In 2009, we achieved some notable successes by purchasing products that were free of hazardous chemicals and other materials. Through our environmentally preferable purchasing program, and now with our new Sustainability Scorecard for medical products, the first of its kind in health care, we require suppliers to provide information on their company’s environmental commitment, use of potentially harmful chemicals in their products, and information about product and packaging recycling.

Because we are a large purchaser, our efforts have encouraged the marketplace to offer safer, more sustainable products. In 2009, our Procurement and Supply Department focused on a variety of products, including:

• Defibrillators that use 33 percent less material in manufacturing, use lead-free soldering, and come in eco-friendly packaging.
• Patient ID bands that are free of PVC (a substance that generates dioxin pollution).
• Laptops, desktop computers, and monitors that meet the gold or silver “EPEAT” standard of energy efficiency and toxin reduction.
• Reusable basin sets.
• Reusable sharps containers that reduce biohazardous waste.

BPA-free baby bottles

In 2009, we completed a five-year study, funded by the U.S. National Institute of Occupational Safety and Health, that examined factory workers in China who were exposed to high levels of Bisphenol-A (BPA).This chemical is used in the manufacture of baby bottles, plastic containers, the lining of cans used for food and beverages,and dental sealants.The study found that exposure to BPA was linked to significant reproductive difficulties in men.While the Chinese exposure levels were higher than the levels in many commercial products, we decided, as a precaution, to purchase baby bottles that are BPA-free.

Our environmentally preferable purchasing program, now enhanced with our Sustainability Scorecard, is encouraging has encouraged the marketplace to offer safer, more sustainable products

A fortunate side effect

Many people believe that environment-friendly practices are expensive. Fortunately, we have seen quite the opposite. Our contracts for environmentally preferable products and services last year are expected to save us about $20 million annually. The products included LED lights for operating rooms, sustainable fabric, reusable surgical gowns, and greener office supplies.

We also took other actions in energy savings and travel reduction that saved millions more. Since we are a nonprofit organization, we were able to apply those savings to improving the health of our members and communities.

Greenhouse gas emissions are threatening to accelerate climate changes that affect health through the spread of infectious diseases and heat-related illnesses. A 2009 study published in the Journal of the American Medical Association found that health care activities contributed 8 percent of America’s total greenhouse gas emissions. Since 2005, we have annually measured and reported our greenhouse gas emissions using protocols established by the California Climate Action Registry and the Climate Registry. By understanding the impact of our various activities, we can set aggressive goals and measure our progress against them. Our current goals are to reduce greenhouse gas emissions intensity by at least 4 percent in 2010 (using 2008 as a baseline) and to use onsite renewable energy sources for at least 25 percent of our building energy needs by the year 2020.

One example of our commitment to green policies is our new hospital in Hillsboro, Oregon, just outside Portland. In 2009, we broke ground for The Kaiser Permanente Westside Medical Center. It will be the first Leadership in Energy and Environmental Design (LEED) Gold-certified hospital in the area—and the first Kaiser Permanente hospital to earn this recognition. LEED is an internationally recognized green building certification system that recognizes the importance of green building methods and energy-efficient systems.

In California, water use is fossil-fuel intensive because of the need for pumping across long distances. We have benchmarked our hospitals and found them to be 40 percent more water efficient than the average U.S. hospital and 20 percent more efficient than the average California hospital. This is largely because of our transition to digital imaging, as well as the drought-tolerant plantings at our facilities.

Because of Kaiser permanente’s scale as an operation, and our belief in total health, we have a special responsibility to be good stewards of the environment.

Less travel for members and employees

We use many new technologies and innovations that help us deliver our services with less travel, including mail-order pharmacies, secure patient-physician e-messaging, telehealth, mobile health vehicles, and fleet vehicle right-sizing.

We also operate in-house distribution networks for laboratory specimens, prescriptions, and medical supplies. Our medical offices and hospitals have retail pharmacies where our members can fill their prescriptions without generating an additional trip to a pharmacy. In 2009, we also used teleconferencing, videoconferencing, and telepresence to reduce employee travel, saving an estimated 456 metric tons of greenhouse gas emissions and more than $247,000 in travel costs.

In an organization the size of ours, even a small change creates large results. We also found large changes that led to even greater results. In 2009, by reprocessing over 376,000 single-use devices, we reduced waste by more than 274,000 pounds and avoided approximately $82,000 of waste disposal costs. More impressive, this saved $7.7 million in medical device purchasing costs. In 2009, we were also able to resell and/or recycle over 60,000 pieces of electronic equipment.

Results of Kaiser Permanente’s medical device reprocessing practices

Total number of medical devices reprocessed

Waste avoided (lbs)

Purchase and waste costs avoided

Reducing our use

Since 2008, Kaiser Permanente has conducted a Reduce Your Use campaign that encourages employees and physicians to reduce their consumption of resources. This Web-based campaign periodically highlights different themes and offers tips on ways to cut consumption and set goals.

The first campaign of 2009 generated pledges to cut back on single-use plastic water bottles that could save nearly 6 tons of waste annually. The second 2009 campaign challenged employees to turn off lights when leaving a room, generating more than 1,000 pledges, which could save an estimated 3 million kilowatt hours a year, avoid more than $300,000 in energy costs, and be the equivalent of taking 343 cars off the road.

Our current goals are to reduce greenhouse gas emissions by at least 2 percent per year and to use onsite renewable energy sources for at least 25 percent of our building energy needs by the year 2020.

Our Green Teams drive grassroots environmental improvements in our facilities. These cross-functional, volunteer teams composed of employees and physicians are finding ways to reduce the environmental impacts of our organization’s everyday activities. We have Green Teams in at least 25 medical centers, as well as in numerous other regional and national facilities. One example of their achievements can be found at Kaiser Permanente’s medical office buildings in San Francisco, where Green Team members implemented a successful composting program.