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Global Health and Safety Initiative

Eco-Health Footprint Workgroup

What Gets Measured Gets Managed

Whether you call it a "footprint," dashboard or environmental management system, the healthcare sector has environmental and natural resource impacts to be measured and managed. When these are measured and tracked consistently, they can be managed well, resulting in more efficient, cost effective and less impactful healthcare facilities, benefiting the health care sector and public health.

The Global Health and Safety Initiative Eco-Health Footprint will aggregate, promote and standardize best practices through which the healthcare industry can measurably advance its environmental stewardship and public health goals.

Eco-Health Footprint Toolkit for Health Care

As part of the Global Health and Safety Initiative's mission to promote environmental leadership for improved health care and provide resources for collaborative sectoral change, GHSI is working with its partners to create a sector-wide standard approach to measuring health care's impact on the environment at the individual (facility/ministry) level and at the collective (industry) level.

The Eco-Health Footprint, as conceived by the GHSI in collaboration with its partner organizations, is a methodology to measure the environmental and health impacts of healthcare operations. The Eco-Health Footprint (EHF) takes advantage of existing tools and best practices to measure the health care industry's contribution to a number of environmental issues. The EHF will be extremely useful in creating a shared understanding of health care's environmental performance, and in identifying the root causes of the largest impacts.

For example, health care is a large user of energy, and energy derived from fossil fuels results in carbon dioxide pollution, which is linked to global climate change. By fully understanding our impacts, GHSI health systems, partners, and the broader health care sector can better prioritize environmental improvement efforts. By using a standardized measurement tool for health care, we can consistently capture and share our performance metrics and best practices, as well as contribute to the growing field of knowledge and standardization for carbon, water, ecological and other footprinting methodologies.

Environmental Impacts

The Eco-Health Footprint reflects unique environmental and natural resource impacts of the health care sector:

  • High energy use, estimated at more than twice the energy intensity of commercial office buildings (In fact, the healthcare industry is the second highest energy intensity of any building type in the U.S.)
  • High water use (about 70% of hospital's total water use is for process water uses)
  • Distinct operations resulting in a unique toxic profile compared to other building types
  • A core mission to promote human health and well-being expressed through environmental stewardship.

Drawing from impact categories of other Ecological Footprint studies and harmonizing with existing tools, the Eco-Health Footprint includes assessing, measuring and monitoring the following:

  • Greenhouse gases including anesthetic and medical gases
  • Water including process and domestic (potable)
  • Waste including solid, liquid, hazardous, recyclable, donations, construction waste and regulated medical waste
  • Toxic chemicals
  • Criteria air pollutants
  • Built land.

Eco-Health Footprint Guide

The GHSI "Eco-Health Footprint Guide" is a concise overview of key terms, concepts and steps associated with footprinting, including the business case, examples of footprint efforts from health systems internationally and guidance on how to design and conduct a footprint for a health care facility. It is the most comprehensive resource of footprinting and environmental metric resources and case studies for the health care sector.

The Eco-Health Footprint Guide: Measuring your Organization's Impact on Public Health and the Environment (Version 1.2 May 2009) is available in a free downloadable PDF format with hyperlinks to case studies and resources.

EHF Guide Table of Contents

  • Foreword
  • Introduction
  • What is a footprint? What is the "Eco-Health Footprint"?
  • Why should you measure your footprint?
  • Who's measuring their footprint?
  • What makes up an "Eco-Health Footprint"?
  • Eco-Health Footprint Tools
  • How to measure your Eco-Health Footprint: A "Step by Step" Approach
  • Glossary
  • Additional Resources

EHF Release at CleanMed 2009

The GHSI Eco-Health Footprint Working Group presented its experiences, footprinting case studies and tools and released the GHSI Eco-Health Footprint Guide at CleanMed 2009 (May 18-20 in Chicago).

The panel discussion titled "Practical, Leading Edge Ecological Footprinting" included a demo of the emerging Eco-Health Footprint Toolkit, which will enable health care facilities to measure and improve their eco-health performance in greenhouse gases (including anesthetic gases); medical wastes; process and potable water; toxic chemicals, air pollutants and built land. The Toolkit's steering committee and early adopters described case studies and demonstrated innovations such as Dartmouth Hitchcock Medical Center's eco spreadsheet, the Global Health and Safety Eco-Health Footprint Guide and Practice Greenhealth's web-based Greenhealth Tracker and Energy Impact Calculator, which measures energy-induced health incidents and treatment costs per unit of energy used.

Presentations at CleanMed included:

Harmonization & Tools

The GHSI is currently working to further harmonize protocols for measuring the components of the Eco-Health Footprint. To date, the most recognized Eco-Health Footprint measurement standard addresses greenhouse gas (GHG) emissions, often using carbon dioxide as the proxy. Standards for energy and waste are also becoming harmonized within the healthcare sector. The GHSI and its Eco-Health Footprint Task Group have worked with Dartmouth-Hitchcock Medical Center to enhance and make their tool available as a standardized approach for the sector, reflecting current best practice in the field.

The GHSI recommends that health systems use the Dartmouth-Hitchcock Medical Center's tool to create a comprehensive footprint across seven categories. Additionally, the GHSI recommends the following tools for deeper analysis and tracking of waste and energy:

Information on these tools is provided in the GHSI Eco-Health Footprint Guide.

Eco-Health Footprint Working Group

GHSI convenes an Eco-Health Footprint Working Group to provide industry expertise and operational insights to define and create a footprint tools and resources customized for the healthcare industry. Group leaders are noted with an asterisk (*):

  • Ascension Health — Bob McCoole
  • Center for Maximum Potential Building Systems — Gail Vittori*
  • Cleveland Clinic — Christina Ayers
  • Dartmouth-Hitchcock Medical Center — John Leigh & Randy Pratt
  • Global Health and Safety Initiative — Michelle Lapinski*
  • Kaiser Permanente — Joe Bialowitz
  • Partners Healthcare — Hubert Murray
  • Practice Greenhealth — Mary Larsen
  • Spectrum Health — Josh Miller
  • US EPA Energy Star — Clark Reed
  • Wallace Partners — Mike Wallace*

EHF Working Group members provide technical guidance and review and beta test existing tools and approaches, complete an eco-health footprint (partial) for some or all of their facilities, and provide recommendations for GHSI to produce a practical Eco-Health Footprint toolkit.

GHSI EHF Working Group members may log in to the EHF Wiki.

Contact

Michelle Lapinski, EHF Workgroup Co-Leader may be reached at footprint {AT} globalhealthsafety.org.

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