University of Pittsburgh Medical Center (UPMC) has over a million members covered by health insurance, 2600 npatients per day, 8000 outpatients per day, 16 hospitals, 400 facilities, 5000 doctors and 48000 healthcare workers.
UPMC is the largest employer in the Pittsburgh area, so when they took a stand to promote a sustainable business model, it had a major impact on the city.
The panel today will be a discussion between leaders in the UPMC, focusing on several questions by facilitator Caren Glotfelty.
Question 1: How did you and your facility decide to green your practices?
Leslie Davis – Magee-Women’s Hospital – personal changes in awareness coincided with institutional changes. Early days, people would cite lack of resources as impediment to changing. Now, a can-do attitude and global awareness is more prevalent.
Roger Oxendale – Children’s Hospital – each one was teaching others.
John Innocenti – Presbyterian Shadyside – Everyone was encouraged to think systemwide, not competing across UPMC units. People were encouraged to think outside the box, and share ideas. Devra Davis at U. P.’s Center for Environmental Oncology had great ideas,, such as bicycles for employee shuttling between facilities, but they also had to remember that sometimes the cold Pittsburgh wiinters had to be factored in as well.
2. What does greening mean to you?
Roger – “Heart-healthy parking” space sign for a spot far away from the hospital building. Dining smart and helping employees deal with their own health keeps them feel better about their jobs and improves attendance and turnover rates as well.
Leslie – Removing mercury, changing PVC tubes, and other changes encountered pushback from clinicians. Continual education was needed with both patients and employees.
Roger – luncheon learning sessions for residents have been popular.
Devra – Tikkun olum – Talmudic admonition that we must heal the earth. Goes along with Hippocratic notion of “first do no harm.”
3. What is structure to create and implement greening in your hospital?
Roger – regular meetings held by steering committee, with minutes widely distributed. Other UP experts are brought in to discuss issues. We consider issues such as capital green fund – $5m for capital purchases for green initiatives. Bedford 27-bed hospital has coal-fired furnace, so we used green fund money to pay for new furnace.
Leslie – Greening Committee is multi-disciplinary, with doctors, nurses, researchers, and others involved. Disposables are addressed, as are other issues.
Devra – smaller scale is good for innovation, with partners in philanthropy working with UPMC to make major changes for the region.
John – Green audit was done by researchers, who then presented to executive committee. School of Engineering at U.P. did study of employee and patient indicators to test hypotheses about reducing turnover, promoting employee health, etc.
4. What challenges do you face to stay on cutting edge?
Roger – We must help re-evaluate the pace of work. For example, needle boxes in exam rooms needed to be managed in a different way, saving over $200,000. Reusable needles were good for the environment, but some employees felt over-stretched to just keep up.
John – We must keep focus, especially in the minds of department heads. We must educate everyone as to why we are doing it and why it is important. And we must re-train and do ongoing training for those new employees who are part of the 20% turnover rate in cleaning services.
Leslie – tradition makes people resistant to change. We must use newsletters and eduate people.
John – Cutting back on file storage space helped move everyone toward paperless electronic record-keeping system. Less paper lost also means less errors in services as well.
5. Lessons for broader health care community?
Leslie – CDC guidelines treated as gospel for those afraid of lawsuits. So we follow them, but also push for innovation such as the microfiber mops, which save 5000 gallons of cleaning compound and thousands of gallons of water each year. Plus, less germs are transmitted across rooms.
Roger – Pennsylvania gave $5 million grant to innovate with greening. This gives the organization courage to move forward. Heinz Endowment also is supportive. We must seek innovative funders to give support to these innovations.
6. So much interest that 15 minutes added for questions from the audience. Question – was it a challenge to get board members to support innovations?
Devra – Fortune 100 companies all have Sustainability offices. Corporate sector knows that going green pays in the long run, in many ways.
Roger – There are enough models of success now, so education means to just show them some of the successful programs and describe savings.
John – Being community leaders is important to hospital boards, so remind them of their community responsibility.
7. How do you tie compensation to greening?
John – Well, money is green. Seriously, Presby-Shadyside has no system-wide incentive for greening.
Devra – but there are stretch goals to encourage more innovation.
8. Tying together greening and capital budgets
John – We go through lists of what we are going to build, and think about items where envionmentally sustainable practices can make a difference. Capital limits may require postponing something to the next fiscal year, or thinking about five year replacement plans.
Devra – Green GDP is economic indicator which factors in green concepts. Perhaps similar indicator needed in health care.
John – Routine equipment replacement must be analyzed to see if greening can take place.
Roger – Get bond rating systems to add that to their analysis – “green bucks.”
