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KSR Publishing, Inc.
Copyright © 2016

         Clinical intelligence for supply chain leadership



September 2016

Special Focus


sustainableSuccess in sustainability? You bet

Sustainability lessons learned

Sustainability trends via Supply Chain

Dartmouth-Hitchcock pushes sustainability envelope

Success in sustainability? You bet

Healthcare Purchasing News asked Greenhealth Exchange owners and shareholders for sustainability success stories they’ve reaped as well as tips for selecting appropriate sustainability projects and "selling" them to administration for implementation support. Here’s what they shared.

Mark FaulknerMark Faulkner, Senior Director of Strategic Supply Chain Management & Sourcing at Partners HealthCare

"One of our system’s sustainability successes was the decision to move away from the class of chemicals known as Flame Retardants (FRs). With amended fire codes for the state of Massachusetts and within the municipalities we operate in we created a standard of going ‘Flame Retardant Free when permissible by code.’ Eliminating this class of chemicals from our products and buildings saves us money as well as removes this toxin from our environment.

"We were always aware that including this class of chemicals in our products, interior furnishings, extended the lead time as well as an additional up charge. The process was to identify the upcharge for the addition FRs to our products, and present the environmental, toxicity, and financial business case to leadership. With approval to move forward the next steps were to create deliverables to help educate our architects, designers, vendors, partners, and colleagues about the new standard, alternative products and validating that we are compliant with the current fire code.  

"To date, in our newest building, Partners Corporate Administrative Building in Somerville, MA, approximately 950,000 sq ft., pending LEED Gold, version 4.0 of a $22-million budget for furnishings, 70 percent of the furniture is free of Flame Retardants, Formaldehyde (per the HHI guidelines), Perflourinated chemicals and less than 1 percent PVC."

Jeffrey ThonpsonJeffrey Thompson, M.D., CEO Emeritus and Executive Advisor, Gunderson Health System

"The efforts at Gunderson Health that are focused around energy include highlights such as:

  • Dropping our greenhouse gasses by 90 percent in 8 years

  • Reducing our energy need by 53 percent per square foot across our facilities

  • Producing more renewable energy than we use on many days

  • Reducing Hazardous pharmaceutical waste by 2,000 percent, and putting any of the profits associated with those efforts towards lowering the cost of care

  • Decreasing our impact on the environment and improving the local economy." 

Running projects up the C-suite flagpole

For administration support, make sure to link the projects and products to patient care and financial goals, according to Partners’ Nakielski. For clinicians’ support, "grow the lines of communication and demonstrate value to their financial goals and operational goals."

Noted Gunderson’s Thompson: "Start with conservation, use many partners, treat it as an investment, prove your results, and stop calling it a project ... it is a way of life.

"These activities should be packaged as part of the organization’s mission," Thompson continued. "Provide proven results and get senior leadership involved, especially those in finance. Implementing sustainable features does not need to be a money-losing proposition that is done because it is the right thing to do. Results can combine savings or profits while creating sustainable future."

Sustainability lessons learned

What are some of the lessons learned from sustainability initiatives? Here’s what two Greenhealth Exchange organizations relayed.

Mark Faulkner, Senior Director of Strategic Supply Chain Management & Sourcing, Partners HealthCare

"There are always lessons learned in what we do [to] improve our process as we continue to align sustainability principles to our purchasing, patient care and financial goals. What resonates with us is ensuring open and honest communication with our colleagues as well as the focus on continuous learning and education of the team. This is for all aspects of Materials Management, including our focus on EPP. We foster relationships through confidence, trust and respect about our product knowledge and subject matter expertise, and when a gap is identified [we] bring in the appropriate individuals, partners."

Lynn DorschLynne Dosch, Director of Supply Chain, Gunderson Health System

  • Don’t look just at first cost rather than considering other value streams in the business case, such as true life-cycle costs associated with products that may not be as sustainable. As an example, there may be cleaning, maintenance, energy, labor and quality cost impacts that can improve a business case for a sustainable product that may be more expensive than the alternative upfront but [you can] save on operating expenses in the long run.

  • Listen to the input of other stakeholders in the process (cradle to grave) that will touch the product during its cycle in your organization. Let them help you find the right solution and balance. Get their consensus and support for the changes required.

  • Just because an item says it’s ‘green’ doesn’t mean it meets our standards. Supply Chain must investigate the product to determine what attributes are present to be labeled ‘green’ and decide if it meets our own standards for use.

  • Don’t be fooled into believing that a ‘green’ product is lower in quality or performance than a traditional product. Take advantage of the growing body of knowledge out there around quality and performance of ‘green’ products. Use your industry contacts to learn about their experiences with products.

Sustainability trends via Supply Chain

What are some of the lessons learned from sustainability initiatives? Here’s what two Greenhealth Exchange organizations relayed.

Monica Nakielski, Senior Program Manager, Sustainability, Partners HealthCare 

  • We are experiencing more interest from our vendors inquiring about what is important to us and align priorities. We view this as a growth in innovation and promotion of many new products and services

  • Chemicals management. There is an increased focus and level of attention towards identifying the chemicals in our products, seeking out alternatives if we discover chemicals of concern and managing the whole process to ensure there are no regrettable substitutions and continuous improvement.

Lynne Dosch, Director of Supply Chain, Gunderson Health System

  • Partnering with a medical device reprocessing vendor. Our partner will collect those that we might not be able to buy back due to contract limitations, and make available to other healthcare organizations. Some items that have met their reprocessing limits can be recycled or used in other products, such as plastics used to create benches, etc., which still keeps it out of the landfill.

  • Reducing packaging waste. Repurposing when you can, such as blue wrap.

  • Investigating ways to increase the portion of local and sustainable food offerings available within the hospital/clinic.

  • Managing fleet fossil fuel consumption.

  • Reducing harmful chemicals in the clinical environment.

Dartmouth-Hitchcock pushes sustainability envelope

For Dartmouth-Hitchcock Medical Center green is the new black.

As one of four owner-shareholders in the new Greenhealth Exchange, a supply chain support service organization designed for strategic sourcing, contracting and purchasing sustainable products for its provider members, the Lebanon, NH-based facility takes sustainability in healthcare so seriously that it solidly invested in its future.

Lynn Dorsch"We became an owner in GX because we strongly believe that sustainability is, and should remain part of our core mission," said Curtis Lancaster, Vice President, Supply Chain Enterprise Support Services, Dartmouth Hitchcock. "Therefore, the concepts around determining what sustainable products exist that provide true environmental benefits and how can we purchase them in a cost effective manner should then be part of our overall supply chain strategy. We also believe that both GX and our main GPO can, and should, co-exist."

Benefits that GX delivers include more than just pricing for sustainable products, according to Lancaster.

"As an example, right now we are discussing with the other members of GX the environmental benefits of polypropylene verses polyethylene terephthalate (PET) in disposable food service ware," he said. "Additionally, we are having products in this category scientifically tested to determine if hazardous chemicals exist in the ‘slurry’ used to mold compostable items as we suspect they do. This in-depth examination is likely not taking place at our larger GPO. Instead, our national GPO is leveraging volume across the country to get the best possible pricing on the majority of products used at our facilities.

Lancaster admitted he’s not concerned whether Dartmouth Hitchcock’s GPO over time will compete in the same space as GX, which may motivate him to use the GPO for those same products and services.

"Ideally, we want healthcare providers across the country to have access to vetted, truly green products, and if the larger GPOs are able to provide those products, it just improves everyone’s efforts in sustainability," he said. "Yet, given the detailed approach exclusively focused on sustainable products, we believe GX will continue to add value outside of the value we receive from our national GPO membership.

"The long-term goal of GX is to expand the availability of green products and improve the sustainability attributes whenever possible for those products that are already in the healthcare market," Lancaster continued. "GX is organized to nurture innovation in this area and press for better and greener products. As such, a portion of the cooperative’s profits go to Healthcare Without Harm and Practice Greenhealth to further the missions of those organizations to improve sustainability in the global healthcare space. Without the initiative and leadership of Healthcare Without Harm and Practice Greenhealth, this important work would not be underway," he noted.

"We believe there is much work to be done in sustainability and our efforts and those of the other GX members will benefit the industry’s focus on safe, quality care in tandem with improving the environment our patients, our staff and our community lives in," he added.