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Environmentally Preferable Purchasing and Green
Resourcesfrom Premier
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Premier Yes to Green
Corporate
Advocacy
Tools-Resources
Supply Chain
Training
Office recycling Paper Bottles, cans Printer
cartridges Computers Energy savings Green Team
Safety Institute Web Topics A to Z green
buildings, mercury, PVC-DEHP, recycling CEO
Scorecard Case studies Green Link Newsletter
RFI green attributes SCA Catalog Standard
terms Searchable Champions Team Latex catalog
Support for CleanMed - Food Med
Conferences Partnerships with H2E, HCWH,
CDC/NIOSH, AHA Global Health Safety Initiative
Educational tracks at Breakthroughs Governance CD
s of case studies Conference Services - Green
In partnership with our members to improve the
health and safety of patients, workers,
environment, and communities.
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Yes to GreenEnvironmentally Preferable
Purchasing (EPP)

• The goal of Premiers Yes to Green initiative is
  to promote health care that is safe and healthy
  for patients, workers, the environment, and the
  community.
• The Environmentally Preferable Purchasing (EPP)
  program, a component of Yes to Green, involves
  collaboration with our members through our
  committees to identify and contract with
  suppliers for products and services that are
  healthier and less damaging to the environment or
  human health when compared to competing products
  and services that serve the same purpose.

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Environmentally Preferable Purchasing

• EPP What is it?
• The act of purchasing products and services for
  which the environmental impacts have been
  considered and found to be less damaging to the
  environment and human health than competing
  products and services that serve the same purpose.

Premier position statement available at
www.premierinc.com/safety
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Why do we care about EPP? Newborns Show
evidence of toxins

• CDC study of newborns
• 287 chemicals per child
• 180 known to be cancer producing
• 217 are toxic to the brain and nervous system
• 208 cause birth defects or abnormal development

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Why do we care about EPP?A few examples

• Why mercury-free?
• Mercury is toxic to brain, kidneys liver
• Persists in the environment for decades
• Premiers goal mercury-free contracts
• Why DEHP-free?
• DEHP used to soften PVC/plastic medical devices
• Linked to birth defects in animals
• FDA warning risk to infants and nursing mothers
• Why latex-free?
• Latex exposure can cause severe/fatal reactions
• FDA requires products packaging labels
• Latex products must be identified

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Why do we care about EPP?A few examples

• Why products with less packaging?
• Hospitals generate 6,000 tons of
  waste a day
• Half the waste is cardboard,
  paper and packaging
• Why computer recycling and take back programs?
• Computers contain toxic materials like lead
  mercury
• 95 of computers are not recycled - end up in
  landfills
• Why energy-efficient?
• Energy efficient products (eg, energy star rated)
  save electricity and green house gas emissions
• Slows global warming

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Why do we care about EPP?A few examples

• Why organic foods?
• 70 of US chickens fed arsenic as growth promoter
• 75 of antibiotics are used as feed additives in
  animals promote antibiotic resistance
• Why safer flooring?
• Flooring, floor coverings and floor-care
  products may contain substances that negatively
  impact indoor air quality and human health.
• Can be carcinogens or cause asthma-like reactions
  

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The role of Premier committee members

• Help identify additional EPP criteria by product
  category
• Consider EPP criteria when reviewing supplier
  proposals and making contract award
  recommendations
• Recommend products that are safer for patients,
  workers and the environment

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Most importantly

• With our committee members, Premier is able to
  make a difference and provide an opportunity for
  members to purchase products that promote the
  safety and health of our patients, workers, the
  environment, and our communities.

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Premiers Environmentally Preferable Purchasing
(EPP) Program is a collaboration between Group
Purchasing and the Safety Institute
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Premier - H2E Champion for Change Award Winner
five consecutive years, 2003 TO 2007
H2E Hospitals for a Healthy Environment

• First GPO to win award
• In recognition of its environmental leadership
  role in helping hospitals
• Eliminate mercury and other toxic substances
• Reduce volume of waste
• Purchase environmentally preferred products

www.h2e-online.org
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Highlights of Premiers EPP Program

• Mercury Elimination
• 2001 Pledged to eliminate mercury from
  contracted products launched web site on mercury
  elimination
• 2002 Developed list of pharmaceuticals with
  mercury to assist in identification, management
  and disposal of drugs with mercury
• 2006 List of Mercury-free pharmaceuticals under
  contract
• DEHP
• Support DEHP product labeling
• List of DEHP-free contracted products

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Highlights of Premiers EPP Program

• Reuse of single use devices
• Presented testimony to US FDA urging an
  evidence-based approach to any reuse of single
  use device policy
• Web site devoted to reuse
• No position for or against reuse of single use
  devices but support member efforts with contracts
• Led industry in standardizing EPP attribute
  terminology now used in SCA to enhance product
  searching
• LATEX-FREE for products without latex
• DEHP-FREE for products without DEHP
  Di-2-ethylhexyl phthalate)
• MERCURY-FREE for products without mercury
• PVC-FREE for products without polyvinyl chloride
• Latex-free product catalog
• 2008 published latex-free catalog for members
• Includes 16,675 items in 250 product groups from
  445 suppliers

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EPP Integrated into the Sourcing Process

• EPP questions included in standard RFI sent to
  all suppliers
• Corporate environmental and green initiatives
• Energy efficiency
• Impact on indoor-air quality
• Recyclable/takeback programs for products and
  packaging
• Availability of green product and/or packaging
  options
• Environmental attributes of products including
  Mercury, PVC, DEHP, latex
• EPP information requested as applicable to
  product category
• Additional product content such as hazardous
  chemicals and persistent, bio-accumulative and
  toxic pollutants
• Green product / packaging details
• Post consumer recycled content
• Reusable
• Biodegradable
• EPP info included in supplier-product matrix for
  committee members to use in selection process

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EPP Product Attributes in Standard RFI

• Included in item level spend data request
• Described in RFI instructions
• Detailed rationale in supplier disclosure

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Information on EPP Products available for
members in Supply Chain Advisor catalog and
Safety Institute Web site
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Ability to search SCA Catalog forLatex, DEHP,
PVC, and Mercury free items
View Master Contracts Item Search
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Environmentally preferable products attributes
also included in launch materials in SCA
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Products and Contracted Supplier ListsSafety
Institute Web sitewww.premierinc.com/saferproduct
s
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Greener, Safer, Environmentally
PreferredProducts, Supplier lists

• Emergency preparedness
• Back injury and fall prevention equipment
• Hand hygiene products
• IV systems - product specific information
• PVC
• DEHP
• Latex
• Latex-free products
• Medical device reprocessing
• Mercury-free products
• Mercury-free and latex-free pharmaceutical report
• Personal protective attire (PPA)
• PPA (masks, respirators, gowns, gloves, etc.)
  contracts and suppliers
• Pesticide management - environmentally preferable
• PVC-DEHP-free products
• Recycling and waste reduction products and
  services
• Sharps injury prevention devices

Safety Institute Web site www.premierinc.com/epp
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Product, supplier list examples

• IV Systems Product Specific Information
• Product cross-reference includes content
  information for
• Latex
• PVC
• DEHP

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Latex-free Product CatalogIndustrys most
comprehensive

• Latex-free medical products, devices, equipment
• Premier latex-free product catalog February
  200816,675 items 250 product categories 445
  suppliers
• Located on Safety Institute Web site OR
• Supply Chain Advisor, Premier Reports
• OR
• Search SCA item search for latex-free
• Latex-free pharmaceuticals
• Download Latex-Mercury-free pharmacy portfolio
  2006-09
• OR
• Search Supply Chain Advisor (SCA) by individual
  drug

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Product, supplier list example
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Product, supplier list example

• PVC-DEHP-free product
• lists include
• Pharmaceuticals
• IV bags, solutions, nutrition, pumps, tubing
• GI enteral
• Respiratory, ventilator, humidification, chest
  drain devices
• Wound care
• OR urologics, neuro, trocars, catheters, ports

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Safety Institute Web Site

• Safety resources, tools for
• Patients
• Workers
• Environment
• Green purchasing
• Green healthcare

www.premierinc.com/safety
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Highlights- Safety Institute Web siteAll Safety
topics A to Z

• Guidelines-Infection Prevention Safety
• Hand hygiene guideline
• Healthcare Associated Infections
• Influenza resources
• Latex Allergies
• Mercury Pollution Prevention
• Occupational TB Risks
• Patient Safety
• Pharmaceutical waste management
• Recalls and product notifications
• Reuse of Single-use Devices
• Surgical Care Improvement Project (SCIP)
• Sharps Injury Prevention
• Tubing Misconnections

• Back injury prevention
• Bar Coding and UPN
• Cell Phones and EMC
• Clostridium difficile
• Computerized physician order entry
• Computers and electronics
• Construction ICRA
• Culture of Patient Safety
• Emergency Preparedness
• Environmentally Preferable Purchasing (EPP)
• Environmental-Safety Product Lists
• Evidence-based practices-bundling
• Fall prevention
• Green, Safer Products, Suppliers

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Highlights- Safety Institute Web siteGreen -
Safety topics A to Z
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• Computers - electronics
• Safer Green design -construction
• Environmentally preferable purchasing
• PVC-DEHP
• Safer cleaners Pesticides

• Green, Safety Products
• Latex allergies
• Mercury pollution prevention
• Pharmaceutical waste management
• Reuse of single-use devices

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Highlights Executive scorecard
Download at www.premierinc.com/safety Use Quick
link Environmental safety
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HighlightsPremiers GreenLink Newsletter
Subscribe on line at www.premierinc.com/safety
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HighlightsSuccess stories, suppliers and members
www.premierinc.com/greencorner
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HighlightsComputers Electronics in Healthcare

• Environmentally conscious purchasing
• End-of-life solutions
• Reduce, Reuse, Recycle
• Searchable database- recyclers
• Sample procedures and tools
• Premier Contracted suppliers
• Environmental initiatives
• Asset Recovery Services

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Premier in the newsfor our computer contracts
July 17, 2007 In January, President Bush signed
an executive order requiring all federal agencies
to buy only EPEAT-registered products in its
computer purchases. Case cited Premier
Healthcare, a major purchasing organization for
hospitals and health care facilities, as an
example of a company that took EPEAT to heart
from the beginning. "They actually take the
Hippocratic oath, which is 'First, do no harm to
your patients' very seriously, they specify EPEAT
products because they see the connection with
their patients' health."
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Member Education -- Safety Store
www.premierinc.com/safetystore

• On-line catalog
• Safety and environmental products
• Items available include
• Audio files
• Books
• CD-ROMs
• DVDs
• Premier co-sponsored conference materials
• Presentations
• Safety tools

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Advocacy at Premier

• Sponsor of national EPP Programs
• CleanMed, FoodMed
• Public position statements
• DEHP labeling of products
• Reuse of single use devices- science based
  approach contracts to support member choice
• Partnerships
• Hospitals for a Healthy Environment / Practice
• Green Health
• Healthcare Without Harm
• CDC/NIOSH
• AHA
• Global Health and Safety Initiative

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Premiers Internal CorporateYes to Green
Initiative

• Corporate Operations Goal
• Green and environmentally preferable
  considerations will guide the acquisition, use,
  maintenance, reuse, recycling and disposal of all
  products and services throughout Premier
  Corporate offices and business operations.

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Yes to Green . Charlotte Office
Examples of what Premier is doing

• Office recycling
• Cardboard, paper
• Shredded paper
• Small batteries, cell phones
• Printer ink cartridges
• Printing on recycled paper
• Default double-sided printing
• Conference services
• Green Hotels reusable/ recyclable supplies
• Staff Communications on Green
• Monday Minutes
• Web site Inside Premier
• Special Email for suggestions
  YesToGreen_at_premierinc.com

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Slides and Flyers of Premiers Programs available
for download
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Location of slides and flyers for download
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Summary available downloads

• Safety Institute Overview Slides
• Safety Institute Flyer
• EPP Program Summary Flyer
• Selected EPP products List
• Green Link Newsletter
• Hurricane resource List
• Influenza Resources Fact sheet
• Influenza overview Slides and audio file

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Co-sponsorshipEnvironmental -Safety Conferences

• 2008
• National Patient Safety Foundation Annual
  Congress
• May 14-16, 2008 Nashville
• Clean Med Pittsburgh PA
• May 20-22, 2008
• 2007
• Food Med 2007
• June 28-29, 2007 Boston
• National Patient Safety Foundation- Annual
  Congress
• May 2-4, 2007 Washington DC
• 2006
• Clean Med Environmental Purchasing and Green
  Health Care
• April 19-20, 2006 Seattle
• National Patient Safety Foundation- Annual
  Congress
• May 10-12, 2006 San Francisco

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Contact us

• On the Web
• www.premierinc.com/safety
• Email
• safety_institute_at_premierinc.com
• Voice mail
• Safety Institute 704 733 5865