Green Line Series NYC | Grassroots Engagement Drives Greener Healthcare at NewYork-Presbyterian

Being successful at sustainability is as much about community organizing as it is about operational prowess. In this Green Line Series, we speak with GoGreen NYC speaker and Corporate Sustainability Officer at NewYork-Presbyterian Hospital, Jessica Prata, on how engaging the organization’s staff across departments — from the OR to nurses stations and maintenance — and giving them outlets to participate in NYP’s sustainable practices has catalyzed their capacity for achievement.

GoGreen NYC: Just how much potential does sustainability hold for the healthcare industry? What kind of impact has embracing this philosophy and these systems made at NewYork-Presbyterian (NYP)?

Jessica Prata: As health providers, hospitals are very central to the community. We have a responsibility to provide the healthiest environment that we can for our staff and patients. We also want to create a very safe environment for staff and families to be in, and for patients to heal in, so that’s where the tie comes in for us.

At a glance, some may not immediately see the connection between environmental sustainability and healthcare.  How does recycling and waste management, energy production, efficiency and cogeneration, and transportation fleets connect to caring for patients in the best way we can? In fact proper management in these areas does impact our organization’s ability to provide the highest quality of patient care in a clean and safe environment. If you consider the broad impact that a hospital has in a community, you recognize how these sustainability initiatives contribute to our overall air quality and environmental footprint. Also, the more money we save by managing resources and waste more effectively, the more money we have to spend on creating the best patient experience possible. The dots do connect.

At NYP, we want to keep our patients as healthy as we can and provide tremendous care, all while doing the right thing in the community. We are members of and promote Practice Green Health, a nonprofit organization that gives support and guidance to hospitals as they embark on this journey.

GG: What was the process for making sustainability a part of your strategic vision and plan for how NYP moves forward as an organization? 

JP: Back in 2005, there was a good amount of movement within our facilities department. A lot of initiatives started there as a part of a very aggressive energy management plan. And 2005 is the year we received our first award from the EPA — we’ve since received seven. Then NYP’s senior leadership started to question what other elements of sustainability could be addressed. Energy is a huge component that helps us save money and control our environmental impact, but we felt there was more to take on.

By 2009, I was hired into the sustainability officer role, and together with our leadership looked at all the other key components. I wanted to figure out how we could incorporate these initiatives so that they engaged our staff. When I came on board, we formed a sustainability council with representation from all the key areas — transportation, procurement, facilities, environmental services, environmental health and safety, nutrition, wellness, and communication. We came together and collaborated to brainstorm some projects to start with. We branded our initiative “NYPgreen”.

Things began to blossom, starting with the work and plans that led up to our first Practice Greenhealth Environmental Excellence award in 2009. When I moved into the role we began to incorporate other programs beyond energy such as recycling, bike rack installs, composting and so on. We are continually expanding our programs while making sure the basic initiatives remain successful.

GG: How do you measure the impact across all of these different departments to report on it to your organizational leadership, and also to the rest of the community? 

JP: As I often discuss with other sustainability professionals building green teams, measuring behavior change with metrics can be challenging because our success is often based more on qualitative results than quantitative results.

In response to this, we found a way to create a metric that would help us track local engagement and give us a mechanism to reward staff. We created two programs, the NYPgreen Champion Program and NYPgreen Workspace Certification Program, which we modeled after a program Harvard put together. We established “green champions” as liaisons between departments in the hospital and the sustainability council and we charged them to go into their workspace to make sure they are recycling the right way.

Once the Champions engaged their department to correctly recycle on a consistent basis, they continued on to pursue NYPgreen Workspace Certification. This initiative has four levels and we measure along the way. For instance, to achieve Leaf 1 (level one) the department or unit needs a green champion in place, they need to establish and appropriately use a recycling system, turn off lights and monitors when they’re not using them, reduce paper consumption, and so forth. These are observable goals and all applications are peer-reviewed to validate the actions are consistent. The result is that our green champions are changing behaviors through the certification process and NYP leadership is able to benchmark our employee engagement. Is it totally comprehensive? Not yet. Is there room for improvement?  Absolutely.  But at this time, we have over 80 clinical and non-clinical departments that are certified as NYPgreen Workspaces and more applications are submitted each month.  We feel we are heading in the right direction.

We closely track our waste volumes, energy use, paper reduction and all associated costs so its a lot easier to measure success.   As an example, increasing recycling and reducing regulated medical waste are two of NYP’s top goals this year, so we have build programs around them to raise awareness, educating staff about the negative safety and environmental impacts of improper disposal.  We work very closely with our waste vendors so that they understand our goals. They provide us with data on a monthly basis so we can track our progress and strategize ways to improve.

BW: Let’s say I’m an orthopedic nurse and I have this idea to decrease energy use, but my department doesn’t have certification or even a “green champion.” Is there a mechanism for me to pass my idea up the chain at NYP? How does your organization create access for all employees to contribute, from the grassroots side of things? 

JP: There is a lot of buzz around these programs at NYP. If we don’t have something in place, we regularly hear from people about how we can advance. We have monthly workgroup meetings that are open to anyone in the hospital, so our employees can learn about the Green Champion and Green Workplace Certification Programs, and how they can get more involved in their area.

To get information out to employees we distribute a weekly green tip to our green champions. The tip is also presented to all management at our weekly Patient Safety Friday forums. We continue to seek new ways to broaden our reach with this information to remind employees that sustainability is a core goal of the organization.

I’ve mentioned our Green Champion Program several times. There are green champions at all five of our campuses. They constitute the campus green team for each site. Each team is led by a green captain, with whom I work directly. Our green teams are out there talking with their campus staff about sustainability, wearing that sustainability hat, and employees know they can talk to their green team leaders when I’m not available. But communication is an area I’m really looking to make more progress in, since improved communication can help get the word out and get our staff engaged.

BW: How do you prioritize where your energy goes? Is it based on the potential for impact or are there also other factors that are culturally important even if they are less measurable? 

JP: I think both are important. There are many priorities that need attention – local staff engagement, strategy, new program development. It takes strong project management skills to balance all these priorities and perform well in each. For example, a typical day may look like the one I had today. At 7 a.m. I conducted an in-service to educate front-line staff in the operating rooms about proper waste segregation. I then returned to my office for a conference call with one of our off-site ambulatory care clinics to discuss the new toner recycling program we are developing together. Then I had a meeting with some green leaders to talk about our goals for the end of the year and where we’re currently at. I also spent time with one of our operations teams in environmental services to help find ways to keep their front-line staff engaged. A good portion of my days are spent problem solving and helping people get over hurdles of working greener. There are a lot of shifting priorities, but the important thing is to aggressively pursue high-impact areas because they often have high visibility, but also listening to the things that are really important to your people.

BW: What are some concrete examples of direct benefits and payoffs you’ve seen from approaching sustainability comprehensively at NYP? 

JP: From both a staff satisfaction and “doing the right thing” perspective, the NYP sustainability initiative is really very central. We have so many staff concerned with these issues in their own personal lives. It would be a huge disconnect not to carry out their values at work. A program like this allows them to connect the dots for themselves and ends up making the workplace better for everyone.

There are also financial savings involved in many of these initiatives. Given the economic climate and the expectation that healthcare reform cuts may be coming, there has been a huge push across our entire organization to find ways to use supplies, resources and time more efficiently.

There is a natural alignment in this area with sustainability — when you save energy, you save money. When you lower your waste, you lower your costs. That’s helped give weight to the initiative, because there are still people out there who see sustainability as a “nice to have.” We’re lucky because the leadership at NYP appreciates the impact it has on staff morale and productivity, sees the economic value and also acknowledges sustainability’s role in allowing us to be good community citizens. From a staff, patient, community, and financial perspective, this aligns with the goals that NewYork-Presbyterian has set and the values it embodies.

BW: According to Google, one of the questions most asked of them by interviewees is around what they do on sustainability. How have these efforts affected NYP’s ability to recruit and retain the best talent? 

JP: Many candidates that apply to our organization inquire about whether or not we have a sustainability program.  NYP’s talent acquisition team does a great job promoting our organization efforts to “go green”.  In today’s job market, there is no question that people are looking for employers that take seriously the role of corporate social responsibility in its core values and mission.  People coming into the workforce want to join a workplace with these values because it has been a part of their upbringing and is deeply embedded in their personal values. When those generations hit the CEO level years from now, they won’t need any convincing that it’s a real issue. Mindsets are changing across industries and generations and that’s a great thing – because sustainability takes a village.  It’s a marathon, not a sprint. We need everyone working together.  Culture change is hard, particularly in the hierarchical hospital environment.  But sustainability isn’t about roles, it’s about doing the right thing. And if you get the right people in the right place, and there’s the right energy around your efforts, the kinds of synergies that change culture can happen.

BW: How great is your impact upstream? Hospitals use so many products and the supply chains are vast — from bandages, to food, medical equipment and energy. What happens when a large system or a provider starts making different decisions in these areas? Has the industry changed to provide the products and services hospitals like NYP are asking for? Or is it still hard to find what you need in order to do business they way you believe it should be done? 

JP: NYP’s procurement and strategic sourcing team in collaboration with our group purchasing organization (GPO) Novation VHA a are working to encourage suppliers to create products with fewer chemicals, packaging that leaves hospitals with less waste, devices that can be reprocessed, and so on.  This helps further the connection between sustainability and patient safety.  It can also help our bottom line.  As an example, we saved over one million dollars in 2011 through third party clinical device reprocessing. There is a great deal of work still to be done in this space in order to continue providing the highest quality care for patients across the country and the world, and we are moving in the right direction

BW: Do you feel that NYP has a direct role in driving a greener economy in New York City because of your choices?

JP: The hospital industry is banding together to communicate what it needs, and is in a position to drive significant change in our marketplace and also within the New York City community. A number of NYC-based hospitals participate in the Mayor’s Challenge to reduce greenhouse gases by 30% by 2018.  A few of us have created a best practice forum separate from that called the NYC Green Hospital Consortium to discuss best practices to sustainability issues across facilities, energy, procurement, safety, clinical, and other functions. We believe we can generate a lot of change through this kind of collaboration.

BW: In terms of transferrable lessons you’ve learned, what are the keys to NYP’s success in sustainability?

JP: I think you have to get your staff engaged — that is number one. Sustainability can’t just be top down and it can’t be just bottom-up either. You’ve got to get both leadership and employees engaged. This issue is something that has both local and global ramifications and every single organization has a responsibility as community members to do something about it.

You also need a point person (or 2-3 point persons) to be a hub for activity to report, communicate, coordinate, and set vision.  It is important to create a brand around your sustainability initiative — something that people can grab onto — otherwise it isn’t tangible enough for people to grasp and understand how it applies to them. You need to engage people in a way that is empowering rather than judgmental or threatening.

I think it’s also very important, no matter what your mission is or what industry you are in, to find a way to position sustainability as an initiative that can help support your organization’s key goals — otherwise, you’ll never be able to truly embed it into your culture in a way that will make impact.

Jessica Prata is the Corporate Sustainability Officer at NewYork-Presbyterian Hospital. She will also share insights and advice on engaging a team around sustainability at the inaugural GoGreen NYC, Wednesday, September 19 at the TimesCenter. For more information and to register, visit newyork.gogreenconference.net

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