The Greening of the O.R. and Hospitals and Corporate Social Responsibility

Although we are living in a world of "throwaways" we are seeing an exciting convergence of corporate social responsibility, green logistics, healthcare, and even humanitarian operations through the recycling, redesign, and reprocessing of medical products and associated medical waste, so there is HOPE!

Interestingly, as The New York Times is reporting, in the article, "In a World of Throwaways, Making a Dent in Medical Waste," by Ingfei Chen, the biggest source of medical refuse is the operating room (O.R.), with 20-30% of a hospital's waste.

A nonprofit group in VA, Practice Greenhealth, is now working on reducing the environmental footprint of health care institutions with its Greening of the O.R. initiative, which is focusing on identifying the best sustainable practices for reducing operating room garbage, energy consumption, and indoor air quality problems, while lowering expenses and improving safety -- all fantastic goals! Reducing the waste associated with medical supplies and equipment,which can be achieved through recycling and reprocessing, for example, can save on new purchases and can also reduce landfill fees and incineration costs.

For example, according to the article, the Hospital Corporation of America, which owns 163 hospitals, eliminated 94 tons of waste last year through the reprocessing of medical supplies!

I am reminded of the similarity between medical waste and recycling and reprocessing issues to that of electronic recycling, or e-cycling, a topic that I have written about in the past, with Dr. Fuminori Toyasaki. Our paper, "Reverse Supply Chain Management and Electronic Waste Recycling: A Multitiered Network Equilibrium Framework for E-Cycling," remains as one of the top cited papers in Transportation Research E.

Dr. Ralph Pennino, the chief of plastic surgery at Rochester General Hospital in upstate New York, notes that surgeons have agreed to use standardized supply kits selected to cover most of their needs while leaving little unused, so that they can “work systems out so we don’t have anything to reprocess." This is said beautifully and speaks to the importance of designing health care supply chains and medical products accordingly, a topic that we have also been writing about, and where we specifically allow decision-makers to assign costs associated with oversupply/waste.

Dr. Pennino notes that leftover items are donated to InterVol, a nonprofit organization started in 1989 by him. Each week, its volunteers gather about 8,000 pounds of unused supplies and reusable equipment from regional health care facilities, then ship the stock to clinics in more than two dozen countries, including Somalia and Haiti. This is an example of the best in green logistics, healthcare, and humanitarian operations!

Green buildings, LEED, and energy efficiency

Did you know that buildings consume 70% of the electricity used in the US? Although there has been clear progress in terms of making appliances more efficient, an enormous amount of energy is still wasted in buildings. Equipment may be left operating when it is not needed, air conditioners may be running full blast where there are no occupants, and mechanical and electrical infrastructure may become less efficient over time.

When one considers how much time humans spend in buildings it is imperative that research into sustainable buildings receives full consideration and support.

Alec Appelbaum has an excellent Op-Ed piece in The New York Times, "Don't LEED Us Astray." LEED, which stands for Leadership in Energy and Environmental Design, is a program which awards points for incorporating eco-friendly material and practices into buildings' design and construction. It has brought great attention to environmental awareness from the buildings and construction sector, as well as from consumers.

The United States Green Building Council gives out the LEED certification, with the highest level being "platinum," and such certification has now become the most-widely used green building measure in the US.

Appelbaum, in his article, notes that much more should and could be done regarding the LEED certifications, since they provide a snapshot of a building at a point in time. According to Appelbaum, and I concur: some certified buildings end up using much more energy than the evaluators predicted, because the buildings are more popular than expected or busy at different times than developers forecast, or because tenants ignore or misuse green features. The government should institute regular audits or "check-ups" to ensure that the certified buildings are performing energy-wise, as certified. Those who perform well may get tax credits or even subsidies for outstanding performance.

I would argue that one needs to capture the entire life cycle of the building (clearly a challenging research and practical problem, but manageable). In order to do this, we need to develop green building supply chain design models. We have, recently, taken a step in this direction with our study, "Sustainable Supply Chain Network Design: A Multicriteria Perspective," which is forthcoming in the International Journal of Sustainable Engineering.

Given how much time people spend in buildings and, hence, how important buildings are to our health and well-being, and that of the environment, we, as a nation, need to push the frontiers of energy research in this direction.

Greening of Supply Chains and Earth Day

Today is Earth Day and there are many special celebrations going on to mark this day!

One of my passions is studying and analyzing supply chains in a holistic, system-wide way and finding ways in which supply chains can be made greener. Two aspects to this is to enhance the manufacturing links as well as the transportation links. As is well-known, today's supply chains are global in nature, so in order to reduce carbon imprints, and to assist in sustainability, one must capture all the supply chain network activities.

Interestingly, Louis Uchetelle writes in the New York Times that the Green Economy is Not Yet Made in U.S.A. (but we are working hard on this). The article quotes a colleague of mine at UMass Amherst, Dr. Robert Pollin, who has done studies for the administration estimating the impact and who is also optimistic: Clean energy is a huge opportunity to revive manufacturing. Last May, we had the pleasure of hosting Dr. Pollin, who spoke in our Speaker Series at the Isenberg School on "How Green Growth Can Revive the Economy," and he was simply terrific!

Another aspect of greening of supply chains is to minimize the emissions associated with transportation and a big issue is how to keep those trucks coming back, as filled as possible. Ken Belson, also writing for the Times, in the Business of Green, in his article, Keeping Trucks Full, Coming and Going, notes that: Deadhead trips, as they are known, are a waste of fuel, money and time, and a producer of greenhouse gases. The article notes a neat, new initiative, known as Empty Miles, which is a program that is the brainchild of the Voluntary Interindustry Commerce Solutions Association, or VICS, a nonprofit group that tries to make the supply chain in consumer goods industries more efficient. Macy's (one of my absolutely favorite retailers) and J. C. Penney have both signed on. The more companies that sign on, the more the trucks will not be traveling empty, improving the flow of freight, while reducing emissions -- a win-win situation, which is terrific!

Let's celebrate the beauty of our Earth today and revel in knowing that by being more efficient, we can actually be more green!