Hospitals for a Healthy Environment Getting Started Using the H2E Ten Step Guides

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Hospitals for a Healthy EnvironmentGetting
Started Using the H2E Ten Step Guides

• University of Kansas Hospital
• www.h2e-online.org
• December 6, 2007

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What is H2E?

• H2E was jointly founded by the American Hospital
  Association, the U.S. Environmental Protection
  Agency, Health Care Without Harm, and the
  American Nurses Association. To achieve our
  vision, mission and goals, H2E is educating
  health care professionals about pollution
  prevention opportunities and providing a wealth
  of practical tools and resources to facilitate
  the industrys movement toward environmental
  sustainability.

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What we knowToxicity The Pervasive Impacts of
Mercury

• 2004 EPA Mercury Advisory data (most recent
  released)
• 35 of lakes, 24 of rivers in US under advisory
  (some for non-mercury reasons)
• 13,183,748 lake acres and 765,399 river miles
  under mercury advisory
• 21 states have statewide advisories against fish
  consumption from all waters
• 12 states have coastal or marine fish advisories

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Warming of the Climate is Unequivocal

• The Intergovernmental Panel on Climate Change
  (IPCC) has just completed its fourth assessment
  of the science of climate change, its impacts and
  possible solutions. The panel of 2,500 scientists
  and other experts declared manmade warming
  "unequivocal" and wrote that it could lead to
  climate changes that are "abrupt and
  irreversible.
• International CONSENSUS document

Listen to H2E Climate Change Webinar with Bill
McKibben And Dr. Katherine Shea at www.h2e.org
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Body Burden

• The current chemical burden of individuals is
  unprecedented in human history. There are
  approximately 100,000 chemicals now used in
  energy production, manufacturing, and consumer
  products. Almost all are manmade with 15,000 of
  them produced annually in quantities greater than
  10,000 pounds and 2,800 in quantities greater
  than 1 million pounds a year. Of the 2,800, only
  7 have been tested for developmental effects and
  only 43 have been tested for human health
  effects.
• (Louisville Charter for Safer Chemicals)

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What We Know

• Every one of us is carrying a body burden of
  toxic chemicals
• Children are more susceptible to environmental
  exposures than adults
• The fetus may be harmed by amounts of chemicals
  that do not effect adults
• Already sick patients or the elderly may be less
  able to deal with environmental exposures

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Toxicity What Is The Concern?

• In the U.S. the prevalence of asthma doubled
  between 1982 (34.8) and 2003 (69.4).
• Autism increased from less than 3 per 10,000 in
  the 1970s to more than 30 per 10,000 in the
  1990s.
• 1 in 6 children now have a learning or
  developmental disability.
• In 1940, a womens lifetime risk from breast
  cancer in was 1 in 22, today the risk is 1 in 7.
• The incidence of hypospadius has doubled over
  the last two decades.
• The Center for Disease Control biomonitoring
  studies show that 1 in 10 women have mercury
  blood levels that poses a threat of neurological
  damage to their fetus.
• In 2005, EWG study of neonatal cord blood
  detected 287 chemicals 180 known to cause cancer
  in humans or animals 217 known or suspected of
  being toxic to the brain or nervous system.

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Our material is speaking to us.are you
listening?
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What we know

• Regulated Medical Waste is 5 -20 times more
  expensive to manage than solid waste.
• Paper and in particular cardboard makes up 15-40
  of total waste.
• Cardboard recycling should, at the very least pay
  for itself.
• Paper recycling should beat the cost of solid
  waste disposal. (HIPAA considerations).
• Hazardous waste, while a small portion of the
  waste stream, is 200 times more expensive than
  solid waste.
• A comprehensive waste management program saves
  money

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Show us the Green!

• Sirota Survey Intelligence, a research firm in
  Purchase, N.Y., underlined the relationship
  between companies' environmental practices and
  employees' attitudes.
• The survey findings, released in September 2007,
  show 82 of employees who were satisfied with
  their employers' environmental practices also
  felt proud to be working for their company. By
  comparison, just 55 per cent of those
  dissatisfied with their employers' environmental
  practices said they were proud of where they
  worked.
• "If employees take pride in working for their
  company, then that unleashes unbelievable
  creative energy and ideas that will help the
  company be successful," Mr. Willard says.

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Three goals of healing environments
Reduce stress of the buildings occupants

• Connection to nature (daylight/ views)
• Choice Control (light and ventilation)
• Social Support (program areas)
• Positive Distractions (views/ program)
• Elimination of Environmental Stressors (noise)

A better building is one that facilitates
physical, mental, and social well-being and
productive behavior in its occupants
Improve Safety

• Improved Indoor Air Quality
• Supportive Lighting Design/ Reduced Glare

Contribute to Ecological Health

• Healthier Materials
• Reduce Energy and Water Use

http//www.healthdesign.org
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Why a commitment to the environment?

• Safety
• Liability
• Community Relations
• Cost Savings
• Indoor Air Quality
• Environmental Impact
• Regulatory Compliance
• Mission Statement
• Healing Environment
• Commitment to Health

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Where do we start?

• Theres so much to do
• How do we get started?
• Who is in charge?
• What to do first?
• No Space!
• No Time!
• No Money!

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1998 American Hospital Association U.S. EPA
Memorandum of Understanding

• 1 Virtual elimination of mercury-containing waste
  from healthcare facilities waste streams
• 2 Reduce total waste volume
• 3 Identify hazardous substances for pollution
  prevention and waste reduction opportunities,
  including hazardous chemicals persistent,
  bioaccumulative, and toxic pollutants.
• H2E www.h2e-online.org

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Ten Step Guide to Getting Started
http//cms.h2e-online.org/partner/10steppartner/

• Step 1 Form a Team
• STEP 2 Subscribe to H2E Program
• Step 3 Assess Your Facility
• Step 4 Establish Baseline Data
• Set Waste and Mercury Reduction Goals

• Step 6 Develop an Action Plan
• Step 7 Kick off the Program
• Step 8 Educate Employees
• Step 9 Track, Measure, and Record Progress
• Step 10 Celebrate Your Achievements

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Greening Your Facility Data

• Materials and Waste
• Occupational Exposure
• Regulatory Infractions
• Air Quality Reports
• Environment of Care Rounds

• Patient Satisfaction Surveys
• Worker Suggestions
• Lost Work Days

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Waste Data what else?

• Risk Management Lost work days, employee
  accidents
• Regulatory Infractions
• Worker morale issues
• Air Quality Reports/complaints
• Respect Issues (sanitary break space, day
  lighting, places of respite, cleanliness)
• Board of Directors/Funding Opportunities
• Patient Satisfaction Surveys
• Facility Audit What are common suggestions,
  complaints, concerns
• Learn from front-line workers get into shops,
  waste areas, sterilization, disinfection, O.R.,
  food Services, radiology, sub basement, break
  rooms, endoscopy, outpatient treatment care areas
  listen!

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Inventories On the ground

• Theres no easy way around it. Walking floor to
  floor, unit by unit and seeing is believing.
• So even if the unit/area insists they have no
  mercury.

Mind if I take a look around?
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Introduce the Front door to the Back Door

• Evaluate what and from whom we purchase medical
  supplies and equipment for its impact on
• the environment (air, water, electric, gasoline,
  etc.) during its use and upon disposal
• staff and patients health (chemical exposure,
  allergens, etc.)
• cost of use and disposal
• Group Purchasing Organization contracting and
  research support of environmentally preferred
  purchasing

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Environmental Structure

• JCAHO Environment of Care
• Quality Improvement
• Mission or Ethics Committee
• Green Team
• Infection Control Consortium

• Multi-disciplinary councils representing each
  hospital site (i.e., EVS, surgical services,
  radiology, materials management, etc.)

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Partner Toolbox
http//cms.h2e-online.org/partners/toolbox/

• Sample Kick-Off Memo
• Press Release for Joining H2E
• Sample Environmental Commitment Statements
• H2Es Self Assessment Guide
• Tips on Getting Press
• H2E Logo and Logo Guidelines
• H2E Webinars
• Awards Fact Sheet
• Sample Results of H2E Award Media Outreach
• Sample Boulder Community Hospital Recycling Flyer
• Sample Environmental Stewardship Brochure

• Intro to H2E Fact Sheet
• Intro to H2E PowerPoint Presentation
• 10 Steps to Getting Started as an H2E Health Care
  Facility Partner
• 10 Steps to Getting Started as an H2E
  Organizational Partner
• Getting Started as an H2E State Partner
• Sample Partner Goals
• Sample Facility Newsletter for New Partners

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H2E Ten Step Guides

• Mercury Reduction
• Regulated Medical Waste Reduction
• Composting
• Environmentally Preferable Purchasing
• Fluorescent Light Bulb Recycling
• Integrated Pest Management
• Transition to Cidex OPA
• Green Cleaning

http//cms.h2e-online.org/partners/toolbox/
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Specific Partner tools include

•  Getting Started An H2E Partner Assessment Tool
• Intro to H2E and data collection Webinar
• Immediate access to industry-wide Listserv for
  all departments
• H2E Partner Hotline for answers to your questions
• StatGreen newsletter
• Greener Operations Now! Newsletter
• Making Medicine Mercury-Free Teleconference
• Online Tool Kits addressing key operations areas
• eWelcome packet
• Certificate of participation
• Eligibility for annual awards program
• Listing on H2E Community Page
• 50 Discount on annual subscription to bi-monthly
  teleconference series (link) and the Waste Data
  Tracking Tool (link)
• Discounted rates on customized technical and
  consulting services

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H2E Environmental Excellence Awards and
Pharmaceutical Waste Workshop Stats May 14-15,
2007, Minneapolis, MN

• 193 in attendance
• 500 Printed Copies of Pharmaceutical Blueprint
  paid by Kendall given our or sent after event.
• Clancy, Mercury sniffing dog
• Over 120 awards given
• Keynote by Pete Myers
• Sessions on DEHP, Data Collection,
  Pharmaceutical Waste, case studies on pharm waste
  management.

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H2E Environmental Excellence Awards SAVE THE
DATE May 20, 2008 www.cleanmed.org Pittsburgh
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Web Site Area of hits/interest
Home Page 87,787 hits in September, 2007
Products and Services Directory 34,956 hits in September, 2007
Teleconference Pages 25,735 hits in September, 2007
Announcements Only List Serve 4 posts per month 2,401 registrants
Stat Green Newsletter 3,300 visits
Information exchange list serve 149 posts per month (membership driven and moderated by H2E.) 1,716 registrants
Pharmaceutical Blueprint Report 14,088 hits in 2006/2007 5,600 visits
Average Number of Participants in GGHC/H2E Green Building Teleconference (1x month) 115 per call
Average Number of Participants in H2E Operational Teleconference (1x month) 71 per call
h2e web stats
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h2e webinar series
GGHC/H2E Green Bldg. 1st Friday of month/90 min GGHC/H2E Green Bldg. 1st Friday of month/90 min H2E Operational Call 2nd Friday of month/90 min H2E Operational Call 2nd Friday of month/90 min Regular Calls Monthly intro/bimonthly MMMF - free
Intro to GGHC 95 Pharm Waste 107 MMMF _at_ 20/call
Energy H2O 111 RMW 60 Intro _at_ 15-25/call
Connect to Nature 95 Food Volume 87
Furnishings 137 CD 114
Toxic Avoidance 77 OR Reduction 125
Top 5 attended calls in 2007
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h2e staff
Janet brown 413/253-0254 Janet.brown_at_h2e-online.or
g
Mark Tecca, Bus. Alliance
Lin Hill, Awards Coordinator
Bill Craig, Now Asst Prof in NH College
Cecilia DeLoach
Laura Brannen
Julie Taylor!
Janet Brown
Im Sarah, but I now work for EPEAT!