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Sustainability Challenges in Health Care
- 1. Sustainability Challenges in Student Health Care Doris Guanowsky, Senior Associate Director Bettyann Milliron, RN Jill Buchanan, CRNP Shelley Haffner, RNC, Infection Control Nurse Manager Penn State University Health Services
- 2. Objectives ï Define sustainability in a college health setting ï Recycling, waste reduction, energy reduction, green purchasing ï Identify clinical waste that can be recycled ï Commonly used materials currently going to landfills, alternative uses ï Identify energy reduction measures ï Computer usage, interior and exterior lighting, appliance and equipment efficiency ï Describe methods to motivate staff to become âgreenâ ï Green team, administrative buy-in, measurements and incentives
- 3. What is Sustainability? (video)
- 4. Our Facility
- 6. Partnership with Physical Plant
- 8. Start of Recycling Initiative
- 9. How many of you recycle?
- 10. Clinical Recycling: Highlights! ï Idea ï Takes time ï Problem solve/ Medical waste concerns ï Build the team and educate ï Trial and error ï Measure and report successes
- 11. Green is In- Riding the Wave
- 12. We AreâŠâŠ.Penn State UHS
- 13. The Team
- 14. ICP Involvement⊠ï In early 2010, the Infection Control and Prevention committee looked at ways to improve hand hygiene compliance through use of âgreenâ products ï The CDC and WHO previously made recommendations to use ABHR (alcohol based hand rubs) as the routine method of hand hygiene for healthcare settings
- 15. Choosing a product⊠ï Needed a product that staff liked and would use ï A product that would be âgreenâ ï A product that would not be cost prohibitive
- 16. What We Found⊠ï There are âcertified greenâ products available ï This meant: ï The product itself was naturally renewable ï The container was recyclable ï The packaging was recyclable
- 17. So⊠ï We needed staff buy-inâŠthis was the easy part! ï Staff tried different products and voted on their favorite ï And in the process, increased their acceptance and use of ABHRs, while continuing the journey towards improved sustainability
- 18. What else could be done? ï Cleaning products ï Which cleaning activities could be done using âgreenâ products?
- 19. Recycling and Composting⊠ï As a healthcare institution, what was our responsibility? ï What could safely be recycled and composted? ï What were the implications of recycling/composting used medical supplies? ï Did the recycling company understand what they were receiving?
- 20. Who do you turn to for answers? ï CDC, PA DEP, and the PA Department of Health ï Received approval to proceed with our recycling/composting plans, provided that all bio- hazardous waste, including sharps, was handled and disposed of properly
- 21. First clinical recycling/composting implementation Fall 2010 ï Table paper ï Clinic wide ïGeneral expectation of participation
- 22. Table paper as mixed office paper Baseline audit Collaborated with OPP to provide containers OPP removes
- 23. Composting within UHS ï Paper towel composting ï Trialed in select bathrooms to begin ï Moved to all BRâs
- 24. Pilot 1 Clinical Composting ï Started with composted paper towels ï Volunteers ï Clinician/ nurse teams ï One or two teams on each floor
- 25. What else? ï Inventory of routinely used products/ packaging ï Worked with Al in OPP ï What could be recycled? ï Receptacles needed?
- 26. How many different categories? What receptacles to use?
- 33. Pilot 2 (still voluntary, limited to several teams) Spring 2011 ï Added other categories ï Rigid plastic ï Film, stretchable plastic ï True trash
- 34. Who Takes it Away?
- 35. Pilot 3 Summer 2011 ï One full clinical floor open during the summer ï Full staff participation encouraged ï Nurses played a critical role ï Problem solving ï Orienting clinicians
- 37. All hands on deck! Fall 2011 ï Summer staff already familiar ï Returning staff educated at clinical and team meetings ï Identified resource people for each floor ï Visual/ hands-on teaching area on each clinical unit
- 42. ï Recycling Audits ï· April 2009 27.6% ï· May 2010 39.4% ï September 2011 56 %
- 43. Successes RIGID PLASTIC VINYL GLOVES Plastic flooring Flexible hose units for outdoor for overseas storage units markets
- 46. Green Paws Certification: a roadmap for sustainable practices
- 48. Patient Education⊠ï Patients were surveyed as to how they preferred to receive health information ï Options were: - receiving hard copy handouts - receiving informational messages and resources electronically - referred to websites
- 49. Results⊠58.40% 60.00% 50.00% 40.00% ï The majority of 29.30% students preferred 30.00% to have resources 20.00% sent to them 9.60% 10.00% electronically 2.60% 0.00% ï Information is now sent through a secure electronic process whenever possible â happier patients, less waste
- 51. Training the next generation⊠ï Instructors from the School of Nursing bring their students to work at UHS sponsored vaccine clinics ï SNs are expected to participate in our sustainability program
- 52. School of Nursing response⊠ï The Nursing faculty was very much onboard with our efforts and saw it as an excellent learning opportunity ï Picture of vaccine clinic ï The SNs shared sustainability practices with the vaccine participants
- 53. Result⊠ï Nearly 100% of the supplies used were either recycled or composted ï Student Nurses expressed an appreciation and pride in being involved in the efforts as well as heightened awareness of what could beâŠ
- 54. Additional Resources ï Penn Stateâs Sustainability Portal, http://www.green.psu.edu/ ï Penn State Student Affairs Sustainability Blog http://www.psu.edu/dept/sa_sustain/ ï Healthcare Without Harm http://noharm.org/ ï Association of Reproductive Health Professionals http://www.arhp.org/professional- education/programs/environmental-impacts/RHE- Provider-Resources ï Practice Greenhealth http://practicegreenhealth.org/about/mission
- 58. Reducing Electricity Usage ï Purchasing energy efficient equipment ï Other green purchasing ï Reviewing the buildingâs occupied/unoccupied heating and cooling settings ï $20,000/year savings ï Encouraging the use of stairs over the elevators ï IT Innovations ï 3 virtual servers doing the work of 80 conventional servers
- 59. Energy Audit Results ï 2009: 980,896 kWh ï 2010: 862,511 kWh ï 2011: 760,894 kWh
- 60. Questions?
Hinweis der Redaktion
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- BETTYANN
- BETTYANN
- JILL
- JILLThis process felt like a part of a larger cultural movement which helped garner support along the way.
- BETTYANNPersonal introâs (Bettyann- nurse, Jill âClinician- Green team clinical reps) Clinical unit consists of two separate floors. 58 staff members, 34 nurses, 24 clinicians, reception referral staff2 clinical floors, 32 exam rooms on each floor, see approx 300 ptâs per day
- BETTYANN
- SHELLEYIf we could increase use of ABHRs: 1. would be in compliance with expert recommendations for hand hygiene 2. improve likelihood of hand hygiene 3. results in fewer paper towels and less water used
- SHELLEYStaff was resistant to use of ABHRs because they felt: 1. dried skin out too much 2. they stung 3. didnât like current product
- SHELLEY
- SHELLEYNot only did we find âgreenâ products, but they were cheaper than what was currently being used AND staff liked them much betterâno longer heard complaints about ABHRsThis exercise demonstrated that being âgreenâ responsible, isnât difficult.
- SHELLEYActivities: 1. Staff washing personal dishes/food containers (dish soap) 2. Walls and floors
- SHELLEYWhat did the experts say? Were there any different standards for medical waste?What if something got recycled/composted that was bio-hazardous?Had anyone talked to the recycling companies to see what their concerns were?
- SHELLEY
- JILL OR BETTYANN???
- J OR B???Alâs inspiration talk at UHS DayOPP â office of physical plant
- BETTYANNStory- In BR- Green team idea through sharing- To exam room
- JILL
- JILL
- JILL A lot of work to get here! Experimentation with containers, buy-in from staffCompost
- BETTYANNMixed office
- BETTYANNPlastic Film - More containers needed- Ice cream tub trial (and failure)
- BETTYANNRigid plastic
- BETTYANNBiohazard imageWe contract bio-hazardous waste removal with a company that promotes environmentally safer practices
- BETTYANNsharps
- BETTYANNTrue Trash image (Very little- predominantly patient generated) Glove in this picture are now recycled NOTE FOR BETTYANN: evolving since this picâŠnow can recycle other stuff (gloves, caps)
- JILLLabeling / names of categories gels up/trial and error on room set-up (Zoom in line items)
- JILLWould the clinical staff have to put it in a certain area or could facilities pick it up
- JILLSummer points- about œ the staff so easier to problem solve, Nursing role-Fine-tuning containers, room layout, (Zoom)
- JILL
- JILLCulture of acceptance and buy-in from summer staff incentives, inservice games, green tour, videos
- BETTYANN OR JILL???West hall photo of recyclables â training for staffStill the out that if in doubt, (or too busy) toss it in the true trash!- Really have not seen this much!
- B OR J???Late Comer: The learning curve continuum â staff request
- JILLOccasional grumble Positive âgreenâ culture of âCan doâ. Team meetings to reinforce/ Invite feedbackSome ongoing evaluations- Code room story.
- JILLPharmacy and lab initiating their own initiatives with sharing of information and resources across departments.
- JILLAmazing volume!
- B OR J??? Feedback to staff on what former trash becomes.
- B OR J???Educated staff questioning trashing âexotic â lunch recyclables- Green Team sub-group created to address and develop a system and did additional continuing ed- Visual aids significantly improved participation MAGNIFYING GLASS AVAILABLE FOR STAFF USEExcited and curious to see next audit results in Fall 2012.Roundtable on sustainability at Student Affairs Day- A lot of pride shared by UHS staff to others within SAâs. Attitudes and actions extend beyond recycling and outside the workplace.
- B OR J???Slide(s)here of Green Paws jean stickers, Alâs tour, etc..enthusiastic staff member and the like!!
- JILLReference the handout, Discuss entrance wall entrance exhibit- Educates students about our process- (patient questions arise in exam rooms too)
- JILL
- SHELLEYCurrent student population is techno savvy â our generation may like printed copies, but what do our students prefer?
- SHELLEYItâs pretty clear that our students wanted information electronically, not printed copies
- SHELLEYEx: Medline, CDC VIS, Health Topics in all Languages, Up-to-Date, WH weblinks, UHS home page
- SHELLEY
- SHELLEY
- SHELLEY
- JILL
- JILLPE on Environmental impact on healthAlso a resource for us as HCPâs (Note scroll bar- many great links to relevant organizations and info)
- JILL
- Additional resources