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Fight pollution--Practice EPP
by Lara Sutherland
Forging a battle plan to fight pollution at your facility? Start with
environmentally preferable purchasing (EPP). An EPP program starts with
environmentally preferable products or services--those that have a lesser or
reduced negative effect on health and the environment when compared with
products or services. Environmentally preferable purchases include energy-
efficient and water-conserving equipment, less-toxic chemicals, and recycled
content products. In a hospital, the practice may consist of reducing the
purchase of mercury-containing products or arranging for a solvent-recycling
service to furnish laboratory solvents instead of buying virgin solvents
from a supplier.
Smart shopping pays off
Selecting products that reduce hazardous or solid waste saves money and
reduces environmental impact. Products with lower volatile chemical content
can improve indoor air quality, and energy efficient products reduce
pollution and cut utility bills.
The concept has attracted the attention of some of health care's biggest
players, which are posting real results. Kaiser Permanente has a
company-wide resource conservation policy that resulted in the development
of a system to evaluate products and distributors on environmental issues.
Kaiser includes information on its environmental policy in its requests for
proposals and requests information from bidders on the environmental impact
of their products. The hospital also requests the sustainable practices of
the bidders themselves.
Now Kaiser no longer buys mercury thermometers or mercury blood pressure
equipment, the facility recycles all its fluorescent lights and has switched
most routine glove purchases from latex to nitrile gloves, avoiding both
latex and PVC.
Similarly, Newton-Wellesley Hospital (NWH) in Massachusetts has dramatically
lowered mercury use and that of other toxic chemicals. The hospital called
on all departments to cease use of mercury-containing products unless no
reasonable alternative was available. A form was developed for tracking
mercury-containing compounds, and the department supervisor must report on
the time line for elimination for each mercury product or provide a
rationale for continuing use if elimination is not planned.
Departments using the mercury products were given the responsibility of
finding alternatives and as a result NWH has nearly eliminated its use of
Some other examples:
* Los Angeles Medical Center reduced solvent purchases and waste disposal
by 500 lbs. by installing an automatic paint gun washer/recycler.
* King/Drew Medical Center in Los Angeles County saved $10,000 per year
by installing an automatic slide stainer.
* City of Hope National Medical Center saves over $43,000 per year by
using microanalytical techniques.
Begin with the "how-to guide" from the Hospitals for a Healthy Environment
(H2E) project, which was the result of the 1998 Memorandum of Understanding
between the American Hospital Association and the EPA. The guide offers
information on EPP to help hospitals implement pollution prevention through
According to the guide, an interdepartmental EPP team can be the best
mechanism to start an EPP program. How a hospital structures such a team
depends on which kind of committee or teams are already functioning. A
hospital-wide environmental improvement committee can dedicate some of its
time to an EPP project, eliminating the need for a separate EPP team. Or a
product standardization committee could choose and implement the project. In
any case, the team should be composed of personnel from all affected areas
and include people willing to work together.
The leader of the team should be someone whose administrative
responsibilities include ensuring that the EPP project is fully executed.
Each affected department or group must be included in the decision stage so
that everyone feels invested in its outcome.
Before choosing a pilot project, consider its pressing environmental
concerns or review major environmental goals and determine if a purchasing
project could help resolve any existing problems.
For instance, a hospital with a high frequency of mercury spills may wish to
instigate a project to purchase mercury-free blood pressure equipment or
thermometers. A hospital with high overhead costs due to large quantities of
hazardous waste may wish to investigate solvent recycling or low-volume
microchemistry kits in the lab.
Plan a project with specific, measurable goals that can be met in a
reasonable time frame. Examples of such goals:
* Buying mercury blood pressure equipment within the next 12 months
* Identifying and purchasing low-VOC maintenance products within six
* Replacing fluorescent lights with low-mercury fluorescent lamps and
ballasts, changing over 30 percent of lights by the next fiscal year
Choose your first pilot project because it is possible and measurable and
because support exists for its implementation. But be careful: Many
well-meaning goals are impossible to achieve. It may not be possible for the
hospital to reduce solid waste by 80 percent in one year or to eliminate
formalin use in three months.
Check with those involved before deciding on specific numbers. The success
of the first pilot project can bolster support for an EPP program as much as
a failure can make people give up on the project.
After deciding which project to undertake, request support from top
management and from all the personnel who will be directly affected. A
policy statement issued by the procurement department, CEO, or other
authority will help the project gain legitimacy and encourage staff support.
If implementing the project will affect how work is being done, unions
should be brought in and their concerns taken into consideration. Ensure
that the person designated to research and identify a new product is allowed
time on the job to do the work. It is essential that everyone be on board.
With all affected parties present, determine a time line for implementation
and develop specific action steps. The time line should be realistic and
must account for time that must be spent researching the availability of
alternative products and training personnel in the use of the new products.
Determine who is responsible for the implementation of the project and put
it in writing. Also, create dates for responsible parties to report back to
When everything is in order, go out and do it. Make sure you come together
at specific times throughout the pilot program to evaluate any problems and
change course if needed. Create a climate where it is all right for staff to
give the team input about the new products and then weigh their reactions.
Designate someone to collect staff feedback and arrange for that person to
bring a report to the committee.
Don't be surprised if things get behind schedule--sometimes it may take
longer than expected to find a new product or arrange for training. Collect
the feedback and keep everyone informed of the project's progress.
Were goals met?
After the pilot has been implemented, the whole team should meet and go over
the results to determine if the goal was met. Review the process and note
what worked and what didn't. Formally thank all the people who made this
possible--the purchasing department, your GPO, the nurses on the floor, the
maintenance workers, or the CFO.
This is a good time to start tracking your progress by calculating the
project's benefit to the hospital and environment. If you switched to
energy-efficient equipment, for instance, you can calculate how much money
you saved and even find out how much you reduced the mercury emissions from
your power plant. Switching to recycled paper can save gallons of water and
acres of forest.
Use the information from this project to choose a new project or expand the
first one. If you switched one building over to mercury-free thermostats,
decide which department could be switched over next. If you specified
energy-efficient equipment in your last purchase request, investigate the
possibility of specifying energy-efficiency in every request.
Keep on trucking
If your goal was not met, don't despair. Learn from this. Perhaps the new
product didn't work out, or progress is slower than you had expected.
Consider whether it is a training problem or if you simply need to allow for
more time to reach your goal.
When Hartford Hospital decided to switch over to mercury-free, latex-free
blood pressure equipment, many latex-free cuffs failed during use shortly
after the new equipment was installed. Instead of switching back to latex or
mercury equipment, the hospital went to its vendor for a solution. The
vendor replaced all the cuffs with sturdier, better-made nonlatex cuffs as
soon as possible.
The new cuffs are durable and have caused no problems. Although success was
delayed, sticking with it has reduced mercury spills and gained significant
savings on cleanup costs.
You can start with a few pilot projects, but you'll achieve long-term gains
by making EPP the standard way of doing business. Environmental purchasing
policies can make finding, buying and using EPPs a part of everyone's job.
This type of institutionalization can take the form of job description
changes, hospital-wide policies, RFP language, or regular training.
Encourage suggestions from employees by offering recognition and awards for
new EPP ideas that are implemented. Designate someone to collect the
suggestions and present them to the EPP team for consideration.
Tracking should also become a permanent part of any EPP program. Make sure
someone's job description permanently includes tracking the purchase of EPPs
and reporting on the program. Tracking should include total expenditures for
EP products, money saved by switching to EP products, reduction in mercury
spills or other relevant events, and statistics that can help determine the
reduction in your solid waste volume or how many trees you saved.
Toot your own horn
Now that you've accomplished your goal, celebrate your achievement! Find a
way to communicate your success and future plans with the whole hospital
through a regular newsletter, e-mails, or posters.
Make sure the public relations department gets information it can tout to
the community. Place information about your EPP program prominently on your
Web site and make sure patients know what the hospital is doing to improve
Also consider sharing your accomplishments with other hospitals or clinics
in your system. Toot your horn!
Lara Sutherland is senior research associate at INFORM, a not-for-profit
environmental research and advocacy group, and a member of the Hospitals for
a Healthy Environment purchasing work group. She can be reached at (617)
This article first appeared in the September 2000 issue of Health Facilities
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