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checkEducation: Environmentally Preferable Purchasing 201 (EPP 201) - Implementation Strategies

All PIM content was independently developed and reviewed to be vendor-, product-, and service provider-neutral.

Description

Developing a comprehensive supply chain management plan creates a structure and culture for success. Organizational readiness components including hardwiring, culture, alignment, structure, leadership, strategy and metrics will be explored.

  • Project Talking Points

    • In the PIM titled “Train your supply chain staff in environmentally preferable purchasing (EPP) 101” the following was reviewed:
      • As supply chain leaders, what is the Supply Chain professional’s role in the sustainability initiatives of the healthcare organization? Is there an EPP program? Within Materials Management and the healthcare organization, what is the level of awareness of the cost saving opportunities within sustainable products and processes?  What other benefits are collateral to the EPP program initiative? 
      • EPP can apply to everything that passes through the supply chain to provide healthcare.
      • Purchasing decisions signal the market to move towards a preference for environmentally superior products and services.
      • Assessment of every product for impacts and alternatives is essential – can we use fewer items, maximize utilization, create less waste and save money while improving quality and outcomes?
      • EPP is the process of selecting products and services whose environmental impacts have been considered and found to be preferable to those of comparable alternatives.
      • EPP is a way for purchasers (health care institutions) to implement their values and goals as they relate to environment, health, and safety.
      • EPP takes into consideration performance, availability, and price.
      • Supply Chain employees are in a position to educate other provider employees in EPP product selection.
      • EPP is  a prime example of the intersection of CQO as it looks at products and processes from the perspective of total costs to the organization, the quality of care and life engendered by use of a product and outcomes generated by the purchase of one product over another.

     

    • The learning objectives for this PIM are to understand how to develop a comprehensive Supply Chain Management Plan that creates a culture and structure for success.
  • Triple Bottom Line Benefits

    Cost benefits: EPP products and services typically have a lower total cost of ownership when compared to traditional products and services. EPP products/services can also have a lower upfront cost (re-usable sharps containers, SUD reprocessing, etc.)

    Environmental benefits: EPP is the process of selecting products and services whose environmental impacts have been considered and found to be preferable to those of comparable alternatives. EPP products and services can be the key to reducing waste, eliminating toxicity and increasing efficiency within products, facilities and operations.

    Social benefits: EPP assesses the human and environmental effects of products and services and uses those results to select healthy and safe products, prevent toxicity and waste, extend the life of products and minimize the use of hazardous materials. The goal is to meet or exceed health, safety, satisfaction and quality standards.  Community awareness, approval, and goodwill are often byproducts of the EPP program.

  • Purchasing Considerations

    • Place purchasing preference towards products and services that address environmental impacts throughout the lifecycle when safety, quality, total cost and services are equal. This includes the environmental footprint of manufacturing, packaging, transportation, energy and water use, and disposal.
    • Assess the human and environmental effect of products and services and use those results to select healthy and safe products, prevent toxicity and waste, extend the life of products and minimize the use of hazardous materials.
    • Use the precautionary approach when selecting products containing specific chemicals and materials.
    • When evaluating new product purchases, require the supplier provide environmentally pertinent information along with other criteria such as safety and quality.
      • Work with your Group Purchasing Organization or vendor to determine if sustainable alternatives are available.
      • Identify which, if any, toxins and chemicals are used in the new product/packaging
      • If possible work with GPO/vendor to identify alternatives
      • Vocalize your desire to purchase products in the future that decrease or eliminate substances of concern.
    • Chemicals/Materials of Concern
      • Newly purchased items should avoid, limit or replace the following:
        • Mercury
        • Poly Vinyl Chloride
        • Bisphenol-A
        • Latex
        • Phthalates
        • Volatile Organic Compounds (VOC’s)
    • Energy
    • Water
      • Place purchasing preference towards water efficient products, devices and retrofits that increase water efficiency within facilities.
    • Waste
      • Product life cycle
        • Product’s end life is considered when making purchases.
        • Products and equipment with a higher durability are favored.
        • Put preference to products that have the ability to be reprocessed or remanufactured.
        • Avoid products that need hazardous or regulated medical waste disposal.
      • Packaging
        • Place preference towards vendors and products with minimal packaging and/or packaging that is recyclable and/or biodegradable.
        • Internal products used for delivery should be reusable. This includes but is not limited to:
        • Totes for internal deliveries
        • Shipping containers
        • Regulated medical waste shipping
        • Rigid sterile cases for surgical items
        • Pharmacy waste containers
      • Materials
        • When possible, purchase products that are made from recycled, bio-based, remanufactured or reprocessed materials.Look for products that can be disposed of through remanufacturing, reprocessing, recycling or composting including:
        • Sharps containers
        • Single Use Reprocessing Devices
        • Compostable kitchenware
        • Blue wrap remanufacturing and rigid container utilization
        • Bio-based kitchenware
      • Wherever possible purchase multiple use products over single use.
    • Landscaping
    • Indoor Air Quality
      • Place preference on low/no VOC paints and primers for new construction, renovations and maintenance
      • A comprehensive green cleaning programshould be used in place of traditional cleaning systems. 
      • Place preference towards green seal certified cleaning products, microfiber mops, cloths and dusters and heap-filtration systems in vacuums.
    • Healthy and Sustainable Food Purchasing
      • When financially feasible place preference towards organic, fair trade and humanely raised products.
      • When financially feasible place preference towards reusable or biodegradable kitchenware if reusables are not an option. 
      • Consider portion control items.
      • Place preference towards local food purchases.
  • How-To

    The development of a Supply Chain Management Plan includes the following components: 

    1. Understanding organizational readiness

    Hardwire

      • Integrate vs. overlay: The EPP program should be integrated into the cultural fabric of the organization vs. creating a separate “overlay” program. Integration means working with staff, management, and leadership on developing “green lenses” so EPP opportunities can be identified and implemented with a strategic, measured and transparent approach. An example of this could be integrating EPP criteria into the general products value analysis team.
      • Developing internal capacity: One way to develop those so called “green lenses” is to develop internal capacity through engagement, targeted education & training programs and communication. If you wanted to make this “green lenses” scenario a little more formal, you can build EPP performance targets into the staff evaluation process.  

    Culture

      • By enabling the culture and developing internal capacity, you will find that staff gravitate to and are eager to engage in this work. Staff buy-in and support helps ensure that systematic change is truly “sustainable”.  
      • A successful EPP program can also increase staff moral and could benefit the retaining and attracting of talent.
      • Train, educate, and celebrate
      • Develop train the trainer, lunch n learn programs, etc.  to educate pertinent staff on your EPP efforts and associated results
      • Label environmentally preferable products to create awareness amongst staff and patients
      • Use data to create meaningful information (environmental indicators)
      • Develop a PR campaign to increase community and donor awareness
      • Develop recognition and awards programs for employees making unique contributions

    Alignment

      • One of the key areas of alignment addresses how EPP integrates and foster the hospital’s mission, vision, values & strategic plan.
      • Another component of alignment is exploring how EPP crosswalks with existing functional areas and/or committees, such as safety committee, hazardous materials committee, Joint Commission, etc.
      • Building upon the functional crosswalk is an alignment with organizational priorities, such as expense reduction, performance improvement, quality, etc. 

    Structure

      • Structure includes building upon and aligning with the current organizational infrastructure. It’s important to identify and illustrate program reporting relationships and how the program lives and breathes within the organization. For example sustainability/EPP should be incorporated into your value analysis process/team. Activities can include:
      • Identifying, vetting and recommending green products and services.
      • Analyzing total cost of ownership (TCO) and cost-quality-outcomes (CQO).
      • Developing a set of standardized environmental questions.
      • Rethinking product costs and attributes
      • Verifying product claims
      • In some cases a green team or EPP team can be createdthat are accountable for the development and continuation of a comprehensive EPP program. The team members are comprised of existing staff who can act as accountable leaders and subject matter experts.
      • All staff should be held accountable for EPP and some organizations have integrated EPP/sustainability language into position descriptions.
      • Line staff play a critical role as they can help identify waste at the operational level that management and leadership may not see. Empower and engage them to identify and make change.
      • Utilize MMIS data tools to track or denote EPP initiatives, ie., simple designation in field of Item Master.

    Leadership

      • Leadership plays an integral role with respect to integrating EPP/sustainability into the cultural fabric of the organization. They can help by creating a culture of sustainability and communicating to staff their expectations and the engagement opportunities available.
      • One of the ways leadership can demonstrate their commitment is through a leadership proclamation, which can be comprised of:
      • An environmental commitment statement
      • An all staff celebration event
      • Announcements at leadership meetings, management meetings, Board of Directors meetings, etc.
      • Internal and external communications/press releases
      • Through the leadership proclamation event it would be an appropriate time to announce who the corporate champion is – someone who can articulate a vision, help develop the business case, set priorities, remove barriers, identify resources, drive accountability and monitor progress.
      • Leadership should also be developed at all organizational levels through engagement and empowerment strategies. All staff are contributors to the program.
      • Leadership should cultivate a fabric/culture that delineates collaborators internal and external to the organization;  implicit with this “chart” would be recognition  of the synergies derived through cooperative endeavors. 

    Strategy

      • Senior Leadership teams are under immense pressure to reduce expenses, so if a strategy that builds a business case for EPP can be developed, the program will be successful.
      • The business case should be rooted in metrics, benchmarking and identifying the best practice gap opportunities.
      • Once you are able to illustrate the triple bottom line opportunities, goals, objectives and action plans should be developed to achieve and hold the gains. 
      • Develop SMART Goals - Specific, measurable, achievable, realistic, timely
      • Develop an accountability matrix / action plan which should include the action, accountable person(s), goal/target, timeline, progress-2-plan and trending.
      • Example Goals:
        • Reduce purchase of mercury-containing products by 80% in 12 months.
        • Increase purchase of recyclables or reusables by 30% in 12 months.
        • Reduce packaging waste or total solid waste by 20% in 12 months.

    Measurement & Reporting

        • In most organizations measurement and reporting with respect to EPP and/or sustainability is not done.
        • Measurement and reporting includes establishing a baseline, benchmarking to industry metrics and identifying the TBL gap opportunities (people, planet, profit). Once the gaps are identified a Plan-Do-Check-Act (PDCA) process can be developed for targeted programs and processes.
        • For each project, identify your KPIs (key performance indicators) up front. Examples include: 
        • Number of sustainable items on contract
        • Cost savings
        • Environmental benefits
        • Social benefits
        • Consider: how will data be turned into information that can be used to take meaningful action? What are the reporting mechanisms? Who is your audience
        • Effective measurement and reporting is key to building the business case and engaging staff. Reporting on progress shows staff their efforts are not going unrecognized and that their time is valued and respected.

    2. Assess current contracts

      • When assessing your current contracts ask yourself what the organizational priorities are with respect to EPP/sustainability and how can this contract meet or exceed those priorities.  
      • Conduct a current state gap analysis against priorities to identify your opportunity.
      • Research what vendors have a “green” product or service that meets your needs.

    3. Ensure control of supply chain functions

      • If your EPP policy states the organization is committed to, for example, non-aerosols, less toxic products, less packaging, etc. make sure all departments are in compliance. Numerous times departments have their own “credit cards” and may purchase the very products that are discouraged.  

    4. Review current policies

      • Adopt a facility-wide EPP policy
        • Define stakeholders: contract administrators & value analysis play a critical role
        • Research and use sample policies as to not re-invent the wheel.
        • The policy should address leadership, structure and strategy.
        • Incorporate environmental, human and financial health considerations into the policy (chemicals, waste, water, energy, IAQ, packaging, durability).
        • Include language on total cost of ownership and life-cycle costing.
        • Communicate your policy with vendors, suppliers, manufacturers, and GPOs and the expectations you require from them. 

    5. Leverage the expertise of your vendors and GPOs

      • Vendors and GPOs have useful resources, tools and support mechanisms such as:
        • 50 Ways to Go Green Checklist
        • Chemical Policy Statement
        • PVC-DEHP Elimination Resource Guide
        • SUD Reprocessing Toolkit
      • Vendors and GPOs can assist your organization with audits and assessments such as:
        • Utilize more reusable totes and shipping containers
        • Reduce/eliminate packaging or take it back for re-use
        • Deliver all printers and copiers set for double sided and black/white copying and printing
      • Some GPOs may have a product evaluation/steering committee. See if your organization can act as a participant.
      • Some vendors and GPOs may have a “Green Product Guide” that will allow your organization to understand how much of your purchasing qualifies as “green”. Once a baseline is established this information can be used to make strategic “green” purchasing decisions moving forward. 

    6. Require chemical disclosure

      • Require vendors demonstrate (with objective measures such as lab tests) that their product does not contain substances you have set as undesirable (for example PVC or mercury).
      • In your RFPs, set this disclosure as a requirement. Example: “For products that contain lead or mercury, [the Organization] will give preference to those products with lower quantities of these metals and to vendors with established lead and mercury recovery programs.”
      • Manufacturers can also help your organization identify low toxicity materials/products.  

    7. Develop standard EPP language

      • Create language for all RFIs, RFPs, and/or contracts. Example language may include that the vendor provides training, educational materials, measurement and verification, packaging take back, end-of-life considerations, etc. 
      • Contract language is shared in the sustainable purchasing community so you don't have to start from scratch.
      • Make sure that environmental claims and labels are well understood before incorporating them into your contract language.
  • Case Studies

    Cleveland Clinic | Greenhealth Magazine

    Key Points:

    • Cleveland Clinic’s sustainability program creates and overarching framework that includes and engages with all departments and campuses
    • The organization’s communication of their sustainability program is a vital part of keeping staff, patients and community engaged
  • Cross References: LEED

    • LEED (2009) Existing Buildings: Operations and Management. Materials and Resources Prerequisite 1: Sustainable Purchasing Policy
    • LEED (2009) Existing Buildings: Operations and Management. Materials and Resources Credit 1: Sustainable Purchasing: Ongoing Consumables
    • LEED (2009) Existing Buildings: Operations and Management.  Materials and Resources Credit 2: Sustainable Purchasing: Electric Powered Equipment
    • LEED (2009) Existing Buildings: Operations and Management. Materials and Resources Credit 3: Sustainable Purchasing: Furniture
    • LEED (2009) Existing Buildings: Operations and Management. Materials and Resources Credit 4: Sustainable Purchasing: Reduced Mercury in Lamps
    • LEED (2009) Existing Buildings: Operations and Management. Materials and Resources Credit 5: Sustainable Purchasing: Food
  • Cross References: GGHC

    • GGHC (v2) Operations: Environmentally Preferable Purchasing Credit 1.1-6.2
  • PIM Synergies

  • More Resources

    • Practice Greenhealth supports its member organizations with numerous components of their sustainability journey. In addition to its member support, its Greening the Supply Chain™ initiative  is open to all hospitals; bringing hospitals, GPOs and suppliers together to innovate. White papers, sample RFI language, case studies, webinars and more are available via the initiative website.
    • Healthcare Without Harm’s vision is to lead the global movement for environmentally responsible healthcare. As thought leaders, researchers and educators, Health Care Without Harm creates and aggregates a wealth of information about the “why” of sustainable healthcare, and ties it to our shared common mission of health. Its sister organization, Practice Greenhealth, focuses more on the “how” of sustainable healthcare. Detailed fact sheets on specific chemicals of concern or global supply chain issues can be found on its rich website.
    • The Healthier Hospitals Initiative (HHI) is a national campaign to implement a completely new approach to improving environmental health and sustainability in the health care sector. HHI is a guide for hospitals to reduce energy and waste, choose safer and less toxic products, and purchase and serve healthier foods. One of the six priority challenge areas is Smarter Purchasing.
  • PIM Descriptors

    Supply Chain

    Level: Beginner

    Category List:

    • Training and Education

    PIM Attributes:

    • Optimize Operations

    Improvement Type:

    • Operations

    Department:

    • Purchasing/Materials Management/Supply Chain
  • Interested in underwriting this PIM? Contact us to find out how!

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