across the country are implementing green initiatives to produce healthier environments for patients and staff, which they say saves not only energy, but money.

Among several provider facilities going green is Stony Brook University Hospital, in Stony Book, N.Y., which recently signed an agreement with the U.S. Environmental Protection Agency (EPA). The agreement outlines energy and water conservation, waste management and the use of environmentally friendly products, and the hospital is currently auditing areas to reduce energy consumption.

“A hospital is unique in that it’s a structure that operates 24/7,” says Andrew Bellina, EPA program coordinator, “So, there are opportunities for powering down in many areas of the hospital that do not impact the people that are working or the care of the patients.

In addition, the hospital is taking on a number of initiatives designed to reuse materials and reduce material waste. For example, staff has eliminated the blue, disposable wrapping used for sanitary operating tools, says Bellina. Tools now arrive in reusable containers.

However, he notes, the hospital has to evaluate recycling from a practical standpoint while also maintaining strict accreditation standards. Even so, recycling at the hospital increased by about 420 tons in 2007 and 2008, and it is expected to be higher this year.

“It significantly affects your carbon footprint when you recycle waste instead of just throwing it out, because you don’t go through the actual mining, the treatment, the procurement, the manufacturing and the transportation,” he says. “You’re cutting all that out.”

Water conservation is another important aspect of the agreement struck with the EPA. Bellina notes water supply costs recently increased 20% in New York City. He predicts water shortages in as many as 36 states in the next three to five years.

The hospital is looking to conserve water in two ways. First, captured storm water can be reused for non-contact functions, such as watering lawns and landscaping. Second, he says, it will be important to reduce demand for water. The hospital is monitoring water use with equipment that limits water flow and reduces total use.

Going green will definitely show a return on investment in the long run, and in most cases, produce immediate savings, Bellina says.

“Five years ago it [going green] would have cost you money, and the payback would be seven, 10 or 12 years, but now there are immediate cost savings. For example, recycling is an immediate cost saver,” he says, “And you reap the economic benefits through the lifetime of the structure after that.”

Determining effects on the quality of care is not as easy, he says, but he postulates that once the hospital’s energy audits are complete and the air handling is upgraded to a more efficient mix of outdoor and indoor air, the quality of air will improve within the hospital. Better air means better health, especially for those who need respiratory care.

EAST CAROLINA HEART INSTITUTE

The structure has only been open for a year, but was built with energy efficiency in mind, according to Brian Floyd, executive director of the Heart Institute. It also contains recycled materials in the carpet as well as in bathroom, kitchen and ceiling tile.

Natural lighting is one feature that overlaps in the green movement and healthy hospital movement. An effort was made to light the Institute with large windows in patient rooms, physician work areas, waiting rooms, lobbies and cafes.

“Many studies show that people recover faster when they have access to sunlight, and we want to make people as comfortable as possible and acclimate them to the day and night cycles so they can heal faster,” Floyd says.

It also requires less energy to light the facility during the day. With the help of sensors, artificial lighting turns on only when someone is in the room and dims when natural light levels are adequate.

The utility plant powering the Institute operates on energy efficient air conditioning chillers, high-efficiency electric motors and variable-speed pumping and air flow systems, according to Floyd.

The monthly electricity expenses at the Heart Institute have averaged 30 cents per square foot, or $142,000 per month, since opening in January 2009, according to James Ryals, Media Specialist for the Heart Institute and Pitt County Memorial Hospital. To compare, over the same period, monthly electricity expenses in the main hospital have averaged 45 cents per square foot, or $533,000 per month. The main hospital was built in 1977, and is twice as big as the Heart Institute, says Ryals.

“The per-square-foot figures are a better basis for comparison than the monthly totals,” he says. “It’s safe to say that, with the efficiency measures we’ve taken, our power expenses at the Heart Institute are roughly 33% lower than the main hospital.”

Certain intangible cost savings, such as worker productivity, are harder to define, says Floyd, but he has noticed that retention of staff is higher and length of patient stays are shorter.

Hospitals Aren’t Investing Enough in the Supply Chain and They’re Paying the Price

February 21, 2022Betty Jo Rocchio, Lee Smith

A look at the challenges hospitals face due to an insufficient supply chain—and how to address them.

When it comes to supply chain management, the healthcare industry comes in last place; and it’s paying the price. Antiquated processes that create inefficiencies, unnecessary expenses, and staff dissatisfaction are contributing to financial challenges that have only been exacerbated during the pandemic.

There are so many inefficiencies in the hospital supply chain. Just one example: demand forecasting, especially helpful for pick preparations, is nearly impossible at many organizations. In some hospitals and health systems, staff spend 58% of their workday on indirect activity, such as searching for supplies needed for patient care activities. That’s a serious problem.

Not to mention the feat of trying to ensure the right supplies are on hand at the right time. Thanks to so many backorder and alternate suppliers entering the market, manufacturers and medical surgical supply distributors are not accountable anymore. That’s dangerous, too, because supplies expire. That impacts not only quality of care but the bottom line.

Financial challenges to hospitals are continually growing due to lost revenue from delayed care and canceled elective procedures during the pandemic. Plus, the skyrocketing rate of overburdened nurses and staff has forced budgets to absorb expensive staffing resources as these employees opt out of healthcare work.

How hospitals can make a comeback

Hospitals can overcome these challenges. It just takes focus—in this case on the supply chain—in four areas.

• Focus Area #1: Use analytics to reduce supply chain waste and identify opportunities to reduce variation
  Effective supply chain analytics can reduce costs by helping hospitals more proactively identify and use items before they expire. Analytics also help lower the cost of unnecessarily high physician preference items (PPI). Analytics can also help with hospital-wide standardization, especially for areas like surgical PPI, which account for 40% to 60% of a hospital’s total supply cost (excluding medications).
  
  A recent survey of hospital supply chain leaders found that 94% believe supply chain analytics reduce supply costs. Just over three-quarters (76%) say supply chain analytics spur higher care quality, and 61% say analytics impact staff satisfaction and retention. In addition, 43% of these leaders say they lost nurses due to supply challenges or shortages.
• Focus Area #2: Improve supply chain efficiencies to maximize OR throughput
  One of the main drivers of inefficiencies and delays in the OR is supply disorganization. When processes are made more efficient through a supply chain management platform, operating room throughput increases, which means revenue also increases.
  
  Regular inventory count is a critical component of cost-savings in the OR. In addition, RFID and barcode scanning point-of-use tools can help nurses and staff document supplies more efficiently. Having non-expired inventory ready and available increases job satisfaction and efficacy of OR nurses, as they won’t have to leave a patient during a procedure to hunt down supplies.
• Focus Area #3: Reap continual margin improvements with AI and demand forecasting
  Demand forecasting with AI technology minimizes errors and ensures more appropriate inventory volumes. This prevents stockouts and cuts expenses from over-ordering. A McKinsey study, found that using AI to enhance supply chain management could cut forecasting errors by 20% to 50%. AI and demand forecasting can also reduce the likelihood of supply shortages, which, as mentioned above, is a significant impairment to workflow efficiency.
  
  As hospitals investigate supply chain management platforms, they should prioritize those that include AI and demand forecasting tools, as well as real-time insights into inventory, cost variances, physician benchmarking, procedural demand forecasting, and supply standardization. They should also seek out tools that integrate with the hospital’s other technologies (such as the EHR, ERP, and MMIS), to improve margins while reducing the risk of errors.
• Focus Area #4: Reduce staffing costs and improve retention
  While upwards of 80% of C-level hospital executives think their organizations manage the supply chain well, they underestimate how supply chain problems are directly affecting staff. For instance, a survey of nurses shows that 86% say their current supply chain documentation systems cause them stress.
  
  Staff who don’t have the tools to work smarter must work harder, which affects morale and job satisfaction. The addition of automation for handling manual tasks contributes significantly to retention and the reduction of staffing agency expenses.
  
  Integrating supply chain efficiencies to optimize clinical workflows is the secret ingredient for staffing success as supply chain management frequently translates to higher staff satisfaction.

Improving the supply chain drives gold-medal success

Hospital executives are realizing the strong connection between supply chain and finances. After suffering through a pandemic that’s lasting more than two years, hospitals deserve some record-breaking success.

Betty Jo Rocchio is Mercy’s senior vice president and chief nursing officer. Previously, she was the chief nursing optimization officer at Mercy after serving as vice president of perioperative services. Prior, Betty Jo held several leadership positions in the Mount Carmel Health System in Columbus, Ohio. These included chief nurse anesthetist, system director of surgical services, and vice president of nursing and chief nursing officer.

Lee Smith, DHA, MBA, BSN, is chief nursing officer at Syft where she is responsible for guiding customers through the implementation of the Synergy point-of-use and analytics solutions. Lee has more than 35 years of experience in healthcare, including 21 years in supply chain and information technology. In her career, she has served as director of surgical services and leadership positions at Cardinal Health, CareFusion, and BD.

More Patients Use and Trust Telehealth: Report

February 20, 2022Ron Southwick

A vast majority said they plan to continue using telemedicine even beyond the pandemic, according to a report from Doximity.

More patients are expressing confidence in telehealth and plan to continue virtual visits beyond the COVID-19 pandemic, according to a new survey.

Doximity, a digital healthcare company, surveyed 2,000 patients on their use and perspectives in its second “State of Telemedicine Report.” The report, released Feb. 16, showed substantial increases in patient comfort with telehealth in 2021, compared to 2020.

Roughly 3 in 4 patients (73%) said they plan to use telemedicine after the pandemic, up from 58% in 2020.

The study found 80% of patients with chronic illness would use telehealth beyond the pandemic, compared to 60% in 2020. Two out of three patients (67%) without chronic illness said they would continue to use telemedicine beyond the pandemic, up from 55% in 2020.

The survey also found similarly broad support among all racial groups in their plans to continue using telemedicine beyond the pandemic. Around three-quarters of Black, Latino and Asian participants all said they’d stick with telemedicine, the survey found.

More patients have used telehealth at least once in the past year. Two out of three respondents (67%) said they participated in a telehealth visit at least once annually in 2021, compared to 42% in 2020.

The survey also showed more patients feel virtual care offers equal or better treatment than in-person visits, although it’s not exactly a landslide.

More than half of those surveyed (55%) said virtual visits offer comparable or superior care than in-person visits, up from 40% in 2020. There were differences in those with chronic illness. A solid majority of participants with chronic illness (67%) said telemedicine visits offered equal or better care, but less than half (47%) of those without chronic illness said virtual visits were comparable or better than in-person appointments.

The report also gauged participants on their preferred devices for telehealth visits. Most of those surveyed (59%) said they preferred using their mobile devices, while 38% said they preferred using a computer (either laptop or desktop). The report noted that 85% of Americans own smartphones, so telemedicine can close the digital gap in medicine.

The federal government eased restrictions on telehealth when the COVID-19 pandemic emerged in 2020. Healthcare advocacy groups have been urging the White House and Congress to approve reforms to make telehealth access permanent.

Earlier this month, U.S. Sens. Catherine Cortez Masto (D-Nev.) and Todd Young (R-Ind.) introduced a bill that would allow the Centers for Medicare & Medicaid Services to extend Medicare payments for telehealth services for an additional two years. The legislation would also authorize a study of the effectiveness of telehealth services during the pandemic, so Congress would have more information to decide if telehealth access should be permanent.

More than 300 healthcare organizations signed a letter Jan. 31 urging congressional leaders to pass telehealth reforms.

A federal report showed use of telehealth by Medicare beneficiaries in 2020 was 63 times higher than the previous year. Medicare reported 52.7 million telehealth visits in 2020, up from 840,000 in 2019.

While telehealth usage has expanded, a federal study showed disparities in access to telehealth, with Black, Latino and Asian American patients using video telehealth services less often than white patients. Healthcare advocates have said lack of broadband access in some areas is an impediment to expanding telemedicine access.

Earlier this month, the U.S. Department of Health and Human Services awarded $55 million to 29 community health centers to expand telemedicine access to underserved communities.