Transcript Slide 1

Environmental Stewardship at
Kaiser Permanente
American Public Health Association Annual Meeting
Washington, D.C.
November 9, 2004
Prepared by Kathy Gerwig, Kaiser Permanente, VP Workplace Safety
Presented by Liz Taghavi, Kaiser Permanente, National
Environmental Health and Safety
Overview
Kaiser Permanente is the nation’s
largest nonprofit health plan
•$25 billion annual revenue
•136,500 employees
•12,300 physicians
•9 states and Washington, DC
30 medical centers
8.2 million members
431 medical office buildings
Environmental Paradox for Healthcare
Hazardous
chemicals and
materials used to
treat patients
Harmful effects on
environmental
and human health
Environmental Paradox for Healthcare
– Incineration of vinyl creates dioxins
– Heavy metals in manometer, fixatives, and
other products
– Wide range of chemicals used, some toxic
– Trash
– Poor environmental quality responsible for
25% preventable ill-health in the world
– Environmentally attributable diseases in
American children cost $55 billion
Eliminating or reducing these hazards will
eliminate environmental health impacts.
KP’s Vision for Environmental Stewardship
“We aspire to provide health
care services in a manner that
protects and enhances the
environment and the health of
communities now and for future
generations.”
Values
– Come from people and events that date back
decades in the history of Kaiser Permanente.
– Concern for the health of communities extends to
the air we breathe and the water we drink.
– Business activities are aligned with protecting public
health and the environment. Environmental
Stewardship supports worker and patient safety,
and is undertaken in full alignment with quality and
cost imperatives.
– Precautionary Principle: where there is credible
evidence that a material we’re using may result in
environmental/public health harm, we should strive
to replace it with safer alternatives.
Environmental Stewardship Focus Areas
Environmentally
Responsible Purchasing
•Reduce toxicity and waste
through product selection
•Increase post-consumer
recycled content
•Select reusable and durable
products
•Eliminate mercury
•Select products free from
PVC and DEHP
Environmental Stewardship Focus Areas
Green Buildings
•Efficient water and energy
systems
•Least toxic building
materials
•Recycle demolition debris
•Make use of daylight
•Manage storm water to
enhance surrounding habitats
•Reduce site development
area to limit disturbances
Environmental Stewardship Focus Areas
Sustainable Operations
•Energy conservation
•Waste minimization
•Safe electronic equipment
disposition
•Optimal reuse of single-use
products
•Capital equipment
redistribution
•Greening janitorial cleaning
products
•Recycling and reuse of
solvents
Environmental Stewardship Focus Areas
Transportation Systems
Management
•Spare the Air
•Bike to Work
•KaiseRider program
•Commuter Choice
Evolution of Stewardship Effort at KP
Clinical products and
materials
(Existing protocols)
Consultants hired for
initial work on
building materials
Non-clinical
products
(Invent
protocols)
Conduct most
activities
internally
Framework for Assessing Materials
Sourcing
No PVC, PBTs, or carcinogens; postconsumer material; security of supply
Sustainable Manufacturing
Waste; energy; water; TRI
Use
CHPS 1350; Green Seal; our own air
sampling; performance; aesthetics
Post Use
Recyclable; reuse; take back
KP’s Role in Initiating Change
Model Programs
That Create Benchmarks
Inform Experts Who
Influence Industry
Educate Constituent
Groups
KP Environmental
Stewardship
Influence Standard
of Performance
Raise
Awareness
Share Tools
Barriers to Environmental Stewardship
– Infection Control, staining/discoloration issues,
wet environments
– Quality and Cost: environmental considerations
will never trump quality and cost requirements
– Although we have an assessment process, it’s in
its infancy, and can be improved
– Trade secrets claimed by manufacturers:
• We insist on objective, independent, transparent
verification of vendor claims and test results.
Barriers to Environmental Stewardship
– Chemicals and materials targeted and removed
are often replaced by other unhealthy
components.
– Once we’ve made a stand, a product is chosen,
many other products come out of the woodwork.
We deal with ongoing improvements by periodic
review (typically one year).
Accomplishments
Waste Minimization and
Pollution Prevention
– In 2003, diverted 8,000 tons of solid waste from
landfills
– In 2003, reused or redeployed 40,000+ pieces of
electronic equipment, weighing 410 tons
– Eliminated 27,000 grams of mercury from KP
health care operations
• Phase out of mercury-containing blood pressure
devices, thermometers, and GI equipment.
– 100 tons of single use devices reprocessed
Accomplishments
We pioneer and test products and publicize our
findings so that others can benefit from our
expenditure of resources, time, and expertise
– Carpet (vinyl free, recycled content, recyclable)
– Resilient flooring (vinyl free, recyclable, non-toxic
cleaners and finishers)
– Casework and furniture (no added formaldehyde,
renewable materials)
Goals
2004 Purchasing Goals
– Implement scaleable criteria during the SST
process
– Review existing contracts for environmentally
friendly products
– Accelerate the existing work to free NICUs of
materials containing DEHP/PVC
– Develop strategy to comply with
Prop 65 (CA) which requires
notification of exposure
to DEHP
Goals
Immediate Future and Beyond
– New Chemical Policy
• Avoid the use of carcinogens, mutagens, and
reproductive toxins, and persistent bioaccumulative
toxic chemicals
– New Food Policy
• Support healthy food systems in health care
• Ecologically sound, economically viable, and socially
responsible
• KP currently has farmers markets in operation at
five medical centers in CA and HI, with expansion
plans.
Imagine
Imagine how many cancers could be prevented by
eliminating the use of carcinogens in health care.
Imagine how much infertility could be prevented if
there were no endocrine disrupting phthalates like
DEHP in neonatal units – or elsewhere.
Imagine how many communities could have access to
nutritious, locally grown organic food if every hospital
made it part of their procurement policy.