Look to the North

Despite the challenges of extreme weather and a tough regulatory environment, health systems throughout Minnesota are blazing a sustainability trail.

By Eric Johnson on May 8, 2017


For many, Minnesota might be better known for its brutal winters than for its environmental progressiveness, but among those who keep up with sustainability issues, it’s no secret that health systems in the Land of 10,000 Lakes have been making huge strides in sustainability for years—despite some major challenges.

For one thing, there’s the weather, which can reach minus 20 in the winter and can occasionally touch 100 during the summer. That means hospitals and clinics must have equipment in place to deal with both extremes. It affects how systems are designed and managed, while at the same time rules out systems that might be sufficient in a milder climate.

For another, Minnesota’s environmental regulations are some of the tightest in the nation, and local jurisdictions can—and often do—have even stricter regulations than the state, which can prove costly and also complicate systemwide implementation of sustainability programs for some of the larger-reaching health systems.

In the end, however, several of the state’s health systems are making notable strides in sustainability, and as the Great Lakes Cohort, a Practice Greenhealth initiative, prepares to bring these players together in a powerful, regional group, the importance of sharing successes and challenges is highlighted even further.

Saving Energy

With more than 35,000 employees at its Rochester Campus, Mayo Clinic is a city within a city with very specific energy demands.

“We analyze the potential energy savings, and that’s how we prioritize the projects,” said Brett Gorden, section head in Facilities Operations. “There are a lot of opportunities, so the ones with the best payback or the biggest chunk of energy toward our goal—those are the ones we target first.”

And Mayo’s goal is an ambitious one: a 20 percent reduction of the full organization’s energy footprint by 2020.

Though Mayo Clinic has been environmentally aware for the majority of its long history (after all, stewardship of both people and resources is one of its eight core values), recent sustainability efforts are built around a committee structure. Green committees on each of the major campuses report to an advisory group called the Green Advisory Council, which sets the strategic direction. Members also bring ideas and projects back to their individual groups.

“It’s a nice way to get a lot of people involved in sustainability,” said Amanda Holloway, section head in Facilities Operations, which includes waste management, recycling and environmental services. “Our focus is really on the team approach, with the expectation that our green committee members take the message of sustainability back to the groups and find ways to make sustainability improvements within their departments.”

At the Rochester facility, those improvements come in several areas, from squeezing as much energy as possible out of utility plants to retrofitting parking garages with LED lighting. “Any time you can reduce your wattage by 70 percent, that’s a huge thing,” Gorden said.

From a building perspective, the health system has also been working through a retrocommissioning program for the last five years, with the goal of retrocommissioning 50 buildings by 2020. “Essentially, that’s going through existing buildings’ mechanical systems and electrical systems, and basically looking at the operations and making sure the building is operating the way it was designed to operate,” Gorden said. “It’s kind of hitting the reset on the buildings and looking for ways to improve their efficiency, and we’ve seen a lot of success with that.”

Partnering with the local utility has also paid off for Mayo terms of rebate programs, particularly for lighting and adding variable frequency drives (VFDs) on whatever motors it can. “Rochester Public Utilities does a great job of helping us understand what the rebates are and making sure we use them to the fullest extent,” Gorden said. “After the rebate, the VFDs are almost free, so it doesn’t make sense not to do them, and with the lighting, they pay for about half of a lighting fixture.”

Partnering with local utilities is a popular way for other health systems to gain ground on their sustainability goals as well.

For Fairview Health Services, a system with six hospitals, 75 clinics and a footprint that extends from the Twin Cities north toward the Canadian border, the relationship with Xcel Energy in particular has yielded significant returns.

“Xcel has assisted us with some different rebates and project schedules, which has been very helpful,” said sustainability coordinator April Schumacher. “They also came and did assessments at three of our clinics last year, which allowed us to put together a list of potential projects across our clinical locations to implement over the next year or two.”

Though the bulk of Fairview’s sustainability efforts have taken place on the hospital side, Schumacher said that over the last couple of years, the system has really started reaching out to its clinic locations, where it has established the Green Masters Program. Specific to the clinics, the Green Masters Program takes different aspects of the overall sustainability program and applies them to the clinics, which have their own unique challenges.

Recently, one clinic was recognized for eliminating almost 40 percent of its regulated medical waste. Though obviously far less than the waste generated by a hospital, the numbers add up: The combined waste volume of all clinics rivals the waste volume produced by one of the hospitals.

Schumacher said Fairview has also partnered with a vendor, Grainger, to complete a lighting audit at two of its larger hospitals. The system also did some HVAC setbacks in the operating rooms at one hospital location, which allowed it to save over 202,000 kilowatt hours.

Tallying all the energy savings projects across the system in 2016, Fairview experienced a savings of more than 1.9 million kilowatt hours and more than 4,400 natural gas therms, resulting in about a half-million dollars in savings.

Meanwhile, HealthPartners, an integrated health care system based primarily in the Twin Cities, is another facility taking advantage of incentive programs, particularly those offered by Xcel Energy.

The system’s leading hospital in energy efficiency initiatives has received more than $460,000 in rebates over the last five years. “Our hospitals and clinics received about $265,000 in rebates in 2016, which translates into about $230,000 in annual savings,” said Dana Slade, director of sustainability programs. “So we’ve got a good, robust program going with the utilities.”

He’s particularly proud of HealthPartners’ commitment to solar power over the last couple of years. He estimates its solar facilities generated 68,440 kilowatt hours last year. “That’s not a lot, but we’ve got some big plans in the future,” Slade said. “We’ve got commitments for community solar of more than 21 million kilowatt hours a year, and we’re about to sign another subscription agreement for community solar that is equal to that.”

The community solar gardens are not located at any of the facilities, but are in counties that the health system is located in or adjacent to. “They’re large facilities of a minimum of probably five acres,” Slade said. “In order for us to meet the commitment we’ve signed up for, we’re going to be a part of many of those five-acre sites.”

When it comes to renewable energy, the Veterans Administration (VA) is one of the largest federal users of renewable energy credits, and with 1 million square feet of space, the Minneapolis VA facility in particular receives a large number of them.

The Minneapolis VA is the largest contiguous VA hospital in the United States. Although the hospital has a number of satellite clinics, the majority of sustainability efforts are understandably focused on the main hospital complex.

During one yearly “lights out” drill in which the hospital is taken off the grid for 24 hours to test its ability to survive, Green Environmental Management Systems Coordinator George Johnson uncovered a surprising energy hog: the ultra-low freezers used for research. “I worked with the head of research, and together we crafted a purchase agreement with some unused research funds to buy 25 new ultra-low freezers,” Johnson said. “Looking at where our vulnerabilities were gave me the opportunity to impose energy and green purchasing policy, and direct the Research Department to buy new energy-efficient appliances.”

The VA has a national goal to reduce energy consumption at least 2 percent every year. According to Johnson, this is accomplished by putting in more energy-efficient appliances, better insulation, heating and cooling system upgrades, and a massive changeover to LED lights to reduce power.

“Because we have the capacity to generate power at our facility, we have also signed an agreement with our state utility that if there’s a need for a brownout or a blackout, they can take us off the grid,” he said. “In return for making that agreement, the facility gets a slightly reduced kilowatt hour rate for its power.”

Protecting Water

According to Johnson, who has worked for the Minnesota Pollution Control Agency as well as the Minnesota Department of Natural Resources, Minnesota’s water quality and discharge regulations are stricter than those in most states, though water quantity is not such a pressing issue.

“For the most part, we are actually in a very water-rich area,” he said. “We have excess rainfall, we have a lot of surface water, and we have very ample groundwater supplies, so we’re not quite so concerned about drought and drought protection.”

Considering the VA complex’s size and location—it covers six square miles and includes old military posts and historic areas, with the hospital less than a quarter of a mile from the Mississippi River—water runoff is always a major concern. So the VA does a lot with rain gardens and infiltration basins.

So, too, does the Mayo Clinic.

“We have a couple of rain gardens on our campus, which helps with stormwater runoff—capturing the runoff from some of our parking lots where it’s filtered through the ground rather than going directly into the stormwater system,” Holloway said.

And just because water is abundant doesn’t mean that water conservation doesn’t factor into sustainability plans. “Given the millions of square feet we occupy in Rochester, our grounds crew has done a great job of finding ways to reduce the amount of irrigated square footage on campus,” Holloway continued.

One of the ways Mayo’s team is doing that is by planting native plants, looking at drought-tolerant plants, using low-maintenance turf, and then amending the soil or using mulch to effectively ensure the plants are getting the water they need without excess evaporation.

Another way is by taking a critical look at operations.

“Our folks at the power plant have found some ways to conserve millions of gallons of water in the last few years by modifying some of the equipment,” Gorden said. “They found a way to take the water used for cooling equipment, which was designed for a once-through, and taking it to a cooling tower to get a couple of uses out of it.”

HealthPartners has also worked on water conservation initiatives, saving 4.8 million gallons of water last year and $12,000. “It’s not a huge cost savings thing for us, but in order for us to have a comprehensive program, we thought we needed to address water conservation,” Slade said. “It’s the right thing to do.”

The Power of Many

Although the Great Lakes Cohort—which will reach across the upper Midwest from Minnesota to Wisconsin to Michigan—is still early in its formation stage, all agree that sharing knowledge is beneficial to the overall success of sustainability.

“Being able to reach out to our peers in the local area is always a good way to share what you’ve had success with and, more importantly, what you had issues with trying to accomplish,” Fairview’s Schumacher said. “I think talking through our struggles is something sustainability as a whole doesn’t like to focus on. We don’t always like to talk about what struggles we encountered—at a specific site, with the state, with the leadership team and the staff on-site. I think having a cohort that is willing and able to talk freely about these things is always beneficial.”

Slade agrees.

“A lot of the things we deal with on a day-to-day basis are local, regional or state-related, so I think a regional group has the benefit of that type of lens to look through and operate through,” he said. “I think a lot of the things we deal with would be better to look at from that perspective instead of a national perspective.”

And given the innovative solutions these health systems have developed to some very specific regional challenges, that focused perspective should help drive the sustainability needle even further in a positive direction.