What We Buy Matters for Good Health

By Beth Eckl Director of Environmental Purchasing Program on July 9, 2012

Practice Greenhealth sets standardized questions for procuring more sustainable medical products for health care facilities.

Hospitals, such as Massachusetts General in Boston, strive to purchase equipment that promotes a healthy environment.
Courtesy of Massachusetts General Hospital.

Companies Providing Sustainable Products

Stryker Sustainable Solutions
Reprocessing instruments

PVC- and DEHP-free IV bags and tubing

Latex-free gloves

Hospital beds

Linvatec autoclavable rigid endoscopes

Do you know the chemicals used to make your hospital’s medical products? Something as seemingly innocuous as a patient identification (ID) band may be made of polyvinyl chloride (PVC), which can produce cancer-causing dioxins during its manufacturing process. In 2009, Kaiser Permanente identified alternatives and made the switch to PVC-free ID bands; in doing so, it eliminated the production and release of dioxins equaling more than 61,000 square feet of PVC each year—that’s equivalent to well over the size of a football field.

While ID bands are small, they make a strong statement to the marketplace that health care organizations continue to safeguard the health of not only patients but also global communities. Healthier hospitals call for products that have a reduced impact on natural resources, contain safer chemicals, and require less energy. What we buy matters.

Making wise purchasing decisions is an effective way to improve the environmental performance of health care products. By selectively choosing medical products for hospital facilities, we can generate demand for safer products and services for patients, workers, and the environment.

Greening the Supply Chain Initiative

Practice Greenhealth has launched the Greening the Supply Chain Initiative, which aims to provide a common set of tools and resources for purchasers, suppliers, and manufacturers and to help drive a sectorwide market shift toward the availability of environmentally preferable products (EPPs) and services that are competitive in cost and comparable in quality to competing products and services. A significant part of this initiative is the development of a tool—the Standardized Environmental Questions for Medical Products, Version 1.0—that can be used to guide the identification, selection, and purchase of environmentally preferable medical products. This tool is designed to do the following:

  • Reduce the negative environmental and health impacts of products and services across the products’ life cycle.
  • Establish a standard for purchasing environmentally sound products, thereby encouraging other health care purchasers to act similarly.
  • Provide a tool for educating staff and others on environmental priorities in health care.
  • Create a safer, healthier environment for patients, health care workers, and communities.

Environmental Questions

Practice Greenhealth’s new tool—Environmental Questions—was developed through a consensus process with five major group purchasing organizations (GPOs). These GPOs have endorsed the questions and are committed to utilizing them during the purchasing process. The questions target a range of medical products used to diagnose and treat or care for patients; these items may include sheets, textiles, apparel, mattresses, draperies, exam gloves, pillows, skin prep applicators, laboratory products, patient care plastic products, drainage sets, containers, and bags. The list excludes electronic medical products (anything that plugs in or has a battery) and pharmaceuticals.

The Environmental Questions tool focuses on three areas—natural resources, chemicals, and waste—and covers key areas of concern in products’ packaging, manufacture, and use as well as products’ end-of-life issues. The questions are not designed to replace product-specific environmental considerations but to help in making informed decisions. Individual users will determine how they will incorporate the information they derive from the questions into their existing evaluation systems.


The development of Practice Greenhealth’s Standardized Environmental Questions for Medical Products aims to achieve several goals:

  • Provide a supply chain tool identifying key environmental attributes of concern to the health care sector in order to inform purchasing decisions.
  • Facilitate collaboration among the largest purchasers of medical products to accelerate the demand for and increase the purchase of products and services that, based on evidence, have reduced environmental and human health impacts on patients, staff, and communities.
  • Inform and educate the health care community—including suppliers, purchasers, health care professionals, and others—about environmental and public health concerns important to health care organizations and professionals as well as the communities they serve.
  • Create a consistent platform to reduce the request for information (RFI)/request for proposal (RFP) burden on suppliers, with each purchasing entity remaining free to decide what to do with the information obtained in response to the questions.
  • Improve the availability of cost-effective and environmentally preferable products and services, and reduce the environmental/public health footprint of the health care sector.
  • Engage suppliers in the process and inform them of the product attributes that are of greatest concern, and provide an opportunity for input in refining the questions for additional clarity.

The questions were chosen based on information from several sources, including product attribute questions currently being asked by all five GPOs and gathered by Practice Greenhealth, selected questions from Kaiser Permanente’s Sustainability Scorecard issued in 2011, and input both from stakeholders, including suppliers, manufacturers, scientists, and clinicians, and from available research.


Hospitals and health care systems can show their commitment to this initiative and to environmentally preferable purchasing by buying products with one or more environmental attributes. They also may pledge to support their GPO by pledging online or downloading a pledge form from Practice Greenhealth (www.practicegreenhealth.org/gsc).

Suppliers can play a role through the EPP Business Leadership Coalition, whose mission is to work diligently and cooperatively to build products and processes that are environmentally preferable and that meet the environmental and human health needs of health care consumers. The group will provide information and comments on tools and resources, including the Standardized Environmental Questions.

Sampling of Standardized Questions

  • Is this product free of intentionally added polyvinyl chloride (PVC)?
  • Is this product free of intentionally added phthalates DEHP, BBP, DnHP, DIDP, and DBP?
  • Is this product free of intentionally added Bisphenol A (BPA) or BPA-derived plastics such as polycarbonate plastic and resins?
    Does this product contain less than 1,000 ppm halogenated organic flame retardants by weight of homogeneous material?
  • Is this product free of intentionally added mercury?
  • Is this product free of intentionally added latex?
  • Is this product free of carcinogens or reproductive toxins under the California Safe Drinking Water and Toxic Enforcement Act of 1986 (Proposition 65)?

Make the Pledge

Solidify your support for this part of the Greening the Supply Chain Initiative by pledging to support the GPOs when contracting for products and to purchase products with environmentally preferable characteristics, as outlined in the Standardized Environmental Questions for Medical Products.
To make the pledge, visit www.practicegreenhealth.org/gsc/pledge.

  • Group Purchasing Organizations
  • Amerinet
  • HealthTrust Purchasing Group
  • MedAssets
  • Novation, LLC
  • Premier Healthcare Alliance