Partners plans PVC cutback in Healthier Hospitals Initiative

April 12, 2012

More than 500 hospitals across the United States with more than $20 billion in purchasing power are joining forces in a project called the Healthier Hospitals Initiative (HHI) in an effort to reduce energy costs, reduce waste, boost recycling and buy "environmentally preferable" materials.

In an interview with Plastics Today, John Messervy, chairman of the HHI, described the consortium as a place where best practices are exchanged. Each member is pursuing its own strategies. Cost reduction is one of the major goals of the project, Messervy said, adding: "That's the environment we live in today."

An architect and the Director of Capital and Facilities Planning for Partners HealthCare in Boston, Messervy began a sustainability initiative in 2008 and says the HHI project is partly a continuation of  efforts at Partners to design "green buildings".

Partners' electrical consumption in 2008 was roughly equivalent to 47,000 single-family homes - or a city the size of Cambridge, MA. Partners, which operates Massachusetts General Hospital, Brigham & Women's and several other healthcare facilities, now plans to cut energy consumption by at least 25% by 2014.

There is also increasing focus on materials used in the hospitals.

Partners is now negotiating a contract to replace polyvinyl chloride (PVC) used in IV bags, tubing and related systems with other materials in view of reports that chemicals in certain types of plasticizers used in PVC can leach out and create health problems. Messervy cited studies done in the European Union as a reason for the change.

He expects new contracts to be in place in as soon as two months. The transition to the new materials will take about six months. Not all PVC can be replaced because the substitutes lack satisfactory physical properties for some applications, Messervy said. He said that Partners feels that about 85% of the PVC it uses in the IV bag systems can be replaced.

Millions in savings

He said Partners expects to save millions of dollars by dramatically reducing its use of PVC in tubing, pumps and ancillary equipment.

Polycarbonate, which contains biphenol A, is not part of the Partner's environmental analysis. "It's not on the radar screen right now. We're focusing on the high-volume, high-value areas," Messervy said.

Producers of PVC and polycarbonate adamantly maintain that science sows that they are safe materials.

Partners is also "aggressively" replacing vinyl composition tile (VCT) with rubber flooring, partly at the request of nursing groups who feel the rubber flooring is more comfortable. Rubber flooring is also less expensive to maintain. Vinyl wall covering is also being replaced with coatings that are more "breathable", he said.

In another change, one hospital in the Partners group has eliminated use of bottled water by using filtered tap water. The cost per serving of water dropped from 98 cents to two cents.

"We're also trying to reduce waste coming out of the operating room because it is very expensive to dispose of," said Messervy. In a project he is currently tracking, Brigham & Women's Hospital last month used 23,000 medical devices that were sterilized and reprocessed. "Previously, these would have been called single-use devices and would have been discarded. There is a list that the FDA puts out by product and manufacturer of

John Messervy of Partners HealthCare is chairman of the Healthier Hospitals Inititiave.

products that are approved for reprocessing." The devices are sent to a third-party, sterilized, repackaged, FDA-tested, and returned. Savings are about 60%. Plus there is a carbon footprint reduction.

"Right now we are moving slowly and conducting our own testing to confirm that the products are coming back totally sterilized."

Another big target at the Partners is solid waste reduction.

"Massachusetts General Hospital generates 800 tons of solid waste per month," said Messervy.  Only about 1% of the total recycled waste is plastic, or about 49 tons.  Partners want to boost that amount, starting with recycling of beverage bottles used by patients and visitors to the hospital.

"It's a no brainer." The challenge is finding space to accommodate the recycling in all of our different environments and getting approval from our infectious control staff, he said.

Partners currently does not use compostable plastics, although significant amounts of food waste generated in meal preparation are being composted in equipment right in the kitchen. "We're certainly looking for opportunities for biobased plastics. They are a premium cost, however."

Questioning antimicrobial

Messervy said the hospital is being careful about antimicrobial claims being made by a number of materials producers. "We're not really sure what chemicals are being used in those materials at times," Messervy said.

The Healthier Hospitals Initiative partnership is being coordinated by Practice Greenhealth, Health Care Without Harm (HCWH), and the Center for Health Design.

In an announcement publicizing the group's work, Knox Singleton, CEO of Inova Health System (Falls Church, VA) said: "Hospitals can no longer afford to be out of sync in their day-to-day work of healing and treating and the environmental impact they have in communities across the country. By reducing waste and conserving energy, among other challenges, we can not only reduce operational costs, we can improve the health of people in our communities before they ever enter a hospital."

HHI's sponsoring health systems include Advocate Health Care, Bon Secours Health System, Catholic Health Initiatives, Dignity Health (formerly Catholic Healthcare West), Hospital Corp. of America, Inova Health System, Kaiser Permanente, MedStar Health, Partners HealthCare, Tenet Health Systems, and Vanguard Health Systems.

By creating an environmentally preferable purchasing program, Kaiser Permanente estimates it will save approximately $26 million a year.

Dignity Health said that it saved $5.4 million in 2010 by increasing the amount of reusable products it purchased for its hospitals and clinics in California, Arizona and Nevada.

During the next three years, HHI will gather data and metrics from participating hospitals to demonstrate the impact these strides are having on the health and safety of patients, workers and communities, as well as on reducing health care expenditures.

Partners' HHI Initiatives

►Reduce energy consumption by 25%

►Replace PVC in IV systems

►Replace vinyl composition flooring

►Replace vinyl wall coverings

►Re-use medical devices when possible

►Boost recycling

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