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Being Green
Recycling and waste management specialist seizes every opportunity to make Legacy a sustainable environment.

Contracting professionals like to talk about the yearly savings they generate through tough contract negotiations, perhaps a change in GPOs, or maybe some gentle arm-twisting of clinicians. But most would agree that the low-hanging fruit gets harder to find as Year 1 melds into Year 2, then Year 3, etc. Only the best - and most determined - find savings year after year.

In many ways, Tom Badrickís job is like that. As recycling and waste management specialist for Legacy Health System, Portland, Ore., Badrick rarely contracts for products. Rather, heís in charge of reducing the harmful environmental impact of the products that Legacy buys. Although he has compiled an impressive track record after six and a half years on the job at Legacy, heís the first to admit "it doesnít get easier, the better you are." And Legacy is pretty darn good.

Indeed, it would have to be someone like Badrick - who calls himself the IDNís "sustainability coordinator" as well as a "compulsive workaholic" - to make such a program work, year after year. "My clock has 30 hours," he says. In fact, not only is he knee deep in garbage at Legacy, but he serves on the Regional Solid Waste Advisory Committee, and at press time, was on tap to speak at the 31st Annual Water Environment School, sponsored by Clackamas Community College in nearby Oregon City. He assists a couple of neighborhoods with their Styrofoam and electronics recycling programs, picks up plastic for recycling from eight veterinary clinics around town, and recently helped the local Whole Foods Market institute a foam recycling program of its own.

A graduate of the University of Oregon, Badrick has lived in Portland most of his life. "I grew up fishing and hiking, an hour from the Pacific Ocean, an hour from the mountains. How can you not grow up caring about the environment?" Indeed, he says he feels lucky to live and work in an area where people actually demand recycling, rather than avoid the subject. "Portland is a wonderful community that is continuing to push boundaries in terms of setting high goals for protecting the environment," he says. Even though he has seen a "drop-off in inspiration" at the state level, he has seen a rise in interest by local communities and businesses - even landfill operators.

Badrick got his feet wet in the industry when he took a job as the environmental and safety manager in the electronics industry. He was in charge of an entire safety program, including hazardous waste, hazard communication, ergonomics, personal protective equipment, waste water management, emergency management and the safety committee. He was hired by Legacy to run its recycling program and to be a technical advisor in the area of medical waste. His job has grown since then - a lot. "Iím not constrained by job titles and assigned duties," he says.

Legacyís involvement with environmental initiatives began before Badrickís time there. In fact, some OR nurses took it upon themselves to collect items from the OR and take them to a recycler. "They kept hammering away, and an intern program developed with other people kicking in support," says Badrick. That intern became Legacyís first recycling specialist who, years later, hired Badrick to his current post. Since then, Legacyís environmental efforts have grown into a "broad and coordinated effort, [which is] no easy feat with 8,500 employees," he says.

Legacy is involved with environmental initiatives because "itís the right thing to do," says Badrick. "It sounds trite, but people here really believe it. Sometimes I get direct Ďsupport,í sometimes I have to read between the lines. But not once in my six and a half years have I ever wondered if people here [cared] about it."

Thanks in part to his efforts as well as others at Legacy, the IDN was awarded a 2006 H2E Environmental Leadership Award by the national organization Hospitals for a Healthy Environment (which is part of Healthcare Without Harm, a Washington, D.C.-based consortium of the American Hospital Association, the American Nursing Association and the Environmental Protection Agency). Legacy was also awarded the organizationís "Making Medicine Mercury-Free Award." The IDNís "green numbers" at the time were:
  • 2,125 total tons of material recycled annually, or 1.45 pounds per employee per day
  • Approximately 46 percent of all waste diverted to recycling - 46 percent of all garbage, 7 percent of all medical waste and less than 1 percent of hazardous waste.
  • 13 tons fluorescent tubes (containing mercury) recycled in 2005
  • 65 tons of sterile blue wrap recycled in 2005
  • 445 tons of shredded paper recycled
  • Eight physically or mentally challenged workers employed sorting materials.
Badrick accepted the award on Legacyís behalf at the 2006 CleanMed healthcare environmental conference last April. The experience was profound. "I became a real nut last year after CleanMed," he admits. He listened to environmentalist and entrepreneur Paul Hawken speak, and attended sessions "about how much worse [the environmental situation] is than your average Joe or Jane thinks," he says. Afterward, he read two books by Hawken. "From then on, I was a lot more driven to really make an impact - not just to have a great program, but to be an example, to do more leading, to share our successes - not to show off, but to show it can be done."

Purchasing and contracting
Legacy has a three-pronged approach to sustainability (four, if you count social justice), says Badrick. They are:
  • Environmentally preferable purchasing
  • Healthy food options
  • Environmental management.
The first leg involves "what and how we buy," he says. Legacy has an "environmentally preferable purchasing" policy on the books to guide those who contract for and purchase products. "My goal is to make this a living, breathing thing," says Badrick. "Why have a policy if youíre not going to do anything with it?"

While the policy lends weight to the IDNís environmental intentions, the fact is, Legacy was well along the path prior to its creation. For example, the IDNís nurses didnít need a formal policy in place to tackle what they perceived to be a major threat to their patientsí health Ė DEHP, or Di (2-ethylhexyl) phthalate, a chemical additive used to increase the flexibility of polyvinyl chloride. It has been used in such devices as IV bags and tubing, nasogastric tubes and umbilical artery catheters. DEHP can leach out and accumulate in body tissues. According to the U.S. Food and Drug Administration, it has been shown to lead to damage to the male reproductive systems of animals.

Like their counterparts in all healthcare facilities, Legacyís contracting professionals find themselves weighing the merits of disposable vs. reusables. But the choice is not always clear-cut, says Badrick. True, our "throwaway society" leans toward disposables, he says. But thatís too simplistic an answer. "Why are disposables presumed guilty? [R]eusable linen and reusable kitchen items both require use of detergents of some kind, [and] both require labor and water and energy to clean. Is the mass balance really favoring reusables? Sometimes, clearly not."

Environmental management
The second prong of Legacyís program for sustainability is environmental management. "Itís a big area, from waste prevention and management, to chemical reduction, to facilities [issues], such as utility conservation and landscape issues," says Badrick.

Legacy is well on its way toward meeting a goal set in 1998 by the American Hospital Association and the U.S. Environmental Protection Agency, to reduce by 50 percent the total volume of all waste generated. Recycling accounts for a good portion of that. In fact, Badrick expects the IDN to achieve a 48.5 percent reduction this year, with a chance of reaching 50 percent, with additional food composting and recycling.

Legacy recycled 2,714 tons of material last year, and Badrick says he believes that 200 to 300 more tons are attainable over the next two years. "After that, I donít know; I have little time to forecast."

"It doesnít get easier the better you are," he continues. "The more you recycle, the harder it gets to find more to recycle. I literally felt two years ago that I was close to the end of the line in terms of what else we could collect without really putting a lot of time and money into [an additional] 2 to 4 percent. I was way wrong, of course."

Sterile-wrap recycling is an example of the industriousness of the Legacy team. Made of spun polypropylene, blue wrap is very recyclable, says Badrick. Because the wrap typically leaves the OR suite before the patient even arrives, itís not contaminated. And healthcare facilities generate, literally, tons of the stuff.

Fifteen years ago, working with Kimberly-Clark, Legacy kicked off a program to recycle blue wrap from the IDNís facilities as well as other hospitals in Oregon and southwest Washington. (Owens & Minor agreed to transport the material in its empty trucks). Legacy continues to recycle as many as 60 to 70 tons annually, and intends to begin recycling patient warming blankets in the future. Weyerhaeuser, the wood-products company, accepts the material and transforms it into a variety of products, including park benches.

While recycling is an essential part of environmental management, it takes second place to waste prevention. "I need to push more at not creating waste, [though that is] way less cool to report on than more tons recycled per year," says Badrick. "Recycling is literally end of pipe - catch it and sort it and you are done. Preventing waste is upstream, not as sexy, hard to measure. Way more important, though."

One way to prevent the creation of waste is to reprocess disposables. The IDN has contracted with Phoenix, Ariz.-based Ascent Healthcare Solutions to reprocess its single-use items. Some clinicians are skeptical about reusing items designed for single use, but the program is growing nevertheless.

Another aspect of Legacyís environmental management program is the reduction of toxic materials coming into its facilities. Only by doing so can the IDN hope to minimize the amount of toxic materials going out of them - not only in the garbage, but in waste water as well, says Badrick.

The City of Portland has avoided regulating the content of hospitalsí waste water, but thatís a mistake, says Badrick. Pharmaceuticals dumped down the hopper are a growing problem, he says. "There should be more regulation."

Water conservation is at the heart of another Legacy project - an 18-foot-by-270-foot bioswale, located next to the recycle center. A bioswale is a landscape element designed to remove silt and pollution from surface runoff water before it is released into the storm sewer system. The bioswale was built on the site of an old rail spur. Badrick secured a grant and enlisted the aid of local high school students in the two-year project.

Healthy food options
The third prong of Legacyís sustainability program is the introduction of healthy foods for the IDNís employees, staff and patients. Such options include organic foods and milk from cows that have not been injected with recombinant bovine growth hormone, or rBGH.

Legacy has begun its healthy-food effort in the cafeteria, one reason being it can raise prices to cover the additional costs. (Badrick says he believes, however, that as consumers increasingly demand such foods, prices will eventually drop.) The cafeteria staff love the change, because they get to do more actual cooking, as opposed to opening cans and boxes and heating things up, says Badrick. "Itís exciting," he says. "The chef just got a new panini machine, and heís trying out recipes." The staff and the neighborhood people who frequent the cafeteria like the new menu. Ultimately, Badrick would like to introduce it to the patients.

A food composting system completes the cycle. Badrick procured a grant for a grinder, which grinds the food and wrings much of the water out of it. It is trucked off to a transfer station, then shipped to Seattle for processing.

Badrick says his role as sustainability coordinator is "not like a normal job." Heís constantly expanding his duties. "Iím an opportunist. Show me an opening I can help plug, and Iíll be there." In fact, when he looks at environmental issues, he sees nothing but opportunity - and urgency. "I cannot say this enough without sounding overly zealous, but we cannot afford to be so bad at managing our environment as we have. We have to change, and we have to do so now."

He is a tireless supporter of the cause, and in one sense, he sees himself as a salesman , selling environmental awareness. "Itís all about sales - getting people to do what they know they should do, but havenít done."

Although he leads Legacyís sustainability effort, by no means is Badrick alone. And thatís probably a good thing. "Thereís a point where my passion is great, but sometimes it rubs people the wrong way, so you get other people involved," he admits. The IDNís Healthy Environment Committee is comprised of people who are excited and eager to build on their successes, he says.

Future projects include enlisting the involvement of students in the nursing dorm. Fifteen students showed up at a meeting recently to discuss the opportunities. "Iím hopeful that once this is running, we can introduce it back to their main campus about 30 miles from here, which will impact a whole new universe." Another untapped opportunity is the introduction of recycling to Legacyís tenant spaces, such as the medical office building across the street from Legacy Good Samaritan.

Complacency is a danger, to be sure. But Badrick says that Legacy will keep its eye on the target for years to come. "I want what I do to be right for us all, and to help the organization spend more money on patient care and less on waste management. Our raison díetre are our patients and our community. We owe it to them to do whatís best for them and their - our - environment."

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