.
"With radio signals and infrared, wireless is a big problem for hospitals," Perkins said. "Because most mobile devices constantly chatter, it causes a lot of noise pollution and interference."
As a device tracking manufacturer that utilizes frequencies for locating devices, staff and patients, Awarepoint is committed to keeping the frequency spectrum clean, Perkins said, because "our devices are off 99 percent of the time...they only talk if there is something interesting." In order for an Awarepoint tag to emit a frequency, something has to change, like a device moving around or staff entering a patient room, he said.
Awarepoint is also greening the hospital supply chain by optimizing workflow, reducing bottlenecks and tracking capital assets, Perkins said. By giving materials managers the ability to pinpoint where specific devices are at any given time, eventually the department will purchase fewer products and consume less, generating an ROI, he said.
He offers OR workflow as an example. For each surgery, the patient arrives on site and from there that patient will pass various milestones - arrival, pre-op, surgery, post-op and discharge. Although there are variations on that process, the milestones are the same for everyone. Yet patient experiences can differ greatly and often do, Perkins said.
"Patients are typically kept waiting at each stage due to communication and location problems," he said. "These are systemic in nature. We can show them where their inefficiencies are and improve them with automated tracking."
Overall, it is inefficiencies that are a primary threat to the environment, Perkins says.
"When you look at the environment, the root cause of why landfills are growing is because of incredibly inefficient processes," he said. "What we try to do is optimize efficiencies so that there is less consumption and waste. Those are true green initiatives."