Cutting Waste in Healthcare with Practice Greenhealth’s Laura Wenger

September 4, 2013

JOHN SHEGERIAN: Welcome back to Green is Good, and we’re so excited and honored to have on with us right now Laura Wenger. She’s the Executive Director of Practice Greenhealth. Welcome to Green is Good, Laura. LAURA WENGER: Thank you. Thank you for having me. JOHN SHEGERIAN: Hey, Laura, you know, we’ve had Practice Greenhealth on before. It’s such an important topic. It’s not covered enough in the media, but before we go into that, we want you to tell our listeners how you had a very interesting journey, how you became the Executive Director of Practice Greenhealth and what led up to this and was this always a dream of yours or how did it really all evolve? LAURA WENGER: Sure. It wasn’t exactly predestined or planned but it is funny how things happen. I’m a nurse by background and worked in critical care for probably more than a decade and was involved with management of cardiac and medical ICUs for quite a while and decided at one point in time for some work-life balance, I really wanted to get rid of that pager, to go on to the business side of healthcare and had a great opportunity to move to Chicago and work with a group purchasing organization where I helped them decide on contracts that go on to 3- to 500 hospitals contracts basically that we worked with and evaluate products and who was awarded various contracts and in evaluating those products, one of my biggest components as a CEO at the time was a strong advocate for environmental attributes of those products and so we developed our own environmental purchasing program as we started to evaluate those products and various suppliers and vendors and became very familiar and really relied on Practice Greenhealth and their resources in looking at products that were being evaluated in their annual conference and then decided as the time came and we went through a merger they needed some additional help with education and training and I did that for a short while to help them and then their board of directors actually approached me and there was an opening and two years later, here I am. JOHN SHEGERIAN: That’s so interesting, and for our listeners out there, Practice Greenhealth, we’ve had them on the show before. You guys are doing such important work. I’m on your website now and the website is PracticeGreenhealth.org. Can you just platform what does Practice Greenhealth do? What’s your mission? LAURA WENGER: Absolutely. Well, Practice Greenhealth, we are a nonprofit membership based organization. Our current membership encompasses about 1,300 hospitals, primarily in the United States and a few hospitals in Canada. We also have business memberships as well as other clinics and community health centers that participate in our membership. Our real mission and goal is to help educate the healthcare sector and the communities to become more environmentally sustainable and look at their own internal operations within the hospitals but also how their operations impact the communities and the health of the patients and staff that they serve. JOHN SHEGERIAN: Okay, and so now, that leads into my first question then: Why is it important for hospitals to incorporate sustainability into their operations? LAURA WENGER: Absolutely, and you know, our hospitals, what I think is important to realize is healthcare is almost 18% of the gross domestic product in the United States so it’s a significant part of the economy and in many communities, maybe not in the large or urban areas, but in many communities, the hospital is the largest employer of the staff and it comes from that direct community. The hospitals are usually one of the largest if not the second largest users of energy of any discipline next to food service production across the United States and a large consumer of waste unfortunately so even though we’re trying to make our hospitals and communities and patients healthier, healthcare tends to be a large contributor and a large polluter to that community, so it’s really important for hospitals to really look at this not only as their own internal operation and how does it impact their own triple aim and bottom line but also, how is it impacting the community and their own staff. JOHN SHEGERIAN: What are the benefits of greening a hospital or making it more sustainable, let’s just say? LAURA WENGER: Sure, so there’s so many benefits, John, but we try to look at it from a couple different perspectives. There’s definitely a quality benefit and patients are not only asking if the nurse has washed her hands for infection control but they’re also looking at what kinds of supplies are they using. We have a much more educated consumer population and patients coming in now with the internet being available so the consumers and the patients are asking these questions but there’s benefits to the staff. Nurses have one of the highest rates of occupational asthma of any discipline. They’re exposed to continuous stimulants and cleaning supplies and solvents and so forth. It does really trigger a lot of asthma rates with the nursing population so you can make your hospital safer for your own staff, decreasing call-offs and work on quality for the patients as well as there are significant cost savings, huge impacts in energy, water. We have hospitals in our membership that are saving six figures with making some fairly small and minor changes and seeing huge impacts in their bottom lines across their operational costs. JOHN SHEGERIAN: So, Laura, it’s not only making a better and healthier environment for the employees that work there, the professionals that work there, but for also your clients, your patients and also you create a cost savings for the operators of the hospital. LAURA WENGER: Absolutely, and that’s where I think our big impact is. It’s really very much a win-win and once we start getting hospitals more educated, too often I think we focus a lot on just the purchase price but really, it’s not just what you’re buying. It’s the actual decrease in expense on the opposite end. JOHN SHEGERIAN: Hey, Laura, the show is called Green is Good. I’ve heard there’s something called now green operating rooms. Talk about green operating rooms versus typical operating rooms. LAURA WENGER: Yes. One of the large initiatives that we’ve done at Practice Greenhealth was to develop a greening the OR program and really launched this whole initiative around the operating room and the reason why we targeted that specific department within the hospital, because it is relatively small square footage when you look at the size of a typical full hospital, but that small number of rooms in the operating room department actually accumulates almost 30% of the entire waste stream for the whole hospital so it’s really a significant opportunity to decrease waste, look at recycling initiatives, decrease the volumes, but it also has a lot of supply costs, a lot of chemicals being used, a lot of energy usage that also goes into the operating room so we try to help educate the hospitals and say, ‘If you’re going to start looking at some really targeted, focused areas, the operating room is really a strategic place to really start doing some green initiative.’ JOHN SHEGERIAN: Also, we found that a lot of chief sustainability officers are the supply chain managers of companies. Can you talk a little bit about how you start changing the purchasing departments of hospitals and how do you help them make greener choices when it comes to medical products versus that potentially aren’t as sustainable? LAURA WENGER: Yes, so what we really try to focus on and it’s kind of an adjective we try to describe a lot is if you focus on what’s coming in your front door, you don’t have to worry about what’s going out your back door and a lot of people don’t always think that way but it’s very true and so what we’re trying to help educate our hospitals and our members on is looking at not only just what are they buying but also, how is it being supplied in the packaging of what they’re buying, for example? So, we have encouraged and we developed working with the five largest group purchasing organizations in the country, which represent multiple billions of dollars in purchases across the U.S., and helped them come together and come to a consensus and standardize environmental questions they’re now building into all of their RFPs and their contracts so it really is requiring the vendors now to disclose all of the chemicals and different various components of their products before they’re being bought so now our role is now that we’ve gotten the at disclosure and that information built into the process is educating the hospitals to go to their GPOs, to look at their contracts, evaluate that information when they’re making their purchasing decisions up front. JOHN SHEGERIAN: Wow, that is so interesting so how about when it comes to green building? Is this whole LEED, let’s just say, trend getting involved also with regards to hospitals? Are hospitals being built greener now also and becoming LEED or Gold LEED certified and all that other kind of stuff? Is that part of what you’re also doing in one of your initiatives? LAURA WENGER: Well, we definitely absolutely promote hospitals in looking at their green environment and their built environment. Some hospitals are quite old and aging buildings in our communities and were built way back quite a long time ago and so they’re not as efficient, especially maybe on energy and the type of coal powered, etcetera that they’re utilizing so definitely in the building of new facilities, you see LEED being used a lot and we have numerous hospitals in our membership that have achieved LEED certification of a gold and even at a platinum level, which is quite hard to achieve on new but we also have hospitals that go through. They maybe not always have the financial whereabouts to build a brand new campus but they’re doing significant renovations so they’re definitely looking to become more environmentally sustainable in the way they’re being built knowing that the ROI is going to be paying out over short period of time and saving them significant cost on their energy bills, in particular, water-minimization efforts. JOHN SHEGERIAN: Laura, we have about five minutes left, and I want to cover some important topics. When everyone goes to a hospital or they have a loved one or a friend go to a hospital, one thing that people always either make fun of or becomes part of the vernacular at a hospital is the food tray and then the food services but food has become such an interesting part of, so embedded in our culture but also, the food revolution that’s going on towards organic, towards veganism, towards vegetarianism and fresh and local, how does that play into what you’re doing at Practice Greenhealth? And for our listeners out there, I’m on Laura’s website right now. It’s amazing, PracticeGreenhealth.org. Both for your employees and also your patients and also, has composting become part of any of the initiatives that you’re covering and encouraging? LAURA WENGER: You know, I’m glad you brought it up because it is a very important issue and it is an ongoing problem but it’s starting to really see a significant turn, which is really encouraging so from a couple different angles. One obviously is looking at healthy and more nutritious food options, for the patients, staff, as well as the employees. Most nurses, for example, are there for 12 hours a day and they’re eating in the cafeterias so you’re wanting to provide much more healthy nutrition looking at how the nutrition impacts chronic disease such as obesity and diabetes that’s then bringing patients into the hospital but then we also try to focus at Practice Greenhealth a little bit more on the environmental and the sustainability aspects and the encouraging of purchasing food that is locally sourced from farmers. Why are you paying to transport your food 2,000 miles across the country when you can purchase it from a local farmer and save all of that greenhouse gas emissions from the transportation of it? Plus, having it obviously maybe much more nutritionally sound and fresh because it is being sourced locally so what we have seen- and some hospitals have been highly successful in this and I can even spotlight like Fletcher Allen or Dartmouth Hitchcock hospitals and they have a very high northeast climate so they’re not exactly have a really long growing season but yet, they have been able to work with their local farmers and food hubs and actually do more contracting to get sources in and know for a fact, Fletcher Allen in Vermont now sources 90% of their beef produced from farms only within the Vermont area so hospitals, once they do this, it’s not always just buying off of national food distributor contracts. When they start actually going off the national contracts and start looking at what’s available with their local farmers are really able to make a big difference on top of the fact that many of our hospital members are actually incorporating farmers’ markets into their cafeterias and on their campus to allow the staff and others to support that local and actually support the ongoing economy within their own community. JOHN SHEGERIAN: Wow. How about composting? On the excess food that’s left over at the end of the day, is composting becoming also an initiative that’s talked about and encouraged at Practice Greenhealth? LAURA WENGER: Yes, absolutely, and many hospitals already have these programs in place. Some of them also have food donation programs for local food shelters. Obviously, for excess food from the cafeterias but composting is absolutely occurring and it really is kind of beneficial even with some of the hospitals even developing their own small farm areas on the campus. JOHN SHEGERIAN: Wow, so we’re down to the last minute or so. I want you to share your vision, Laura. What is a sustainable of the future going to look like? Give us a little snapshot. LAURA WENGER: Boy, that’s a good question. Trying to look out and we all wish we had that crystal ball, that vision, but our goal would be to really start helping the hospitals and the community to incorporate sustainability in all three aspects of the triple aim so sustainability can be incorporated into the patient quality aim of increasing the quality of the care being provided by decreasing chemicals, irritants, exposures and so forth within the hospital itself. Sustainability should be incorporated into the other aims focused on the community absolutely by decreasing an amount of dioxins and pollution that’s going out in the air quality as well as into the landfills that they’re generating, the amount of greenhouse gas emissions with the amount of energy that they’re using, and then the easier one is obviously is sustainability being incorporated into that financial aim of the hospital. We can help the hospitals truly become more educated and save significant dollars on their operation costs by making some small changes and really impacting the communities and the staff and patients that they serve. JOHN SHEGERIAN: Thank you, Laura. You’ve been an amazing guest. It’s www.practicegreenhealth.org. Laura Wenger, you are leading us to healthier communities across the United States and truly living proof that green is good. LAURA WENGER: Thank you.