Going Green…The Team Approach! University of Maryland Medical Center Victoria E. Stewart, MBA Maryland Hospitals for a H

1. Going Green…The Team Approach! University of Maryland Medical Center Victoria E. Stewart, MBA Maryland Hospitals for a Healthy Environment 11.12.08

2. Objectives • Describe the team approach used at UMMC to “Go Green” • Describe how UMMC is incorporating sustainability principles into their current operations • Describe how UMMC is evaluating sustainability alternatives

3. The Beginning • The Green Team was formed in April 2007: • The Green Team Oversight Group • Patient Care Green Team • Administrative Green Team • Periop Green Team (subset of Patient Care Green Team) • We embarked on a cultural change to conserve, reduce, reuse, and recycle – 10 million lbs of waste (2006 data) @ $1.354 million dollars in waste disposal costs and $12 million in utility costs • Financial Goals Set: • Operating Savings – 833K • Capital Savings – 905K

4. Team FormationSelf Selection Process • Driven by annual budgetary shortfall - $40 million every year for the last 10 + years. • VP’s, Directors & Pt Care Managers self selected on cost reduction teams that would meet for 16 hours a week for 4 weeks straight to identify opportunities • Sr. Leadership initially reluctant to start Green Team due to cost concerns…started at last minute as after thought. I had 2 minutes to form the team and get them organized. • People wanted to work on a new team, something that provided hope, that they could really put their heart into not the same supply chain, ADT, charge capture, etc…teams that form every year!

5. Facilities Planning and Operations Pastoral Care Perioperative Services Women’s & Children’s Services Central Sterile Processing Emergency Planning Human Resources Marketing and Planning Strategic Planning Financial Planning Purchasing / Contracts Materials Management Environmental Services Food Services Employee Health Food & Nutrition Diverse Team Membership

6. UMMC Waste Tracking

7. THE GREEN TEAM FISCAL YEAR 2008 THE PLAN

8. Financial Savings Targets

9. THE GREEN TEAM FISCAL YEAR 2008 WHAT HAPPENED!

11. Sharps Containers • Implemented pilot of recycled sharps containers in Periop, Lab and ICU. Will be rolled out house wide in FY09. • 63,000 lbs to be diverted from the incinerator • $77,000 annual savings in containers, labor and disposal.

12. Open / Unused Supplies • Resterilizing open / unused supplies in the OR, Cath Lab and EP lab • 2 tons of supplies diverted from the incinerator • $50,000 annual savings

13. Cardboard Recycling • 266,000 lbs of waste diverted from the incinerator • $50,000 in waste disposal costs will now be avoided once the incinerator contract amendment goes into effect.

14. Isolation Supplies • Changed practice of isolation supply management • Minimize stocking in patient rooms • $134,000

15. Construction Management • Use recycled furniture on projects • Recycle demolition materials • Incorporate sustainable principles in construction contracts • $905,000 savings in construction costs • $156,000 savings in depreciation expense

16. Utility Management • Turn off business PC’s, printers, fax machines, monitors, etc… at night and on weekends. 1% of energy consumption • Facilities management of utilities • Daily Code Red Alerts and adjustments to usage by individuals • 6% - 9% reduction in energy costs depending on how evaluated (by bed, by patient day, etc…) • $500,000 savings

17. THE GREEN TEAMUtility Management

18. THE GREEN TEAMUtility Management

19. Recycle Blue Wrap & other Plastics in the Operating Rooms • The Operating Rooms, ER & L&D are now recycling blue wrap, saline bottles, bunny suits and all other plastics.

20. Annual FinancialSavings

21. Evaluating SustainableAlternatives • In addition to doing a clinical and financial analysis on new products, conduct an environmental analysis. UMMC has started to ask the following questions regarding new supplies: • Will they take back the product it is replacing? • What is the life cycle cost of the item? Purchase, Service, Energy, Parks, Disposal • Does it contain mercury, latex, PVC, etc… • Can the packaging / product be easily recycled? • Is the package/product made of recycled material? • Can we reprocess the item? • What is their history regarding upgrades? How often do they come out and to they take back the old product? • Is the company ISO certified 14001? • What are their efforts to “green” their operations & distribution? • Are they members of Hospital’s For A Healthier Environment?

22. Evaluating SustainableAlternatives - Response • The answers we receive indicate many vendor representatives do not know what sustainability means and are not aware of their company’s initiatives if they exist. • Most vendors representatives do not know what materials their products contain other than if it contains latex or mercury. • The Novation database does not contain enough information on sustainability so that individual member hospitals don’t have to ask every vendor these questions.

23. Evaluating SustainableAlternatives - Next Steps • Contracts is modifying their standard contracts to include UMMC’s sustainability contracts. • Vendor Education – UMMC and MDH2E will be piloting a vendor dialogue on 11/20/08 to educate local representatives on what sustainability is, what UMMC is doing and expects in terms of sustainability and the impact of waste on their local community and families. • Value Analysis – Development of a environmental product analysis template that is complementary to our clinical and financial analysis templates. • Asked that a UHC Council on Sustainability be established – Approved – Thank You 

24. Preliminary FY09 Goals • Implement segregation of regulated and non-regulated waste. Implement recycling. Target reduction in incineration from 80% to 40% of current waste stream. • Implement environmentally preferable purchasing, i.e. PVC free • Implement coordinated car pooling program with University • Implement green roofing • Implement farmer’s market • Implement sustainability curriculum

25. Preliminary FY09 Goals • Increase energy conservation initiatives • Increase construction recycling and reuse programs • Conduct Green Guide gap analysis and become compliant with Green Guide • Increase local food purchase and consumption in cafeteria and patient care areas. • Implement IT green practice standards • Create an environmental management system (per ISO 14001 or similar) for UMMC

26. THE GREEN TEAMLinks • http://www.premierinc.com/epp/ - Environmentally preferable purchasing (EPP) • http://www.sustainablehospitals.org/cgi-bin/DB_Index.cgi - Sustainable Hospitals • http://www.epa.gov/ - Environmental Protection Agency • http://www.hospitalbuyer.com/ - Hospital Buyer • http://www.h2e-online.org/ - Hospitals for a Healthy Environment • http://www.gghc.org/ - GREEN Guide for Health Care • http://www.theGREENguide.com/ - National Geographic – The GREEN Guide • http://www.healthdesign.org/ - The Center for Health Design • http://www.noharm.org/ - Health Care Without Harm

27. THE GREENE TEAMContacts • Oversight Team • Victoria Stewart, MBA, Co-chair, 410-328-2684 • Jim Chang, Co-Chair, 410-328-6001 • Harold Polk – Sustainable Development Coordinator, 410-328-6491 • Chris Tamburo – Waste Manager, 410-328-0876 • Administrative Green Team, Harold Polk, Chair • Patient Care Green Team – Chair, Denise Choiniere, RN, 410-328-5426 • Periop Green Team • Marnie Kommalan, RN, GOR – 410-328-5910 • Ann Cross, RN, STC OR – 410-328-6850 • Joan Plisko – MD H2E, plisko@son.umaryland.edu

28. Unquantifiable Ideas - Insert