Download The Clean, Green Initiative - Physicians for Social Responsibility

Seattle Children’s Hospital
Clean, Green Initiative
Final Project Report – January 2010
Submitted by Washington Physicians for Social Responsibility
Purpose of this report:
This report is designed to update the Martin-Fabert Foundation concerning 2008 and 2009
Sustainability Initiatives performed at Seattle Children’s Hospital. Further, it is hoped that this
report will serve as support for other medical facilities interested in these practices.
In 2007, Children’s launched the Clean, Green Initiative, which aims to set a high standard of
environmental stewardship in the community as well as demonstrate leadership among
hospitals nationally. Since then, Children’s has made significant strides toward reaching this
goal. This report outlines the major activities and progress over the past year and previews
some upcoming “green” projects.
For support and guidance, Children’s has enlisted the help of Health Care Without Harm through
a grant from The Martin-Fabert Foundation, which also provided funding for internal staff
support of this initiative. The Clean, Green Initiative now carries huge momentum internally,
across practically every department in the hospital.
Why Seattle Children’s Hospital?
Seattle Children’s Hospital is not afraid to stand out: they were among the first in the country to
sign the Healthy Food in Health Care Pledge; they are one of only two medical facilities in the
Seattle Climate Partnership; and they recently submitted a Master Plan to the city of Seattle for
campus construction that will allow them to become carbon neutral by 2030. They set lofty
goals and then figure out how to achieve them. They pilot new projects and share their results
Why can Seattle Children’s Hospital take these types of risks, when so many medical facilities
shy from disrupting the status quo? Much of that likely stems from their mission:
We believe all children have unique needs and should grow up
without illness or injury. With the support of the community and
through our spirit of inquiry, we will prevent, treat and eliminate
pediatric disease.
Because “prevention” is a part of the Seattle Children’s Hospital mission, it allows the staff to
adopt elements of the precautionary principle into their purchasing decisions. In its simplest
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1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
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form the precautionary principle puts action behind the words: first, do no harm. If something
might be a health risk, Seattle Children’s can take that into account. When selecting a product or
process, factors like ‘efficacy’ are balanced by factors like ‘environmental health’ and ‘lifecycle
analysis’.
The other phrase that stands out is “spirit of inquiry:” asking questions is part of the culture at
Seattle Children’s Hospital. This is most apparent in their adoption of Continuous Performance
Improvement (CPI). Pioneered by the Toyota Motor Company, CPI is a way of constantly
searching for better ways to do things. Because CPI is part of the Seattle Children’s culture, staff
time is dedicated to improving existing processes aimed at increasing efficiency and reducing
waste. Change is an integral part of the organizational structure, and protocol has been
established for introducing staff to new ideas and tinkering with existing procedures.
A prime example of this approach can be seen in the hospital’s construction of a new LEED Goldcertified clinic in Bellevue. To increase efficiency, an Integrated Design Process was utilized that
brought all the developers to the table to discuss the new construction prior to breaking ground.
In this process, developers and contractors were able to communicate their needs and abilities,
and agree on solutions to problems before they physically arose. Although this sounds like
common sense practice, it is unusual. The Integrated Design Process coupled with the LEED
certification process created synergies, which worked together to make both processes more
effective. This type of upstream thinking reduces costs by reducing waste and inefficiency
before they are generated. As a direct result of the IDP process Children’s Bellevue facility was
awarded a $540,000 grant from Puget Sound Energy, and will realize $117,000 in energy savings
yearly.
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1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
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Seattle Children’s Hospital 2008-2009 Sustainability Initiatives
Table of Contents
Energy……………………………………………………………………………………..4
Transportation……………………………………………………………………………..5
Food Service……………………………………………………………………………....6
Waste Management………………………………………………………………………..7
Environmentally Preferable Purchasing…………………………………………………..8
Pilot Project: Organic Cotton Linens……………………………………………………..9
Washington Physicians for Social Responsibility
1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
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ENERGY:
“The biggest issue is culture change.”
–Jeff Hughes, Sustainability and Grounds Manager
Recent Accomplishments:
 Completed 2008 Carbon Footprint Assessment
 Letdown turbine installed to generate on-site electricity
 Energy reduction through changes in lighting and computers
 Re-lighting to replace outdated fixtures
Carbon Footprint Assessment:
In May, Children’s Hospital brought in an environmental scientist from Sweden in an internshiplike capacity. Jakob Sjoberg is currently conducting a carbon footprint assessment of Seattle
Children’s Hospital to identify areas of improvement for the facility. Initially, it looks as though
the largest area for improvement is a reduction in energy consumption. Seattle Children’s
utilized the Seattle Climate Partnership tool for this assessment.
2030 Plan:
Seattle Children’s Hospital would like to reduce its energy consumption of non-renewables to
zero by 2030. They are working toward this goal by investing in alternative energies. Children’s
Hospital has made a commitment to reducing greenhouse gas emissions, in an effort to make a
healthier planet for the children they serve. Money saved can be re-directed toward pediatric
care. This goal is contingent upon approval of the Master plan for the campus.
Energy Efficiency:
Although Seattle Children’s Hospital already utilized motion-sensitive lighting in offices and
conference rooms, they are planning to incorporate a Lutron system that senses ambient
lighting in rooms, and adjusts the lighting accordingly. For example, a light next to a window
could be turned off during the day without disrupting light in the rest of the room.
Seattle Children’s is also working with Seattle City Light to replace one type of old light bulb
facility-wide with Energy Star-rated light bulbs.
Finally, Seattle Children’s is looking for a way to turn computers off when not in use. Currently,
the computers run 24 hours each day and 7 days every week, at an estimated cost of $400 per
year per computer. With a new Windows 7 operating system, some computers will be turned off
when not in use, without data loss.
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1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
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TRANSPORTATION:
“Driving is really expensive, and a lot of those costs are hidden. We try to make them more
apparent.”
--Paulo Nunes-Ueno, Director of Transportation
Recent Accomplishments:
 130 “Company Bicyclists” who commute by bike at least 2 times per week
 3rd largest employee shuttle program in Washington
 70% of Seattle campus signed up for MyCommuteTools.org to track monthly commutes
 1,508,696 miles have been saved from single-driver commuting
 1,063,969 pounds CO2 kept out of the atmosphere
 54,836 gallons of gas not used
 149,266 trips saved since October
 8% reduction in drive-alone trips
Company Bike:
Employees who promise to bike to work at least twice per week are given bicycles by Seattle
Children’s Hospital. This has multiple benefits: it benefits employee health, reduces the facility’s
carbon footprint, and decreases the number of parking spots needed at the hospital. The
program is monitored by MyCommuteTools.org.
MyCommuteTools.org
This online tracking device allows employees to monitor how they get to work each day. For
example, if they bike, they drag a bike icon onto that calendar day. Employees receive $3.25 for
each day they utilize alternative transportation, such as taking a bus or shuttle. Additionally,
MyCommuteTools.org tracks savings generated in dollars, carbon emissions, and wear and tear
on personal vehicles to highlight the cost of driving alone.
Seattle Children’s Hospital runs the 3rd largest shuttle service in Washington, after Boeing and
Microsoft, both companies with significantly more employees. Shuttles pick up employees in
Seattle’s University District, which is a major bus hub, as well as from 7 other Seattle Children’s
buildings/parking lots and drive them to and from the Seattle Children’s Hospital campus.
Seattle Children’s is currently working with King County Metro to create an all-electric vanpool
fleet.
Employees who drive to work are charged $5 per day to park. Thus, there is a double incentive
to find alternate transportation. In the 2008 Carbon Footprint Assessment, employee commutes
accounted for approximately 10% of facility-wide greenhouse gas emissions—a significant
amount. The 2009 transportation initiatives seek to reduce that number.
Washington Physicians for Social Responsibility
1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
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FOOD SERVICE:
“We’ve always served a lot of vegetables, but we’re trying to find ways to make them more
interesting.”
–Walter Bronowitz, Executive Chef
Recent Accomplishments:



Switched patient meals to match new federal school lunch guidelines, reducing sweet
portion sizes and emphasizing vegetables
Modified snack cart to reflect healthier options; removed Snapple beverages
Organics To Go provides Grab n’ Go options in cafeteria
Due to hospital-wide budget restrictions, Chef Walter was not able to bring about all of the
change he wanted to see in 2009. Specifically, he was not able to switch cafeteria service ware
to compostable materials, and is still using plastic bowls, although the plates are compostable.
However, Chef Walter was able to switch the 3-pack service ware used for patient meals to
compostable materials.
Also, Full Circle Farm is no longer holding a farm stand on-site, which means that the kitchen is
no longer able to profile a seasonal, farm fresh item. However, Full Circle Farm’s CSA program is
still operational.
Environmental Sustainability and Waste Management:
Seattle Children’s Hospital utilizes a tray return service, which allows cafeteria patrons to leave
post-meal trays on a conveyer system which cycles to the dish area, where the tray is sorted by
staff. A staff member separates the compost, recycling, and garbage into separate bins before
the tray is sent through the dishwasher.
One key to Seattle Children’s successful waste disposal is employee education. There are
multiple signs in the kitchen depicting how materials should be separated, including one large
poster titled “Go Green With Composting” with photographs depicting specific cups, plates, and
other items found in Children’s cafeteria. Informational material on recycling and composting is
posted in English, Spanish, and Mandarin.
Used cooking oil is collected and stored in a container near the recycling, composting, and
landfill dumpsters. The cooking oil is collected by a company called Standard Biodiesel, and is
turned into fuel.
Master Plan Kitchen Proposals:
Approval of Children’s Master Plan includes larger facilities with more room for processing fresh
produce, and a rooftop herb garden.
Washington Physicians for Social Responsibility
1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
www.wpsr.org
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WASTE MANAGEMENT:
“You have to understand where your waste is going.”
–Mitch Birchfield, Environmental Services Manager
Recent Accomplishments:
 Increased recycling and composting to divert 36% of hospital waste from landfills
 Compost 6 tons of waste per month, reducing waste removal cost by $800 per month
 Began using reusable sharps containers which diverted 36,000 pounds of plastic from
landfill
 Increased training on correct use of Regulated Medical Waste receptacles
 Nominated for a Washington Green Business Award
Strategies:
Because Seattle Children’s Hospital utilizes Continuous Performance Improvement techniques,
they are constantly looking for ways to reduce or eliminate waste while reducing costs.
Environmental Services focuses on “Low Tech or No Tech” strategies to reduce waste, including
enhanced waste segregation and employee trainings.
Recycling:
Seattle Children’s Hospital was able to increase waste diversion to 36% in 2009, up from 24% in
2006. This increase was largely due to Seattle Children’s switch to single-stream recycling, which
means that one mixed-waste receptacle can accept non-sensitive papers, cans, glass, and
plastics #1-7. The waste is separated at the plant, simplifying disposal at the hospital. Seattle
Children’s requires all contract custodial vendors to train staff to properly segregate and dispose
of or recycle materials in the correct receptacles.
Regulated Medical Waste:
One of Seattle Children’s Hospital greatest successes in 2009 came from an unlikely place: the
Operating Room. Because Regulated Medical Waste (RMW) is ten times more expensive to
dispose of than solid waste, and because RMW is incinerated, Seattle Children’s had an interest
in reducing the amount of RMW generated. The Operating Room and Emergency Room are the
main generators of RMW at Seattle Children’s, so staff worked to position the correct containers
in easily accessible parts of the OR. Rather than throwing all contaminated and uncontaminated
materials into the RMW bin, OR staff now sort waste as they work. This simple segregation
practice diverted about 66,000 pounds of medical waste from the waste stream, and reduced
waste costs by $45,000. Nurses were integral in this effort and this exercise highlighted both the
importance of working to reduce waste at the point of generation and the fact that staff can
adapt to new challenges in daily routines.
Washington Physicians for Social Responsibility
1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
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ENVIRONMENTALLY PREFERABLE PURCHASING:
“I want to keep costs low, but I want to be able to introduce new products to meet our changing
needs.”
--Dan Salmonsen, Purchasing and Logistics Manager
Recent Accomplishments:
 Designed organic cotton lab coats with Sustain Tex for 2010 purchase
 Eliminated all products with mercury, including several cleaning products
 Utilize Environmentally Preferable Purchasing standards for cleaning supplies when
possible
 Moving to 100% recycled paper towels
Standards:
Children’s Hospital 2009 Cleaning Plan requires the following:
 Cleaning products must be odor and fragrance-free,
 Products must be Green Seal certified when possible,
 Titrated (concentrated) products be used when available,
 Neutral cleaners on non-critical surfaces and metal-free floor products be used in
patient areas,
 Manufacturer-approved cleaners and disinfectants must be used for equipment and
devices.
The plan is designed to protect the health of patients and staff while maintaining strict
standards of cleanliness. Contract custodial vendors must have a list of the products they will
use, and are responsible for purchasing and tracking Seattle Children’s Hospital’s approved
cleaning products.
Practices:
Seattle Children’s Hospital matches cleaning practices to facility needs by breaking rooms down
into three categories: Critical/High Risk, Medium Risk, and Non-Critical/Low Risk. Because there
is no “green” disinfectant, this allows the hospital to use disinfectants on an as-needed basis,
targeting Critical and Medium Risk areas, with less emphasis on Low Risk areas. They focus
disinfectant use on cleaning high-touch areas. Seattle Children’s utilizes microfiber cloths for
cleaning and dusting, HEPA rated vacuums, and hot water extraction carpet cleaners. Propane
equipment is not allowed.
Seattle Children’s gives preference to items manufactured from recycled raw materials or
renewable resources, reusable items, and items that are totally or partially recyclable. Life-cycle
analysis is taken into account when comparing comparable products.
Washington Physicians for Social Responsibility
1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
www.wpsr.org
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PILOT PROJECT: Organic Cotton Lab Coats
Lab Coats:
Seattle Children’s Hospital is currently in the final design stages of creating a 100% organic
cotton lab coat, as well as an organic cotton and polyester-blend lab coat. Over the last year, the
Purchasing Department has worked with Sustain Tex, LLC to create a prototype that will
withstand wear and tear, while presenting the clean, crisp image expected of lab coats.
Because they are currently the only medical facility pursuing this product, Seattle Children’s
Hospital had to find and work with a manufacturer. Sustain Tex sent a prototype, which the
Purchasing Department has laundry-tested and approved. The single fabric (100% organic
cotton) coats ultimately will be compostable.
The organic cotton lab coats will be an option for clinical staff in 2010. Sustain Tex is tailormaking an organic cotton lab coat for Seattle Children’s CEO, so he can set an example. The
coats currently cost approximately 27% more than conventional jackets, and Seattle Children’s
Hospital would not have been able to justify the cost difference without the support of the
Martin-Fabert Foundation.
Scrubs:
Seattle Children’s Hospital does not provide scrubs to all of their employees. Because employees
often select and purchase their own scrubs, Seattle Children’s Purchasing Department elected to
use jackets—which they provide—for the pilot project. However, Sustain Tex will soon be
introducing a line of 50%-50% polyester-organic cotton scrubs, which will retail for a price at the
upper end of the cost of conventional scrubs. Those scrubs will be available in February 2010.
Sustain Tex, LLC
Sustain Tex plans to launch these lines under the brand name “Mantra” in 2010. Sustain Tex
manufacturers their own fabric, so they are able to maintain costs as well as guarantee the
organic integrity of the fabric. Because the greatest environmental impact is production, Sustain
Tex is able to reduce environmental harm by making sure they utilize environmentally-friendly
chemicals in the production stage.
Sustain Tex is also working on a recycling program for used scrubs, which they hope to premier
at the CleanMed 2010 conference. Used scrubs will be distributed globally, or destroyed and
used for insulation.
Although the organic cotton products are more expensive initially, Sustain Tex believes the cost
will come down when they have built more support for the product. As more hospitals purchase
the products, they will become more in line with conventional costs.
Washington Physicians for Social Responsibility
1604 NE 50th Street, Seattle, Washington 98105 ~ 206.547.2630
www.wpsr.org
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