SummaryOver the past 20 years Bronson Methodist Hospital has put considerable effort toward creating a solid sustainability program through initiatives such as recycling programs, local food sourcing efforts, and hazardous chemical reduction strategies. However the hospital reached a point where if it were to continue to expand and improve its sustainability program, it needed to grow beyond the more easily-captured efforts and focus on initiatives that would require considerably more time and effort to achieve.

Traditionally, most of the sustainability initiatives within the hospital had been employee-driven and localized to individual departments. Overall Bronson lacked a centralized department and staff to coordinate existing efforts, provide assistance to employees, create community partnerships, and have the time to drive new program implementation. To address this issue Bronson Methodist Hospital partnered with a local college to create an internship position to evaluate the advantages of a full-time position focused solely on sustainability efforts. Through calculating a return on investment, the intern was able to successfully demonstrate the value for a full-time sustainability coordinator position (refer to the “Benefits” list for identified cost savings examples) and further investment in healthier environments. The HHI Engaged Leadership Challenge provided the steps to take a good sustainability program to the next level.

Bronson Methodist Hospital, Kalamazoo, MichiganThe Problem While Bronson Methodist Hospital had accomplished numerous sustainability

successes in the past, the more easily achieved efforts had been implemented

and next level strategies would require a much greater cost commitment of

time and effort to achieve. As a result, old successes were maintained but

new initiatives were slow in development, even when significant cost-reduction

opportunities were identified. In order for Bronson to maintain its reputation as a

leader in environmental stewardship in the sector, a method for increasing focus

and attention solely on sustainability would have to be developed.

The Strategy SelectedBronson Methodist Hospital’s environment of care and sustainability manager,

Lisa Hardesty, partnered with local college Aquinas to create an internship

for a student in the sustainable business program, a program made possible

by Steelcase, Herman Miller and other regional businesses. The focus of the

internship would be to produce a return of investment analysis for the creation

of a position focusing on hospital reduction of resource use and capturing of

sustainability financial incentives, such as ENERGY STAR rebates.

Bronson brought in intern Brendan Molony in June of 2014. He used the Green

Guide for Health Care LEED O + M (operations and maintenance) Program as

a template to assess the state of the current program and to begin to roadmap

future sustainability activities. A final ROI assessment was completed in the fall

of 2014 and successfully demonstrated beneficial financial and environmental

outcomes associated with a full-time sustainability position. Using the ROI,

the environmental safety and sustainability manager was able to present a

case for budgeting resources from recently vacated positions to develop the

new role around sustainability programming (see the “Return on Investment”

document at the end of the case study for the list of activities and the return

on the investment analysis). The new position of sustainability coordinator was

created in the fall of 2014, and would have the resources to explore potential

opportunities that would lower operations costs, reduce resource utilization within

the hospital, and capture financial incentives.

Case Study: Engaged Leadership - Bringing Sustainability Programming to the Next Level

Implementation ProcessThe HHI Engaged Leadership Challenge was used to elevate the established

hospital sustainability program to the next level. Bronson Methodist Hospital

performed a gap analysis of the Challenge to establish a list of objectives that

would further embed sustainability into the core operations of the health care

environment.

One baseline requirement of the challenge was to create an executive

commitment statement. The intern was tasked with developing the documentation

while leadership was engaged for review and approval. Having an intern to

evaluate the qualitative measures, as well as the support of the environmental

safety and sustainability manager to drive engagement of upper management,

was a very important aspect which attributed to the success of this Challenge.

The Engaged Leadership Challenge identified 24 other qualitative activities that

can be tackled to further support a long-term, successful initiative integrated

into the overall operations of the facility. The measures were identified as key

activities which would create a more formal sustainability program that could

withstand staffing changes, competing agendas and a 24/7 operation. The full

list of opportunities is identified below. Bronson Methodist Hospital achieved

the highest recognition of Level 3 by implementing more than the ten required

qualitative measures.

About Bronson Methodist Hospital

Bronson Methodist Hospital, located

in heart of the downtown area

Kalamazoo, Mich., is the flagship of

Bronson Healthcare, a not-for-profit

healthcare system serving all of

southwest Michigan and northern

Indiana. With 434 licensed beds

and all-private rooms, Bronson

Methodist Hospital provides care in

virtually every specialty—cardiology,

orthopedics, surgery, emergency

medicine, neurology, oncology

—with advanced capabilities in

critical care as a Level I Trauma

Center; in neurological care as a

Joint Commission certified Primary

Stroke Center; in cardiac care as the

region’s first accredited Chest Pain

Emergency Center; in obstetrics as

the leading BirthPlace and only high-

risk pregnancy center in southwest

Michigan, and in pediatrics as one

of only six children’s hospitals in the

state.

Bronson serves the largest

percentage of Medicaid patients in

the area and provides a substantial

benefit to the community through

outreach and charitable care. It is

the recipient of the 2005 Malcolm

Baldrige National Quality Award,

the nation’s highest presidential

honor for quality and organizational

performance excellence. In 2009, the

hospital received the AHA McKesson

Quest for Quality Prize awarded

annually to only one U.S. hospital

and joined the top five percent

of hospitals in the nation to be

designated a Magnet Hospital for

Nursing Excellence.

2

HHI Engaged Leadership Challenge Activities

Yes Baseline: Sign and submit an executive commitment statement.

No Create a strategic sustainability plan.

Yes Create an environmental mission statement/guiding principles/charter.

No Formulate a sustainability program budget. (in the works)

Yes Appoint a sustainability executive owner.

No Build in sustainability measures as an organizational priorty.

Yes Create a sustainability reporting structure.

Yes Create sustainability responsibilities within the organization.

Yes Create an environmental steering committee with routine meetings.

Yes Conduct a sustainability baseline assessment.

No Define measurable sustainability objectives

Yes Identify leader for sustainability efforts.

Yes Identify the clinical champion.

Yes Demonstrate progress on at least two HHI challenges.

Yes Communicate progress on sustainability initiatives to the board.

Yes Report progress regularly on sustainability initiatives to the leadership team.

No Communicate sustainability progress from the leadership team to the organization regularly.

No Create and distribute an annual sustainability report.

No Provide a feedback mechanism for sustainability initiatives.

Yes Participate in programs to support employee and community engagement.

Yes Educate all employees about sustainability including new employee orienation.

No Share sustainability best practices within the industry.

Yes Engage organizational leaders to act as spokespeople for the sustainability program.

No Include sustainability initiatives in the community benefit report.

The Green Team

Brian DeRoo, Contract Specialist

Carolyn Wyllie, Communications Specialist

Dan Kettenbeil, Director of Facilities

Daphne Johnson, Property Coordinator

Dorinda L Diaz, Manager Materials Management

Grant Fletcher, System Director of Nutrition and Retail Services

Lisa Hardesty, Environment of Care and Sustainability Manager

Mike Way, Senior Vice President

Tiffany Brady, System Director of Environmental Services and Patient Transport

3

Factors Included in Bronson Hospital’s ROI Analysis:

Financial Benefits (savings or cost avoidance)

• $3,560 Battery Savings

• $912 Lead Recycling

• $50,223.95 PC Management

• $50,839 - SUD Reprocessing

• $17,800 - Energy Rebates

Environmental Benefit (reduced energy, pounds reduced)

• 502,239 kWh PC Management

• 15,756 kWh AHU4 $27,439

• 73,220 kWh Lighting Project $29,288

• 160,017 kWh $17,601.87

• Increased Recycling Rate from 16.9% (2013) to 29.35% (2014)

Other Measurable Outcomes (reduced exposure, increased satisfaction)

• Better understanding of programs and outcomes.

• Increased amount of sustainability programs and employee engagement.

• Continuation of car seat recycling program.

Challenges and Lessons LearnedHospitals can realize great benefit to a sustainability program through a team

approach, and may benefit from considering internships or other low-cost

strategies to focus on certain key areas. However in order to maximize the

capabilities of a program, an identified team lead is optimal. The case for a full-

time sustainability lead can be made by tracking positive outcomes and cost

savings, increasing staff engagement, and improving safety.

4

Return on Investment: Sustainability Coordinator

Investment

• One FTE Salary + Benefits • Job Training (One-time cost)

o $550 Building Operator Certification ($1,450 - $900 rebate) o $3,750 Power Logic ($1,400 + $2,350 travel) o $4,800 Tridium ($3,200 + $1,600 travel)

$9100 = Total Training Cost

Savings

• $136,550 (Consumers Energy rebates) • $114,398 (energy reduction) • $4,909 (water) • $5,593 (natural gas) • $2,109 (solid waste) • $25,000 (can/bottle deposits) • $48,000 (contractor hours saved) • $3,062 (batteries)

$339, 621 = Total Savings

Soft Savings

• $50,000 - $100,000 (sustainability report - consultant cost) • $60,000 (LEED O+M (Existing Building ) analysis)

Return on investment (%) = (Net profit / Investment) × 100

Cost Savings %ROI $ROI

Salary = xxx Training = $9,100 $339,621

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ENVIRONMENTAL MISSION STATEMENT

GUIDING PRINCIPLES &

REPORTING STRUCTURE PHILOSOPHY Bronson strives to create a healthy healing environment for the health and safety of its patients, employees and the community. The hospital’s focus is on four key areas—waste responsibility, green building design, local/sustainable purchasing and community involvement. GUIDING PRINCIPLES PEGS Pollution Prevention: The goal is to reduce waste by focusing on what can be eliminated, reused or recycled, use of less harsh chemicals while maintaining high standards of infection control to create a healthy environment for patients and staff. Energy Conservation: The goal is to reduce the amount of gas, electricity and water used through facility ugrageds and staff behavioral changes and to reduce the amount of fossil fuels used during transportation by establishing contract with local vendors and suppliers. Green Building Design. The goal is to design and build using healthier building materials as a means of improving public health and preserving the global environment. Bronson will strive to use natural, environmentally friendly products and low-emitting materials to provide a healthy healing environment. Sustainable Food: The goal is to offer healthy food options that are locally grown without the use of harmful chemicals to our patients, visitors and staff.

REPORTING STRUCTURE A number of departments within the hospital have created department specific green teams that report up through the hospital wide Green Team. The Green Team is a subcommittee of the Hazardous Materials and Waste committee. This committee reports to the EOC Oversight Committee that reports up to the Board. The Green Team is a multidisciplinary group that includes; Director of Facilities Services, Director of Housekeeping, Food Services Manager, Distribution Center Manager, Safety Manager, Process Management Consultant, Corporate Communications Consultant, IT Tech, Surgery Nurse and Labor and Delivery Nurse. The Executive over this group is the VP of Facilities Services.

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