St Vincent’s Health Australia (SVHA) is 12 months into a strategy designed to transform its environmental footprint.
The organisation-wide strategy covers six public hospitals, eight private hospitals, about 13 aged care facilities, and four co-located research institutes, and a territory spanning mainland Australia's three eastern seaboard states.
As the nation's largest Catholic not-for-profit health and aged care provider, SVHA operates 27 facilities and employs more than 16,000 staff. Some of the nation’s finest research institutes are affiliated within the group including the Victor Chang Cardiac Institute, Garvan Institute of Medical Research, O’Brien Institute, and St Vincent’s Institute of Medical Research.
SVHA’s group manager, energy and environment Matthew Power says its environmental resolution is much more a full body immersion, than a toe in the water pilot. It is enterprise-wide, audited and reportable to all key stakeholders.
He outlined the project, which commenced in 2012 and is scheduled to run until at least 2015, to David Hutchins, editor of CCN's sister publication, Hospital and Aged Care magazine.
Power is responsible for formulating and implementing the ambitious enterprise-wide environmental imperative, which he says is the organisation’s response to several key factors.
“There are a number of reasons for committing to an environmental strategy but probably the biggest was that St Vincent’s use to consist of four separate organisations. They amalgamated to form SVHA and there was an opportunity to address our environmental impact at a group level and in a uniform way," he says.
“Primarily the driver for SVHA is that we feel strongly that it is inherent in our mission as
a catholic health organisation to not only help those at the margins particularly through healthcare but to also be good stewards of the earth.
“Hospitals and healthcare by their nature have a major environmental footprint so it would be in our view irresponsible not to address that impact."
The strategy also ensures the entire organisation meets regulatory compliance such as the National Greenhouse Energy Reporting System and Energy Efficient Opportunities or EEO.
Power says the business cases for environmental change was developed with a common purpose to ensure returns equal or are better than those generated by other conventional commercial investments.
These will be used to impact four fundamental areas of SVHA’s facilities and management. These include: supply chain and procurement; waste avoidance and resource recovery; buildings and physical environment
utilities and GHG emissions.
As well as addressing these elements, Power says the strategy’s aim is to reduce consumption of energy, water and outputs of waste and emissions across the enterprise.
It prescribes significant pre-work, surveys and audits to establish baselines and benchmarks. These works are analysed and distilled into business cases for ongoing environmental transformational change projects.
Power says these projects will be visible and will impact areas across the group including interactions with suppliers and partners.
“Sustainable environmental initiatives will be included within all future capital development proposals and we will develop an environmental database of audit solutions containing accurate SVHA environmental metrics, KPIs , targets and report annually on usage," he says.
“We will develop a formal Environmental Management System to ISO 14001 standard legislative monitoring practices to ensure all current requirements are addressed, as well as an Environmental Communications and Education Plan, and an Environmental Champions Network.
“Environmental outcomes will be measured and reported to stakeholders and we will isolate current or future technologies for implementation across the organisation,” Power says adding that SVHA’s commitment to the plan cannot be understated.
“The commitment is demonstrated by the appointment of a senior manager to drive the strategy at an organisation level and with the sponsorship of the CEO and Board.
“The SVHA environmental strategy was signed off by the Board and CEO along with our environmental policy. The policy and strategy applies right across the organisation,” he says emphasizing that executive stewardship is essential for such a program.
“Executive stewardship is vital to any activity in an organisation but even more so with environmental or sustainability practices. Without executive sponsorship environmental practices invariably wither.
“The need for senior leadership to lead by example on environmental issues is pivotal
in getting an organisation to change its behavioural practices. The most difficult
part of driving environmental outcomes in organisations is not providing the tools to enable reductions in environmental impact but facilitating staff to utilise them, particularly in those areas where staff have a direct impact such as waste,” Power says.
Executive stewardship can, Power says, make or break ambitious transformational change projects which in brownfield hospital and health sites are always going to be formidable because of challenges associated with accessing the existing infrastructure.
“Foremost hospitals are aimed at addressing the health issues of their patients and therefore most other considerations tend to be secondary including such things as energy efficiency.
The primary aim particularly of base building services is to maintain occupancy conditions that are often very tightly defined and/or regulated and this is exacerbated when addressing specialist areas such as operating theatres," he says.
“The challenge presents itself in that often facilities managers are prevented from undertaking full maintenance regimes due to the difficulty in shutting down major pieces of building service infrastructure particularly in facilities that are deemed critical infrastructure this is a unique consideration not generally faced by many other sectors in the built environment,” Power says.
Negotiating such complexities can be like running a gauntlet with the environmental business case on one side and savings, asset management, governance and risk management on the other. Getting the case over the try line can be complicated.
“These complexities apply to pretty much any existing healthcare facility and is one our major considerations particularly when addressing our energy consumption. That is how we isolate opportunities to do full works overhaul or a major plant upgrade," Power explains.
“Funding can often be an issue but generally less so with major plant work as the impact of a catastrophic failure and the additional downtime this generates makes for a compelling argument when put against costs.
“We had an example of this in a major Heating Ventilation Air Conditioning (HVAC) replacement of an aging existing plant at one of our private hospitals in Melbourne.
“The logistics were quite substantial given the importance of the system to building performance and the reliance on supplementary systems during change-out.
“However, due to the passage of time, efficiencies in HVAC design and performance have seen substantial reductions in their energy consumption. At this facility the HVAC replacement was also coupled with a lighting upgrade leading to an almost 20 per cent reduction in energy consumption at that site, primarily driven by the plant replacement," Power says.
“There’s an interesting example of a catastrophic chiller failure at a regional Australian hospital which led to the evacuation of one wing and the extended use
of supplementary air conditioning systems at substantial costs. The cost of the supplementary units was obviously additional to the cost of the planned chiller replacement and created additional delays in project implementation."
He says other inhibitors to such projects include making a winning business case to secure funding.
“Funding is also a constant issue. Hospitals and the health sector generally have lean budgets which mean funding for additional activities such as environmental programmes is often difficult to obtain," Power says.
“Another major issue is the ability to mount compelling business cases; it is often difficult to justify an environmental project outcome against providing primary care to the sick, however compelling the return on investment.
“These days substantial environmental upgrades can produce compelling returns, which are often better than conventional commercial investments. Property and equity investments have produced long term returns of between 10 and 11 per cent, but environmental investments can yield as much as a 15 per cent return on investment,” Power says.
Consideration of such projects must, Power says, be balanced and consider cost factors and savings alongside promised environmental benefits.
“Like all things there needs to be a balance. SVHA is aware that not all environmental initiatives will have a strong cost benefit attached to them. The balance is always between compelling environmental outcomes and real world cost implications," he says.
“However, across the board on most occasions the financial case is quite strong and meets basic internal cost benefit thresholds. Particularly in relation to such things as energy reduction measures, these projects often return financial outcomes superior to just about any other commercial investment opportunity.
“We have demonstrated similar outcomes when addressing waste reduction opportunities given the pressures being applied to waste disposal costs which like electricity and gas are only heading higher."
After just over a year into implementing the SVHA Environmental Strategy Power says its already produced substantial results such as:
$400,000 per annum savings after upgrading the lighting at Sydney’s
St Vincent’s in Darlinghurst;
More than $200,000 in savings for upgrading lighting and HVAC at St Vincent’s Private in Melbourne;
HVAC upgrades are driving savings of $700,000 per annum;
Building Management System (BMS) is driving substantial energy reductions and;
Overall the lighting upgrade has generated a reduction of more than 2.5 million kWh and savings of $350,000 per annum.
With the current undertaking about one third complete and with significant work remaining, Power agrees that the process and policies being formed will likely mould SVHA’s environmental footprint for many years to come.