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Waste

Nationwide, hospitals generate an estimated 6,000 tons of waste per day. Highly complex and regulated, achievements in responsible management of healthcare waste are hard won. Cleveland Clinic has made a commitment to reduce the amount of waste we generate and to divert as much waste as possible away from landfills, a diminishing resource. In addition to standard practices of waste management and traditional recycling programs, we are taking the lead in our community by working with local businesses and authorities to develop recycling markets to divert materials from landfills. We work collaboratively with our supply chain to reduce the amount of waste generated from product consumption and are donating and re-purposing materials to in-need populations. As an example of our progress, several of our hospitals have exceeded a 30% landfill diversion rate in 2010.

Complete Waste Systems

From kitchens to procedure rooms, hospitals generate a wide variety of waste material in every corner of its facilities. While it’s true that hospitals generate much of the same material as any other business, such as paper, food waste and consumer recyclables, we are also faced with specialized or even hazardous waste streams that add to the complexity of waste management. Examples include lab chemicals, dental amalgam, bio-hazardous materials, electronics waste, and pharmaceuticals. Each of our 37 waste streams requires its own process, compliance assurance measures and education programs to ensure compliance, landfill diversion, cost management and discipline. Successful programs provide value to our patients and our organization, the environment, and the business community. For example, increasing the ease of paper recycling helps us meet our landfill diversion goals, generates valuable material for other businesses, reduces cost and helps us protect our patients’ personal health information.

Source Reduction

The best way to manage waste is to avoid generating it at the outset. Our environmentally preferred purchasing practices put pressure on vendors to reduce product packaging, deliver products on reusable pallets, have end-of-life management plans, or make sure that products and packaging are recyclable. In an effort to improve patient and worker safety, the healthcare sector increasingly relies on disposable materials, while driving up waste volumes. Finding select opportunities to safely reuse, reprocess or re-manufacture products can control waste and costs in both clinical and non-clinical environments. For example, we have deployed reusable cases to sterilize instruments, reducing our use of disposable materials without impacting effectiveness. Waste can also be prevented by delivering just-in-time inventory, optimizing supply storage and making sure multiple item kits or packs have only what’s needed.

Waste to Value

Waste, by definition, is to "fail to take advantage of or use". Recycling, for instance, is another way to take advantage of materials previously determined to be waste, as is donation or composting material. If we examine waste streams in this light, new opportunities arise to reduce waste or for businesses to take full advantage of the materials value. We perform waste audits to determine our best opportunities and seek value within our waste streams. A key example is our program to capture operating room packaging for recycling. Unable to find an outlet for this material, we began by finding a market for the material, connecting our waste hauler to the market and designing a safety-focused process for collection. This program is now being offered to other hospitals across the nation.

Infrastructure

Caregivers across Cleveland Clinic are learning about proper waste disposal and making better choices every day. Putting structures in place is key to ensure successful use of the recycling, waste management and waste minimization programs. Tactics like color coding waste streams, planning sufficient space to store recyclables in buildings, educating caregivers and designing processes that make doing the right thing the easiest choice are all parts of our comprehensive approach. Our 2008 Service Center exemplifies designing for success. In addition to supporting idle reduction strategies, the building’s supply logistics systems capture cardboard at the docks and delivers just-in-time supplies to reduce expired supplies and packaging waste. Transportation

Transportation

Thousands of vehicles visit our campuses daily, and we deploy hundreds of vehicles to transport materials or keep us safe every day. Northeast Ohio is often listed as a non-attainment area for air quality due to particulate matter and vehicle emissions are respiratory irritants tied to serious health impacts. We are taking steps to ensure the responsible management of our transportation fleet by adopting advanced technology and helping our employees reduce the environmental impact of their transportation choices.

Fleet Management

In 2009 and 2010 we deployed our first alternative fuel vehicles, and implemented a comprehensive emissions-reduction strategy and related policies. Our main campus fleet successfully improved its fuel efficiency by 9% in 2010 by transitioning to new vehicle types. Transportation Services maintains a new vehicle procurement policy that emphasizes hybrid and low emission vehicles, and we've found these high-performance vehicles to be cost effective. We also strive to provide mobility with zero-emissions technology, such as bicycle patrols, Segway-style electric vehicle patrol, and all-electric parking patrol vehicles. Emissions are controlled via proper maintenance and idle-reduction practices for buses and other large vehicles.

Idle Reduction

Northeast Ohio is often listed as a non-attainment area for air quality due to particulate matter, largely generated by vehicles. We've implemented a "No Idle Zone" in our valet parking areas and in our delivery docks where vehicles are turned off during transactions. We instituted an anti-idling policy in June 2009 for our Cleveland Clinic Police Department that encourages officers to turn off engines, limiting idling to no more than 5 minutes.

Low Impact Commuting

Employee commuting is a large part of our emissions. To encourage low-carbon commuting, we incentivize bus ridership, offer a carpooling match program and preferred parking for carpools. We also offer purchase rebates and discounted parking to our employees who drive qualified low-emission vehicles. Over the past several years, we have added bike racks and shower access across the enterprise to encourage wellness and sustainable transportation.

Infrastructure

In 2008 we completed our LEED Silver Certified Service Center, which increased our dock capacity 5-fold and introduced an improved dock scheduling system that creates narrow appointment windows for deliveries, greatly reducing truck wait time and subsequent idling. The service center docks were designated as no-idling zones, resulting in measurable savings and reduced emissions from idling at our busy docks. Also in 2008, we introduced a new parking system at the Main Campus that shifted parking access from a badge swipe to an automated sensor (AVI) at our main campus garages. This technology has reduced idling time, queuing, and subsequent emissions. Energy

Energy

Cleveland Clinic works to create better buildings. We are Focusing our Energy on Patient Care Our program is comprehensive and is designed to enhance patient experience and outcomes and also reduce operating expense. Further, we view our energy program as a direct contributor to a healthier community. Northeast Ohio is often in non-attainment of air quality standards, and our region's heavy reliance on coal for electricity is a major contributor. We can impact the health of our community by reducing the need to build new plants or to retain older, less efficient plants. As a leader in healthcare, we consider it our responsibility to also lead in this area. Electricity consumption constituted nearly 80% of our 2008 carbon emissions, so our energy management efforts directly address our contribution to climate change. "Cleveland Clinic's robust energy management program is a national model, demonstrating how to fight climate change through energy efficiency," said Elizabeth Craig, Acting Director of EPA's Office of Atmospheric Programs. "Effective energy management not only helps the bottom line, but it also is our most cost-effective climate strategy." To further reduce our impact and create local jobs, we installed our first solar panel array in 2010, and are co-founders of the first local community-based carbon action fund, The Cleveland Carbon Fund. Cleveland Clinic's commitment to continuous improvement in energy management was furthered by our commitment as a Partner to the US Department of Energy's Better Buildings Challenge, setting a goal to further reduce our energy intensity by 20% by 2020.

Conservation

Cleveland Clinic has been a proud ENERGY STAR Partner since 2008. Buildings can be rated by ENERGY STAR, much like appliances, and seven of our buildings have earned ENERGY STAR awards from the US EPA, acknowledging buildings that operate in the top 25 percent of comparable buildings nationwide in terms of energy performance. We educate employees on energy-saving opportunities and have entered into a contract for our first solar installation in 2010 through a new employee-owned power purchase agreement.

SC2019

Northeast Ohio has come together to make a commitment toward a sustainable future and build an economic engine to empower a green city on a blue lake. By 2019, the 50th anniversary of the famous burning river in 1969, we hope to realize this powerful vision and be part of a vibrant, healthy, successful community. Each year, Sustainable Cleveland 2019 (SC2019) has a designated focus to help our citizens and business rally around focused progress. 2013 is the Year of Advanced and Renewable Energy, and our region's businesses and communities are committed to realizing the potential that this sector offers for innovation, economic growth and a cleaner future. We invite you to learn more about SC2019 and engage in our collective effort to help our region fulfill its vision of a green city on a blue lake. Collaboration: Energy technology is a dynamic and changing field, making collaboration a critical part of leadership. In addition to collaborating locally through Sustainable Cleveland 2019, the Northern Ohio Society for Healthcare Engineering, and the Corporate Sustainability Network, we are working at the national level as well. We are a Partner in the Environmental Protection Agency's ENERGY STAR Program, a Partner in the Department of Energy's Better Buildings Initiative, as well as a leader in the deployment of LED lighting and advanced energy management in clinical settings. We proactively participate in governmental and industry collaborations centered on learning and best practice sharing toward the advancement of new technologies, purchasing standards and education and awareness. Clean Energy: Our first solar array was installed in 2010 at the Main Campus. The 100kw array has 480 panels and provides an average of 9% of the building's energy needs. While we celebrate our first solar installation, we are most proud of our role in helping the employee-owned business, Ohio Cooperative Solar, get off the ground. Part of the Evergreen Cooperative network, OCS has already created 17 jobs in struggling neighborhoods and turned a profit in its first year of operation. We are looking forward to future installations. Infrastructure: Cleveland Clinic became an ENERGY STAR Partner on March 12, 2008. As part of this formal commitment, we appointed an Energy Director with specific duties that mirror those recommended by Energy Star's Guidelines for Energy Management Overview.
Continuing to follow those same guidelines, our Energy Committee was created in 2009 and is made up of leaders from across the organization, geographically and organizationally. The Energy Committee controls an annual capital budget for the improvement of energy performance, which can be used not only to improve energy performance but to incentivize personal action and positive behavioral change. This investment has helped generate significant momentum for and employee ownership of the Clinic's energy policies. Take Action: All of us consume energy. Conserving at home and at work makes dollars and sense. Consider making a personal commitment to conserving at home and taking the ENERGY STAR Pledge or encouraging your company to become an ENERGY STAR Partner. The energy we consume is also a large part of a household's climate change impact. Here at Cleveland Clinic, nearly 80% of our carbon emissions (Scope 1 and 2) are attributed to electricity consumption. Consider visiting The Cleveland Carbon Fund to calculate your personal carbon impact and to learn about ways to reduce your footprint. Even the smallest changes like installing an energy efficient light bulb can have a big impact!

Collaboration

Energy technology is a dynamic and changing field, making collaboration a critical part of leadership. In addition to collaborating locally through Sustainable Cleveland 2019, the Northern Ohio Society for Healthcare Engineering, and the Corporate Sustainability Network, we are working at the national level as well. We are a Partner in the Environmental Protection Agency's ENERGY STAR Program, a Partner in the Department of Energy's Better Buildings Initiative, as well as a leader in the deployment of LED lighting and advanced energy management in clinical settings. We proactively participate in governmental and industry collaborations centered on learning and best practice sharing toward the advancement of new technologies, purchasing standards and education and awareness.

Clean Energy

Our first solar array was installed in 2010 at the Main Campus. The 100kw array has 480 panels and provides an average of 9% of the building's energy needs. While we celebrate our first solar installation, we are most proud of our role in helping the employee-owned business, Evergreen Energy Solutions (E2S), formerly Ohio Cooperative Solar, get off the ground. Part of the Evergreen Cooperative network, E2S has already created 17 jobs in struggling neighborhoods and turned a profit in its first year of operation. We are looking forward to future installations.

Infrastructure

Cleveland Clinic became an ENERGY STAR Partner on March 12, 2008. As part of this formal commitment, we appointed an Energy Director with specific duties that mirror those recommended by Energy Star's Guidelines for Energy Management Overview. Continuing to follow those same guidelines, our Energy Committee was created in 2009 and is made up of leaders from across the organization, geographically and organizationally. The Energy Committee controls an annual capital budget for the improvement of energy performance, which can be used not only to improve energy performance but to incentivize personal action and positive behavioral change. This investment has helped generate significant momentum for and employee ownership of the Clinic's energy policies.

Take Action

All of us consume energy. Conserving at home and at work makes dollars and sense. Consider making a personal commitment to conserving at home and taking the ENERGY STAR Pledge or encouraging your company to become an ENERGY STAR Partner. The energy we consume is also a large part of a household's climate change impact. Here at Cleveland Clinic, nearly 80% of our carbon emissions (Scope 1 and 2) are attributed to electricity consumption. Consider using this carbon footprint calculator to determine your personal carbon impact and to learn about ways to reduce your footprint. Even the smallest changes like installing an energy efficient light bulb can have a big impact! Food

Food

Only about 1% of the approximately $10 Billion spent on food in Northeast Ohio stays within this rich agricultural region. From an environmental perspective, by some estimates, food travels an average of more than 1500 miles to the American plate, all the while consuming fuel and generating emissions. Many of the communities surrounding Cleveland Clinic exist in urban food deserts, where fresh fruits and vegetables can be difficult to find. Cleveland Clinic's focus on fresh, healthy, local produce makes a difference at its facilities and in the community. We've embraced local food through farmers markets, local procurement and hospital kitchen gardens. Cleveland Clinic Community Farmers Market Details Buying and serving local foods in Cleveland Clinic cafeterias provides economic opportunity for rural neighbors and a growing base of urban farmers, and helps to provide fresher, healthier foods to patients, employees and visitors. In 2008, we signed the Healthy Food in Healthcare Pledge, further demonstrating our commitment to reducing the significant environmental impact of our food service operations.

Local Procurement

The success of our local farming community depends on individuals and businesses' support. Only about 1% of the approximately $10 Billion spent on food in Northeast Ohio stays within this rich agricultural region. In 2008, we began to procure more of our food within 200 miles of Cleveland and have forged productive new relationships with both urban and rural farmers in our region. To encourage dialogue about the importance of purchasing food locally and supporting local agribusiness, locally-sourced foods are in our cafeterias are marked with a local food sign, stating where the food was grown and how far the food has traveled. If you are a local grower and have interest in becoming a supplier, please contact the Office for a Healthy Environment at 216.448.8729.

Healthy Eating

In addition to addressing where our food comes from, Cleveland Clinic maintains a comprehensive vision that aims to improve the patient experience with food. It remains our sincere commitment to improve the healing environment with appropriate and responsible food selection, professional preparation standards and a rigorous dedication to consistency and service.

Farmers Market

Cleveland Clinic hosts several farmers markets and farm stands around the system. The Main Campus flagship market, Cleveland Clinic's Community Farmers Market, launched in July 2008 and continues in 2011 for its fourth season, Wednesdays from June 1, 2011 through October 5, 2011. To improve healthy food access in the communities that surround our Main Campus, we engaged our local government to issue special WIC Farmers Market coupons 3 times during the season which significantly boosted neighborhood participation. In 2010, we expanded our effort to improve access by working with North Union Farmers Market Association to accept Ohio food assistance. Each week, market visitors enjoy live music, food samples, and additional offerings from Cleveland Clinic's information booth, such as free health screenings, wellness campaigns, or live cooking demonstrations. Raffle prizes, surveys, and reusable shopping bag giveaways are featured throughout the season. All food grown at our Farmers Markets originates from around 100 miles of the market, and is sold directly by the farmer. These policies strengthen our local economy and curtail the emissions used in transporting conventionally grown food that, on average, has traveled 1,500 miles to reach your plate. Please join us in celebrating the bounty of our region. Cleveland Clinic Community Farmers Market Details

Sustainable Cleveland 2019

Northeast Ohio has a come together to make a commitment toward a sustainable future and build an economic engine to empower a green city on a blue lake. By 2019, the 50th anniversary of the famous burning river in 1969, we hope to realize this powerful vision and be part of a vibrant, healthy, successful community. Each year, Sustainable Cleveland 2019 (SC2019) has a designated focus to help our citizens and business rally around focused progress. 2012 is the year of Local Foods. This year businesses and communities are focusing on growing and supporting the local food economy. We invite you to learn more about SC2019 and consider making your own local food commitments in 2012. Join us as we engage in a collective effort to help our region fulfill its vision of a green city on a blue lake. Toxics

Toxics

Taking a precautionary approach, we are reducing patient and employee exposure to toxins by maintaining a virtually mercury-free environment; procuring Green Seal-certified cleaning products that have the minimum human and environmental health impacts, while maintaining hospital-grade effectiveness; furthering our latex-safe environment; reducing PVC and DEHP exposure; and reducing food-to-plastic contact. We also are reducing the toxicity in our built environment through the use of safer adhesives, sealants, furnishings and finishes. We have an enterprise-wide contract for integrated pest management (IPM) that adheres to Green Guide for Healthcare guidelines for IPM. Climate

Climate

Cleveland Clinic health system is developing its first greenhouse gas inventory for its US operations and is tracking direct GHG emissions from our main campus plant. Over time, we hope to expand the scope of this project to include our international sites. We also endeavor to educate our employees, patients and community on the public health effects of climate change. Water

Water

As stewards of our community's health, we see preservation of our community's natural resources as a vital part of our health mission. In fact, 20% of the world's fresh water is found in the Great Lakes. Cleveland Clinic is actively protecting our water supply through conservation measures and storm-water management. In 2004 we undertook a significant water efficiency project and perform routine water efficiency projects as we refresh our facilities. Opportunities to conserve building systems water, called process water, are evaluated as infrastructure is recapitalized or new equipment procured. Our new major construction projects pursue LEED certification, and therefore consider water conservation and storm-water management from the outset of design. To ensure that every project has an eye toward conservation, we have updated our building design standards and implemented a new storm-water management approach in parking lot design. As a result, we are incorporating native plantings, bioswales and engineered soils to slow and filter storm-water in our new or refurbished parking lots. Better Buying

Better Buying

We are committed to using our buying power to help transform the healthcare sector and prevent waste at its source.

Transforming Our Sector

As in our diversity and patient centered care approach, purchasing decisions are critical to sustainability at Cleveland Clinic, and have great potential for reducing our environmental impact. The Office for a Healthy Environment works hand in hand with Supply Chain Management and our vendors to seek opportunities to stop waste at its source such as reduced, recyclable or reusable packaging, energy efficiency requirements, increasing recycled content, and choosing non-hazardous products. For example, 2010 saw our first zero-waste contract, and new approaches to reducing patient PVC exposure. We are confident that we can co-innovate with suppliers to reduce waste, cost, energy consumption and risk, while improving service, transparency, patient experience and safety by making more sustainable choices; a win for all involved, including our vendors, communities and our environment. We invite vendor participation in the national green healthcare movement and to report transparently on their achievements and struggles. We seek to fulfill our vision of becoming a healthcare system that is ecologically, economically and socially sustainable and a source of healing and wellness. We invite suppliers to join us as partners in this important work. About Cleveland Clinic

Community Commitment

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