Engaged Leadership Challenge

By Janet Howard, DIRECTOR, FACILITY ENGAGEMENT, PRACTICE GREENHEALTH, AND Director, Content and Outreach, Healthier Hospitals Initiative on October 21, 2014

A conversation with Mary Larsen, Environmental Stewardship manager for Advocate Health Care



Mary Larsen

Progress was submitted this year by 178 facilities in the Engaged Leadership Challenge of the Healthier Hospitals Initiative.

The Engaged Leadership Challenge creates the foundation for long-term programming and articulates “the ask” when approaching leadership. How does one create the infrastructure for operationalizing sustainability initiatives? The answers are 21 actions that are broken into four categories: Strategic Priority, Operational Focus, Systematic Communication and Stakeholder Engagement. Achieving Level One of this challenge is achieving three of the action items, Level Two is achieving six and Level Three is 10.

Mary Larsen is the Environmental Stewardship manager for the HHI sponsoring health system, Advocate Health Care, a 12-hospital system in the Chicago area with more than 35,000 associates and a combined bed count nearing 4,000. Prior to publication, it was announced that Advocate Health Care has merged with NorthShore University HealthSystem and will have a new name—Advocate NorthShore Health Partners. Mary is a friend of the family and a former director of Sustainable Operations for Practice Greenhealth, where she worked from 2008 to 2011. She now reports to Al Manshum, vice president of Facilities and Construction, as the lead on Advocate’s sustainability efforts.

Advocate is a five-time System for Change Award winner through Practice Greenhealth. Three of its 12 hospitals won the prestigious honor of the Top 25 Award this year, and several hospitals won the Circle of Excellence for leadership in Waste, Energy and Environ­mentally Preferable Purchasing. At over 100 years old, Illinois Masonic Medical Center is the oldest building in Advocate’s system, and it has also been recognized with the Environmental Protection Agency’s Energy Star award for an energy efficiency rating of 98 out of a possible 100.

As director of content and outreach, I had a virtual sit-down with Mary to talk about Advocate’s work with the Healthier Hospitals Initiative and how the Engaged Leadership Challenge has helped Advocate create a systemwide, coordinated sustainability strategy that provides a structure for the various programs and activities that go into a robust, multifacility sustainability initiative.

Janet: Why was it important for Advocate to sponsor the Healthier Hospitals Initiative?

Mary: Sponsoring HHI was a way for us to show our leadership in sustainability and be part of the call to action to other hospitals in the sector and make it available to them at no cost. We are proud to mentor those that are just getting underway while we continue on the journey of reducing Advocate’s environmental impact and improving the quality of our healing environments. The Engaged Leadership Challenge aids in an intentional culture change that is underway at Advocate. The leaders want to engage the hearts and minds of the staff toward a mind-set of conservation. They are committed to staff education and host events on Earth Day and America Recycles Day and make a big effort to educate and recognize and celebrate staff who embody the value of stewardship. This work is very important to our leadership.

Janet: One of the goals in the Engaged Leadership Challenge is to appoint an executive sponsor. Who is yours at Advocate Lutheran General Hospital?

Mary: Al Manshum, our VP for Facilities and Construction, was essentially self-appointed. When Advocate had an opportunity to construct a new bed tower, Al’s passion for environmental protection and conservation shined as the project manager of the first LEED Gold hospital project in the Midwest. As a result of his experience, he wanted to extend sustainability to renovations and operations and not stop with the newly constructed bed tower. Through educating senior leaders, he was able to secure their support, and this led to the creation of my position and also the position of manager of Energy Solutions, led by Austin Rennick.

Janet: Another goal in the Engaged Leadership Challenge is to build in sustainability measures as an organizational priority. How did Advocate do this?

Mary: As a data-driven organization, we decided that we needed to measure our sustainability programming. Our very first environmental goal was to reduce energy by 20 percent by 2015 from a 2008 baseline, which I am proud to say we are on track to achieving. And if we were measuring energy performance, what other environmental improvement activities should we take on and measure? We added waste, construction and demolition debris recycling, single-use device reprocessing and paper reduction. Under waste, we broke out solid waste, recycling and regulated medical waste. We started looking around to identify benchmarks for each of these items, and with Practice Greenhealth and the use of its awards program and benchmark report, we could set targets and see how we compared with others.

In 2012, we developed a sustainability scorecard as a way to educate key stakeholders and executive sponsors. The data is both rolled up in the aggregate and provided by site. Sharing the data drives competition among the sites and motivates them to achieve their goals. Seeing how they performed compared with others is very helpful.


Janet: How is the scorecard populated?

Mary: Populating the document is shared between myself and the energy manager. He calculates all of the energy data, including greenhouse gas emissions, weather adjusted for each site, and I do all of the other data collection. Some tips for success include identifying key vendors for each category and requesting the data prepared for us on a quarterly basis. These data requests are made clearly so the data is given in the format of our preference. The data is shared through a system-level committee made up of all green team leaders and it is posted on an internal website and emailed to executive sponsors. Data samples are shared in the annual sustainability report. This year, we are doing something different. The health and wellness program has a partnership with sustainability to ramp up joined efforts around education and develop a computer-based tutorial describing the connection between environmental and human health. The computer-based training is online and a raffle is used to incentivize its use.

Janet: Another goal under the Operational Focus heading is identifying a clinical champion. Tell me about clinical engagement at Advocate.

Mary: One of Advocate’s infection preventionists has been leading our efforts in Advocate’s systemwide infection control consortium for antibiotic stewardship, including when and how to provide them. The consortium is supporting a recommendation to reduce purchase and sale of meat raised with the nontherapeutic use of antibiotics. This is a powerful support of our sustainability work—connecting environmental stewardship activities with public health and wellness issues. We have other clinicians engaged in specific program areas like in our single-use device reprocessing in surgical services. One of our clinical champions is also a green team leader.

Thanks to Al Manshum, our executive sponsor, and senior leadership at Advocate, a newly formed council made up of vice presidents from each hospital site and ambulatory facilities is empowered to make strategic changes to support environmental and human health. This council supports our focus on meat procurement reduction through the Healthier Hospitals Initiative’s Healthier Food Balanced Menu Challenge. The council can help with the financial analysis and the details we need to make the case for less meat and healthier meat. This council offers us a new, powerful method to make strategic decisions that impact the entire system.

Advocate has a model of clinical operations that is centralized, and now supply chain and other initiatives are made at a system position and rolled out to the various locations. This is valuable for making evidence-based decisions, best practices, systems thinking and standardization for cost and operational efficiency. Policies are developed systemwide. In our Health Outcomes Council, which is chaired by our chief medical officer, we submitted a chemical exposure policy. It was approved by the council in an effort to protect workers and identify healthier materials and medical products in our health care environments. This has led to Advocate’s recent focus on healthier materials, HHI’s Safer Chemicals Challenge and a commitment to avoid chemicals of concern in furniture, fabrics and finishes.

Janet: What are the feedback mechanisms for staff?

Mary: We have a section in our computer-based tutorial where suggestions can be offered.  Additionally, each site has a green team and a process for receiving suggestions. We have developed a departmental Green Advocate program where individuals represent their department, implement sustainable practices and can achieve a workspace certification. The Green Advocate can engage with their co-workers and communicate needs, ask questions and request education. Green Advocates answer questions like: How do you set up double-sided printing? Can we put in an occupancy sensor? Where do we recycle this type of paper?

Janet: What’s next for Advocate?

Mary: Engaging patients and families. Telling the story.