The Need for Nuance: Environmental Key Performance Indicators in the Healthcare Sector

Transcription

1 The Need for Nuance: Environmental Key Performance Indicators in the Healthcare Sector Dr. Crystal Saric Fashant Associate Professor, Metropolitan State University 1

2 Practice Greenhealth is a nonprofit membership organization founded on the principles of positive environmental stewardship and best practices by organizations in the health care community. Overview: Healthcare Sustainability and my Data Sources Minnesota Technical Assistance Program (MnTAP) at the University of Minnesota. They work to strengthen Minnesota businesses by improving efficiency while saving money through energy, water, and waste reduction. Local Examples: Sustainability Managers and Directors at HealthPartners, Mayo Clinic, Fairview Health Services, Hennepin County Medical Center, and others 2

3 Examined two research questions: My Doctoral Dissertation What is the combined current state of environmental performance at the long term care facilities that have applied for a Practice Greenhealth award? What are the proposed environmental key performance indicators for the long term care sector?

4 Starting at the end: 6 Drivers, 4 EKPIs

5 Developing Indicators of Performance 1. Practice Greenhealth Environmental Excellence Awards (source data) 2. American Society for Healthcare Engineering 3. Global Reporting Initiative 4. Green Hotels Global 5

6 Study Population Demographic characteristics for Practice Greenhealth environmental awards data. n = 33 Region of U.S. West 3, South 4, Midwest 6, East 20 Urban, Suburban, or Rural Facility Type Senior Care, Behavioral, or (nonbehavioral) Rehabilitation Number of Patient Beds Number of Full Time Employees Gross Floor Area (in square ft.) Urban 8, Suburban 11, Rural 14 Federal Facilities 9, System 19, Stand-alone 5 Senior Care 16, Behavioral 11, Rehabilitation 6 Minimum 32 to a Maximum of 385 Minimum 54 to a Maximum of 1654 Minimum 39,400 to a Maximum of 1,171,034 These Long Term Care facilities were compared with data from 322 hospitals

7 Study Population is Engaged Engaged Leadership - key responses. Has the facility appointed an Executive Champion to provide administrative support for environmental stewardship? Yes No (or no selection) 85% 15% Has the facility established a Green Team/ Sustainability Committee (or did it utilize an existing committee) for ownership/oversight of designing, implementing and reporting on environmental sustainability initiatives? 94% 6%

8 Water Water usage for Practice Greenhealth environmental awards data n = Trimmed Mean at 20% Hospital Median (n = 322) Gallons of water used per gross floor area (sq. ft.) annually. Gallons of water used per full time employee (FTE) annually. Cost of water per 10,000 gallons purchased gallons 47 gallons 30 22,702 gallons 19,945 gallons 14 $85 Not available

9 Energy Use Intensity (EUI) Score EUI score for Energy Star website and Practice Greenhealth data n = Median EUI 95th Percentile Energy Star: Senior Care Community Practice Greenhealth: Long Term Care Facilities Energy Star: Hospitals Practice Greenhealth: Hospitals

10 Renewable Energy Summary of renewable energy sources for Practice Greenhealth data Off-site renewable energy (source unspecified) One at 1.6%, one at 4.2%, one at 7.6%, and one at 29% On-site solar One at 14% On-site biomass One at 28.6% 18% of LTC facilities utilized renewable energy; 36% of hospitals in the Environmental Awards dataset utilized renewable energy.

11 Energy Costs Energy costs for Practice Greenhealth environmental awards applicants n = Minimum Value Maximum Value Trimmed Mean at 20% Total cost of energy per square foot 21 $0.74 $4.82 $2.66 % spend on conventional electricity 21 36% 84% 67% % spend on natural gas 19 2% 64% 29% % spend on fuel oil 5 4% 43% 18% Average spend on energy at facilities in these data = $745,515 per year. To Compare: $75,100 per year was the median cost savings per facility for hospitals reporting efficiency measures (n = 322). Energy cost at a medium-sized local hospital is $2 million per year.

12 Hazardous Waste: Incorrect Treatment? A notable finding from these data is that 18% indicated yes to the following question, Pharmaceutical waste is being disposed of in red bags or sharps containers. Pilot Study showed similar results: 3 of 6 had minor hazardous waste compliance issues 1 of 6 had a major hazardous waste compliance issue

13 Waste Key waste indicators for Practice Greenhealth environmental awards data Waste Indicator n = Percent of recycling as a percent of total waste Minimum Value Maximum Value 90th Percentile Long Term Care Median Hospital Median % 62.84% 46.19% 28.29% 28% Total pounds of waste generated annually, per gross floor area pounds 7.70 pounds 1.83 pounds 3.65 pounds 3.1 pounds Percent of Regulated Medical Waste (RMW) as a percent of total waste. Pounds of Regulated Medical Waste (RMW) per staffed bed annually % 11.39% 0.16% 0.64% 6.9% pounds pounds 2.87 pounds pounds Not available

14 Waste Costs Waste costs for Practice Greenhealth environmental awards data n = Long Term Care Median Hospital Median Cost per Ton Solid waste costs per ton 23 $141 $103 Recycling costs per ton 22 $71 $67 Regulated medical waste (RMW) costs per ton 20 $2,048 $1,142 Pharmaceutical hazardous waste costs per ton 14 $2,283 $4,245

15 Common Healthier Food Initiatives Engagement Initiative Example: Healthier Food Hosted a local farmer's market Has signed the Healthy Food in Healthcare Pledge Supports an on-site farm and/or garden Preferentially purchases antibiotic-free meat 23% Hospitals 45% 31% Hospitals 47% 35% Hospitals 22% 38% Hospitals 54% Has a sustainable food services policy 38% Hospitals 65% 0% 5% 10% 15% 20% 25% 30% 35% 40%

16 Drivers for Improving Environmental Performance (i.e. the reasons for engaging in sustainability work) Environmental Performance Categories (i.e. waste, water, energy) Environmental Performance Goal (i.e. goal setting to reduce waste, reduce water, reduce energy use) Environmental Performance Indicator (i.e. percent of recycling, water used, electricity used) Metric (pounds, gallons, kwh) Drivers for Improving Environmental Performance

17 Ending where we started: 6 Drivers, 4 EKPIs

18 Thank you! Dr. Crystal Saric Fashant MPNA, DBA Associate Professor, Department of Public and Nonprofit Leadership College of Community Studies and Public Affairs, Metropolitan State University I Office: Full Dissertation is Open Access on ProQuest: Environmental Performance in Long Term Care Facilities by Fashant, Crystal Saric, D.B.A., Metropolitan State University, 2017, 169;