Leading the Path to Sustainability
in Healthcare
Objectives
 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.
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,
10th largest in Philadelphia region.
Christiana Care Environmental
Stewardship 2005
Forming the Green Team
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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
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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.)
Environmental Stewardship Committee // FY11 Goals
1. Improve Environmental Health and Patient Safety
1.1 Design and operate healthier and safer facilities for patients and employees
Designing and operating healthier and safer facilities means adhering to nationally
recognized standards for new buildings and additions. More sustainable buildings are
constructed using environmentally-friendly materials and processes and allow
Christiana Care to reduce long-term energy use.
Initiatives:
 Achieve LEED Certification for one or more buildings
1.2 Purchase safer and more sustainable products and materials
How a product is manufactured and what materials are used to make it should be
important considerations in Christiana Care’s purchasing process. As powerful industry
consumers, large healthcare systems like Christiana Care have the ability to drive the
market towards producing more sustainable products.
Initiatives:
 Continue to expand environmentally-preferred purchasing program
1.3 Support the use of safer chemicals and green chemistry
As the largest user of user of chemicals, the healthcare sector has enormous
opportunities to reduce the use of toxic chemicals that can cause serious illness and
pollution.
Initiatives:
 Explore more environmentally friendly alternatives to soap and hand gel products
 Assess literature on PVC, DEHP and BPA to determine Christiana Care’s
position regarding use of products containing these chemicals.
1.4 Promote nutritious, sustainable food choices
Major Sustainability Initiatives
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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.)
Recycled Waste over Time
1600000
Pounds Recycled
1400000
1200000
1000000
800000
600000
400000
200000
0
FY07
FY08
FY09
Year
FY10
Recycling Program
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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.)
Recycled Waste over Time
1600000
Pounds Recycled
1400000
1200000
1000000
800000
600000
400000
200000
0
FY07
FY08
FY09
Year
FY10
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 – 2010 - Partners for
Change with Distinction award.
 Delaware Valley Green Building Council Business
Leadership Award. - 2010
 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?