Brown University Children’s Environmental Health Center, Community Outreach and Translation Core and Superfund Research Program Community Engagement Core present:

Best Practices for Environmental Excellence in Healthcare

Monday, April 2, 2012
Women & Infants Hospital’s South Pavilion
101 Dudley Street
Providence, Rhode Island

Conference Report: Saving Lives and the Environment

 More than one hundred healthcare professionals, governmental agency representatives, and community group members convened for the second annual Best Practices for Environmental Excellence in Healthcare conference on April 2. The conference, which took place at the Gold LEED-Gold certified South Pavilion of Women & Infants Hospital, provided an opportunity for those in the healthcare community to explore available resources, foster new relationships and partnerships, and learn more about ongoing initiatives to advance environmental sustainability in the healthcare sector. Hospitals for a Healthy Environment in Rhode Island (H2ERI), the coalition that organized and hosted the event, invited leaders in the movement for environmental sustainability in the healthcare sector to present their findings and experiences in implementing system wide changes designed to reduce waste and harmful exposures in hospitals and other healthcare facilities.

Women & Infants Hospital’s Chief Operating Officer, Mark Marcantano, expressed in his welcome note address his commitment to green buildings and workspaces. He commended the coalition for their continued efforts in advancing environmental sustainability in healthcare facilities. Rhode Island Representative Naughton (D-21) noted that, “hospitals are the heart and soul of our communities” and they should take a leadership role to build a health agenda that heals our bodies, the environment and our communities.

Mark Marcantano, COO, Women and Infants Hospital

Christina Zheng, Phil Brown, Director H2ERI, Rep. Eileen Naughton and Sylvia Weber


The keynote speaker, Janet Brown—Director of Facility Engagement at Practice Greenhealth and newly appointed Director of Content and Outreach of the Healthier Hospitals Initiative (HHI)—spoke about the nationwide effort to reinvent hospitals as community anchors for health, sustainability and disease prevention. HHI’s three-year campaign has identified six specific challenge areas of focus: engaged leadership, healthier food, leaner energy, less waste, safer chemicals, and smarter purchasing. Through standardized methods of data collection in these specific areas, HHI will use data to demonstrate the financial and environmental benefits of many specific interventions. Hospitals that enroll in the program will commit to addressing at least one of the six challenge areas. Through these initiatives, HHI hopes for a day when cancer centers will no longer have carcinogens and children’s hospitals will no longer have chemicals linked to birth defects.

Amy Lipman, the Sustainability Coordinator at Beth Israel Deaconess Medical Center in Boston, posed a question to attendees: “How can you afford NOT to green your hospital?” While each hospital is different and so is their sustainability journey, she detailed the annual savings amounting to about half a million dollars at Beth Israel Deaconess Medical Center from basic waste reduction and recycling alone. In a very interactive and encouraging presentation, Lipman shared her strategies to start a sustainability initiative: “Start with the tactics that are easy to accomplish, save money, and meet employee expectations,” she said.

Amy Lipman asks How can you NOT green your hospitals?

Peggy Harlow on Performing Hospital Waste Audits


This year’s conference also featured six workshops addressing a variety of topics. The three breakout sessions in the morning featured metrics for measuring sustainability, composting and sustainable landscaping, and healthy beverages in healthcare facilities. Afternoon workshops addressed medical waste management, green cleaning, and establishment of sustainability committees and sustainability plans.

In the Metrics for Environmental Sustainability workshop, Janet Bowen from the Environmental Protection Agency (EPA), Peggy Harlow from Waste Management, and Janet Brown from Practice Greenhealth discussed ways to minimize waste through programs such as ReTrac, Energy Star, and usage of tools such as the Practice Greenhealth Eco-Checklist, Sustainability Dashboard, and Greenhealth tracker. The workshop provided an overview of how to conduct an effective waste audit, analyze waste streams, and create benchmark data. Going through the channels of seven different types of waste, the speakers emphasized that proper segregation means cost savings and that “you cannot manage what you do not measure.”

The workshop on landscaping and composting delved into the idea that lawns and lawn maintenance are climate change and public health issues. Sustainable landscaping or “low impact landscaping,” as described by the speakers, is a unique dynamic between hydrology, soil, and vegetation. That sustainable landscaping creates a space that reconnects people to the natural systems, enhances the sense of place, increases aesthetic values, and reduces the urban heat island effect in that area. The workshop also covered an interesting case study of Kent Hospital’s rain garden and serenity garden with stunning visuals of these landscapes before and after their installation.

In the workshop addressing the obesity epidemic and sugar sweetened beverages, speakers presented many facts about our current food consumption in the US. Over 48% of the sugar consumption is from beverages, 20% of which is from sodas. Furthermore, the US has the highest calorie consumption of sugar in the world. The “hydrate for health” focused on the growing movement of healthy food and healthy beverages in healthcare to reduce chronic diseases such as Type 2 Diabetes, obesity, heart disease, and cancer. During this segment, the speakers voiced their beliefs that local food is primary care—a key measure in preventing illnesses. Specific programs reviewed included Connecticut-based Plow to Plate and Health Care Without Harm’s healthy beverage campaign in healthcare.

During the afternoon workshops, Janet Brown and Monica Manooshian, a member of the Miriam Hospital staff, discussed the need for sustainable reform in the operating room (OR). The OR is the largest generator of waste in a healthcare facility. Almost 80% of packaging waste is generated even before the patient enters the OR. These presentations looked into the waste streams in the OR and discussed strategies to reduce them.

In another workshop, a representative from the company Stericycle gave a presentation on proper ways to handle and dispose of pharmaceutical waste. Mark Dennen from the Rhode Island Department of Environmental Management wrapped up the session by helping participants understand current state and federal regulations regarding hazardous medical waste. He also gave insight into legislative initiatives that require further attention such as legislation for residential sharps collection at pharmacies and hospitals, federal hazardous waste rules for pharmaceuticals, and better processes for the disposal of chemotherapy waste.

In the green cleaning workshop, John Welenc and Laurie Tostenson, from Dartmouth-Hitchcock Medical Center, shared their comprehensive approach to implement a green cleaning program at their institution. They detailed their experiences using track off mats, micro-fiber mops, green cleaners and green cleaning techniques, as well as specialized vacuum cleaners, floor finishers, and an integrated pest management program.

No discussion on environmental sustainability is complete without an understanding on how to organize green teams and develop a sustainability plan. Amy Lipman’s ninety-minute afternoon workshop focused on just that. Activities included developing a sustainability goal, membership list, sustainability plan, team structure, and content and measurement tools to meet these goals and achieve needed change. Some of these goals are not easy to attain but Lipman reminded attendees: “everyone has time for things they believe are productive, worthwhile and achievable.”

At the end of the conference, Lipman facilitated a discussion among conference attendees about environmental sustainability. Networking and leadership support emerged as a major theme in this discussion to promote environmental sustainability in healthcare.

Aside from speaker presentations and breakout sessions, H2ERI provided other resources for sustainability in the healthcare sector. Everyone from vendors of sustainable products to representatives of local community groups had exhibits and provided further information about their organizations. Exhibitors included Stericyle, Shred-It, Claflin, Clean Water Action, Berkshire Natural Healthy Vending, and Farm Fresh Rhode Island.

Berkshire Naturals

Our locally sourced, fresh food lunch.


The food at the conference was a major event in itself. H2ERI, in conjunction with Kids First/Real Food First with Farm Fresh Rhode Island and Karen Henning, the Director of Food and Nutrition Services at Women & Infants Hospital, created a lunch installation with healthy, locally sourced foods. Breakfast and lunch followed the Meatless Monday menu, with delicious dishes such as Vegetable Frittata and Eggplant Parmesan. Locally sourced items included yogurt and mozzarella cheese from Narragansett Creamery and milk from Rhody Fresh. Self-serve water towers were provided throughout the day to minimize the use of plastic bottles, and all silverware, plates and cups provided were compostable.

It is hard to support healthy life in a sick planet. The healthcare community is beginning to realize that healing our bodies also requires healing our environment and our communities.

For more information about the conference, including the full list of speakers, workshops, and sponsors, visit: http://biomed.brown.edu/Events/RIHforHealthyEnvironment2012/

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Speaker Powerpoints

Keynote Speaker: 

Janet Brown – Healthier Hospitals Initiative

Featured Healthcare Program/Institution:

Amy Lipman – How Could You NOT Green Your Hospital?

Workshop A1: Metrics for Environmental Sustainability:

Janet Bowen – EPA Data Management Tools

Peggy Harlow – Performing Hospital Waste Audits

Janet Brown – Metrics for Environmental Sustainability

Workshop A2: Sustainable Landscaping and Composting

Tom Benjamin – Sustainable Landscape Design

George Harvey – Sustainable Landscaping: Groundwork Providence

Workshop A3: Addressing the Obesity Epidemic and Sugar Sweetened Beverages

Roberta Friedman – Addressing the Obesity Epidemic and Sugar Sweetened Beverages

MaryDale DeBor – The Hospital as a Change Agent in Food System Reform

Stacia Clinton – Healthy Beverages in Health Care

Local Hospital Environmental Initiatives:

Rhode Island Achievements

Workshop B1: Medical Waste Management

John Lacarrubba – What Hospitals Should Know About Pharmaceutical Waste Compliance

Monica Manooshian – Greening the OR in RI

Mark Dennen – Understanding State and RCRA Regulations

Janet Brown – Greening the Operating Room

Workshop B2: Reducing Toxic Exposures in Health Care

Jay Welenc and Laurie Tostenson – Green Cleaning at DHMC

Workshop B3: Establishing a Sustainability Committee and Strategic Sustainability Plan

Amy Lipman – Making the Case for a Sustainability Strategic Plan and Green Team


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