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Inside the toxin-free hospital of the future

Leading health care providers are re-examining the potential health impacts of climate and sustainability concerns.

Last week, hundreds of changemakers from hospitals, health systems and medical products or supplier companies gathered in Dallas to learn and compare notes at the 13th CleanMed Conference.

CleanMed is the nation’s largest conference focusing on health care sustainability. Every year, we connect the health care leaders working to accelerate our sector’s commitment to environmental sustainability and to spur a movement in regenerative health. These are people who have moved beyond protecting the environment and human health, to improving them.

When united, the health care industry can do a lot because we are big and powerful. Health care represents a whopping 20 percent of the nation’s market. Every year, health care companies buy $300 billion worth of goods and services.

When a hospital or health system makes a purchase, the organization likely has gone through an evaluation to assess pretty standard metrics for each product including: cost; safety for patients and staff; and performance.

Leading hospitals are beginning to evaluate a product’s potential toxicity to human health, the amount of resources used and the overall lifecycle cost.

Over the last decade, leading health care organizations have begun to re-evaluate products and goods purchased using some different metrics, and this is making a big difference in the kind of healing environment hospitals are creating for both patients and staff.

Aligning directly with health care’s healing mission, leading hospitals are beginning to evaluate a product’s potential toxicity to human health, the amount of resources used and the overall lifecycle cost.

Among the many tracks, presentations and conversations at CleanMed this year, it was clear that as leading hospitals change the kinds of products they buy, they are creating an entirely new kind of hospital: one where patient healing and environmental healing are fundamentally connected.

Food with a purpose

A major focus of CleanMed was on harnessing the buying power of health care to promote healthy, sustainable, locally sourced food in hospital cafeterias and food service.

This includes examining the impacts of agriculture on the environment (greenhouse gas emissions, water use, pesticides) as well as promoting foods on-site that support better health outcomes and reduce chronic disease.

Over the last few years, conference attendees have tackled how and why to make the switch from conventional meats and poultry to antibiotic-free meats and poultry, as part of the health care community’s longstanding work to reduce the overuse of antibiotics.

This year, conference attendees also discussed strategies to tackle food waste.

When food waste is sent to landfills, it is a major source of methane, a potent greenhouse gas. Opportunities for composting, as well as getting uneaten but still edible food to hungry Americans via food rescue organizations, is on the agenda in 2016.

Furniture and bedding

Many products used in health care settings may contain or release carcinogens, reproductive toxins or other hazardous materials. In addition, chemicals used in these everyday products — including beds, chairs and mattresses — have not been tested for toxicity.

We continue to see the sector shift away from chemicals of concern, especially when present in health care interiors. These include: flame retardants; stain- and water-resistant perfluorinated compounds; antimicrobials; PVC or polyvinyl chloride plastic; and formaldehyde.

This year at CleanMed, many hospitals discussed the strategies of implementing "Environmentally Preferable Purchasing (EPP)," a system of purchasing that helps hospitals move toward purchasing safer products, all while reducing waste, energy and water use.

Starting with furniture and bedding is a great way to begin to embed EPP into a hospital’s purchasing system. And the more hospitals and systems that choose EPP, the more the market changes.

A big announcement was made at CleanMed that will help accelerate EPP across the sector. Attendees witnessed the launch of Greenhealth Exchange (GX), a purchasing cooperative created by four founding health systems — Dartmouth-Hitchcock, Dignity Health, Gundersen Health System and Partners HealthCare — and Health Care Without Harm.

Working with health care suppliers and group purchasing organizations, GX will help make it easier for hospitals and health systems to purchase green products.

Through detailed product specifications and supplier performance requirements, GX will offer members access to high-quality green products brought together in one catalog at competitive prices; apples-to-apples comparisons on key product features including price and sustainability score plus health, environmental and community benefits; and reporting on the benefits associated with every purchase.

Green cleaning

The health care sector is beginning to recognize that chemicals can and do play a significant role in the development of disease, even at miniscule amounts.

While chemicals are used in health care for a variety of good reasons (including providing life-saving medications to cleaning and disinfecting to diagnostic testing to diagnostic testing in labs), many leading hospitals are creating a framework for choosing safer chemicals where possible — or even eliminating them altogether.

This includes using safer alternatives for pest management, cleaning, mercury elimination, reducing hazardous waste and disinfection.

Recognizing climate change as one of single largest threats to public health, hospitals and health systems shared strategies to address the causes and impacts of climate change.

Of course, hospitals and health care facilities must follow strict protocols to prevent infection and maintain health and safety. In the past, this meant traditional cleaning products that did a good job at maintaining a sterile healing environment, yet many contained chemicals known to cause health problems for patients, the environment and health care professionals alike.

In fact, the health care sector has a higher incidence of work-related asthma than other industries, with cleaning products identified as one of the top causes.

Today, leading hospitals are turning to options such as ultraviolet (UV) light to clean and sterilize. UV disinfection is so effective, it has been cited as a chemical-free alternative to cleaning by both the Food and Drug Administration and the Centers for Disease Control.

According to a study from the American Journal of Infection Control, antibiotic-resistant superbugs are decreased among patients by 20 percent after adding UV disinfection to the cleaning regimen.

Best of all, it poses no health hazards to patients or staff.

Reduced emissions

Climate change is emerging as the most important environmental and human health issue of our time. Operating 24/7 means hospitals consume vast amounts of energy, making them a leading source of greenhouse gas emissions.

When it comes to their commitment to address climate change, CleanMed attendees never have been clearer. We heard from a number of hospitals making measurable progress towards reducing greenhouse gas emissions in their own operations.

This includes members of the Health Care Climate Council, a leadership network of health systems built around the idea that hospitals can be more effective in addressing climate and health issues by working together.

Recognizing climate change as one of single largest threats to public health, hospitals and health systems shared strategies to address the causes and impacts of climate change.

This includes accelerating investment in renewable energy and energy efficiency; scaling the health sector’s adoption of climate change mitigation and resiliency programs; and advocating for local, state and national policies that ensure a sustainable and healthy future consistent with our collective vision for healthy individuals and communities.

A new social contract

Health care is the only sector of the economy that has healing at the core of its business. At CleanMed, I spoke with many leaders who are interested in creating a new social contract between health care and society, a contract that expands our healing mission outside our walls to the communities we serve and the environment that sustains us.

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