"At Northwell Health, we recognize a profound sense of responsibility to contribute in every way possible to the health and well-being of the communities we serve, not only through providing the best quality healthcare but also by employing sound environmental business practices and programs.”
-Michael J. Dowling, President and CEO
These comments are at the heart of Northwell Health’s sustainability and social responsibility mission. In November 2010, our CEO, Michael J. Dowling, shared these ideas in an article he wrote for employees shortly after Northwell publicly partnered with the Environmental Protection Agency (EPA) to establish far-reaching, environmentally responsible programs and business practices at its facilities. We did not stop there, however. In the two years since we signed the EPA agreement, Northwell has embarked on a journey to weave sustainability and social responsibility further into the fabric of the health network. For us, the essence of community health is underpinned by a commitment to a strong environmental stewardship and social agenda, because it is the right thing to do and better for people’s health and well-being.
We must avoid contributing to the environmental hazards that are causing health problems in our communities and work to increase health, economic and social equality to help people live healthy lives. To steer this activity within the health system, a Sustainability and Social Responsibility Council was established in 2012. Made up of a cross-section of leaders, the Council has begun to create comprehensive, holistic goals and practices that reach across the health system and will help shape the way we do business.
Northwell Health’s sustainability and social responsibility (SSR) mission is focused on improving the health and well-being of our communities and society at large. Through responsible decision-making and support of our communities, we will protect and enhance the environment and improve quality of life.
Social vulnerability Index
Northwell Health's sustainability and social responsibility mission focuses on improving the health of our communities and society at large. In an effort to better serve our communities, Northwell Health is developing a social vulnerability index (SVI) in collaboration with a data science firm. The SVI will be a valuable tool that measures the social vulnerability of individuals and communities by identifying social determinants of health (SDH). It will be comprised of a score that allows providers and community benefit personnel to identify the most impactful social determinants of health and facilitate actionable interventions in collaboration with key community members and community-based organizations.
The SVI will also help Northwell to empower the members of the communities we serve and create sustainable change via strategic investment. The SVI will be a valuable tool for identifying social determinants of health that predict 80% of clinical outcomes, and will also be a helpful tool to drive policy change and reimbursement modeling for value-based care.
Social determinants of health screener
At Northwell Health, we recognize that the most effective strategy in addressing total health is by engaging patients as partners. Our standardized self-reported SDH screening questionnaire allows patients to self-identify sensitive social issues that impact their lives at the time of their visit to our facilities. Our self-reported SDH screening tool incorporates a social model of health and removes the sole focus of body function, structure and disease alone, creating the ability to assess and identify patients’ needs in real time and allowing our providers to be engaged in the overall plan of care and to connect patients to needed social services.
Early identification of SDH barriers can help patients and their families achieve optimal health. Our strategic approach incorporates digital technology with a clinical system integration model of collaboration and engagement with providers. The model aligns delivery of patient needs via digital network referral and on-site staffing to tackle social vulnerabilities and improve health outcomes.
Community referral platform
Once the social determinants of health in a community are identified, providers are often not equipped to address them. Lack of information and resources can create a roadblock in helping patients and communities reach total health.
The solution? We leverage technology to allow providers and patients to connect to community-based organizations that can provide these needs, create highly matched referrals, facilitate closed-loop referrals, support bi-directional patient engagement, and document referral outcomes in an integrated approach.
Through the use of a bi-directional referral platform providers and patients are able to connect to community-based organizations identified to meet a patient’s specific support needs. Need-based referrals with bi-directional communication allow the provider and community based organization to collaborate on behalf of the patient and document referral outcomes.
Reducing our carbon footprint
Setting the standard for sustainability in healthcare
Northwell Health is dedicated to achieving healthier operations and reducing our carbon footprint. In 2010, Northwell Health's carbon footprint equated to 254,631 metric tons of carbon dioxide — equivalent to heating and operating 30,902 homes for a year. We are committed to continuing to reduce our carbon footprint. In fact, from 2009 to 2011 we reduced our carbon footprint by 15.6 percent! Our New York City hospitals are among the 13 hospital organizations participating in Mayor Bloomberg's PlaNYC Hospital Carbon Challenge. We are achieving our carbon-reduction goals through:
- Focusing on “green” facilities
- Reducing the use of natural resources
- Seeking sustainable building materials and design
- Reducing waste and encouraging recycling
- Streamlining transportation and distribution channels to reduce motor vehicle pollution
- Purchasing environmentally preferable products
- Developing an efficient IT infrastructure
Green facilities, energy and water usage
Northwell Health’s sustainability and social responsibility initiatives have a strong focus on “green” facilities and reduction in use of natural resources. Northwell participates in the EPA Energy Star Partnership Program; our signed agreement with the EPA was established in 2010. Recently, as part of the development of our SSR strategy, the health network organized an expanded, multi-year survey of its energy usage and overall carbon impact to more readily measure progress against our goal of reducing our carbon footprint by 20 percent by 2020. And we are well on our way — between 2009 and 2011 we reduced our carbon footprint by 15.6 percent!
Northwell Health is committed to pursuing LEED® certification in its new building construction and major renovations, and seeks innovation in sustainable design, green building materials and energy- efficient systems. Currently, more than 45 projects have been registered for certification. In 2012, The Katz Women’s Hospital at North Shore University Hospital became the first hospital project in New York, and only third in the country, to be awarded the LEED® Platinum certification, the highest rating awarded by the USGBC. With the Platinum rating, on average, The Katz Women’s Hospital uses 18.6 percent less energy, 51 percent less water and 100 percent of the electrical power consumed in its first two years of operation will have been generated using renewable energy from wind power in Texas.
In addition to network-wide initiatives, engineers at Glen Cove Hospital are hard at work improving the energy efficiency and operations of this busy community hospital. Their efforts to conserve energy have earned Glen Cove the U.S. Environmental Protection Agency's distinguished Energy Star award in 2009, 2010, 2011 and 2012. It is the nation’s symbol for superior energy performance and environmental protection. Glen Cove is only one of two hospitals in New York State that has earned this prestigious award for four years in a row. And, only six hospitals nationwide have achieved this same recognition. Meanwhile, at Southside Hospital in Bay Shore, New York, a new solar energy facility consisting of a 50 kilowatt photovoltaic rooftop array has successfully generated 27,325 kilowatt hours of electricity in 2011. Northwell hopes to add additional facilities to the list of those employing solar systems.
Waste management: Reduction and recycling
As part of its sustainability and social responsibility in healthcare initiative, Northwell has installed recycling bins in all of the system hospitals and plans to advance the work done with staff at each facility on major waste reduction and recycling initiatives. Proper sorting of waste, recycling and hazardous materials is paramount to our efforts to reduce our overall consumption, particularly of single- use items, and divert trash from landfills.
Northwell has instituted a major recycling program across all network facilities. Recycling containers have been placed in strategic locations at each of the hospitals and off-site locations and, since 2010, we have recycled 8,208 tons of waste. The health system is also currently diverting a large percent of the construction and demolition debris from our new construction sites from landfills.
Drug take-back days
Since 2010, the health network has partnered with the on several Drug Take-Back Days. Through this program, over 1,300 pounds of unused or expired medications were collected at Northwell Health facilities alone. This program helps to reduce the amount of unused prescription drugs that currently enter landfills and drinking water systems.
A state-of-the-art food bio-digester, lovingly named “Chester,” was installed at Lenox Hill Hospital in 2011. Chester helps Lenox Hill divert 1,200 pounds of food waste from landfills each day. The health network continues to explore opportunities to install brothers and sisters for Chester at other hospital kitchens.
Sustainability in transportation and distribution
A key contributor to the health network’s carbon footprint is motor vehicle pollution—from trips to and from our facilities by our patients, employees and visitors, transportation and distribution of goods and operation of our ambulance fleet. Given the serious effects of direct and indirect vehicle use on air quality, the environment, energy consumption and travel safety in our communities, Northwell is committed to finding an effective path to reduce vehicle miles travelled and the resulting pollution.
A streamlined distribution center
Northwell recently opened a new center to streamline medical/surgical supply distribution. The manufacturers deliver most of the products used by the health network’s hospitals to the center. Reusable totes of supplies are then assembled and distributed to each nursing unit. With this facility, manufacturers have one delivery point, which reduces energy consumption and vehicle miles traveled. It also allows the center to have direct control of the recycling of the corrugated cardboard resulting from the deliveries to ensure high recycling rates.
Safer healing environments
As a health network, we seek to create a safer healing environment for patients, employees and visitors that is free from hazards posed by chemicals that are toxic, irritating or noxious. Northwell intends to reduce or eliminate the purchase of environmentally hazardous or otherwise undesirable chemicals through the purchasing of environmentally preferable products.
The health network's Environmental Services Department has switched to Green Seal-certified cleaning products. is given to products and services that comply with “a rigorous set of criteria designed to achieve leadership levels in sustainability.” When a stronger cleaning agent is required to kill specific bacteria and germs, Environmental Services has implemented a safety program to ensure minimal impact on people and the environment. Solvents used in many Northwell laboratories are recycled rather than put into the waste stream, and the health network has reduced mercury in our hospitals by 90 percent.
Efficient IT infrastructure
Smooth operation of our health network and the delivery of quality care rely on a vast and efficient IT infrastructure. Running this network requires a significant amount of energy and materials and Northwell Health is committed to reducing our impact from these activities. Our IT team is also committed to bringing technological solutions to the challenges faced across the health network in implementing our comprehensive SSR efforts.
Northwell is utilizing our vendor partners to handle our various IT waste streams more effectively and efficiently. Today, we dispose of our shredded confidential documents at a pulp facility that recycles the material into new paper products. We also ensure responsible recycling of e-waste and last year donated over 300 data-scrubbed BlackBerry devices to those in need. As part of the upgrade of the television systems at North Shore University Hospital, 12,344 pounds of e- waste were recycled and the health network as a whole continues to pursue recycling and proper disposal for all large-scale replacement efforts. We have also converted capable networked printer devices throughout the health network facilities to default to double-sided and the initiative has received significant positive feedback from employees.
Healthier food choices
The food we eat is critical to our collective health. The U.S. food system’s current methods of food production, processing, packaging and distribution has had significantly negative effects on public health, chronic disease prevalence and the environment. Northwell Health is committed to helping the US move toward a more equitable and sustainable food network. The network has begun purchasing more environmentally sustainable foods and strives to serve healthier meals and beverages to patients, employees and visitors.
In April 2012, chefs from 11 Northwell hospitals competed in the health network’s first-ever cooking challenge to prove that hospital chefs can serve up gourmet restaurant-quality meals, but without the high fat, calories or sodium. Coinciding with National Nutrition Month, hospital culinary teams from Queens, Long Island, Manhattan and Staten Island faced off at Glen Cove Hospital’s Pratt Auditorium, which was transformed into a giant kitchen equipped with stovetop burners, a pantry and farmers market for the “Ultimate Chef Healthy Entrée Challenge.”
Each team had one hour to create a delicious, attractive and nutritious meal. Three celebrity chef judges awarded Forest Hills Hospital’s chefs with the top prize for their original dish of stuffed pork tenderloin with cranberry wild rice. Lenox Hill Hospital received second place and Syosset Hospital came in third.
Helping the Community
As an anchor institution, Northwell Health serves as a model of good behavior by protecting and enhancing the sustainability of our communities, locally, regionally and globally. We engage with community partners in coalitions to help identify the underlying environmental and social causes of chronic diseases and health disparities and leverage our resources to address these issues to create systemic change.
Northwell employees and physicians displayed extraordinary teamwork and emergency preparedness during 2011’s Tropical Storm Irene, establishing a safe haven for more than 5,000 patients, outside nursing home residents and others seeking shelter. They helped evacuate nearly 1,000 patients from Staten Island University Hospital, Southside Hospital and outside hospitals and nursing homes with minimal assistance from outside agencies. In the aftermath of the storm, when many facilities were running on backup power and without air conditioning, they continued to care for patients. Whether a natural disaster, terrorist attack or pandemic, Northwell consistently drills its employees through multiple emergency scenarios so it can partner with the community when help is needed most.
Our more than 9,400 physicians and 10,000 nurses are at the heart of the patient- centered care Northwell provides. They represent a driving force for social responsibility and sustainability within the health network that goes beyond the quality care they provide every day. We have engaged a vendor to take our open/unused supplies in the operating rooms and reprocess it for redistribution and use in underserved nations. Furthermore, a partnership between Northwell and MedShare has successfully diverted surplus materials to developing countries that have desperate need of the medical surplus. This medical donation partnership fulfills our mutual mission of improving health care. The high-volume, high-quality supply and equipment donations from Northwell make our combined efforts well executed and impactful. Since 2011, MedShare has received 11,341 pounds of assorted medical supplies, 341 beds, 148 mattresses, 440 IV poles and 546 pumps from the health system. Among recent shipments, medical donations from Northwell were shipped to South Sudan, Haiti and Bangladesh.
At Northwell, we recognize the unique position we are in as the largest provider of healthcare in the region that allows us to partner with local legislators, policy makers and community groups to influence the ever-changing landscape of healthcare. Our work in the advocacy/policy arena ranges from healthcare reform on the national level to community and economic revitalization and policy development on the local level. To pursue these goals, Northwell is represented on the boards of numerous local organizations including Sustainable Long Island, Erase Racism and Hispanic Counseling Center, among others. In addition, health network leaders sit on the boards of regional and national organizations and coalitions including:
Each year in the United States, secondhand smoke exposure is responsible for 150,000 to 300,000 new cases of bronchitis and pneumonia in children aged less than 18 months. Northwell Health has worked with community organizations, including the Queens Smoke-Free Partnership, to educate the public about the dangers of secondhand smoke. Our advocacy work has enabled us to affect policy including the NYC Smoke Free Parks and Beaches legislation, garner the commitment of all Nassau and Suffolk hospitals to adopt smoke free campuses, and help organizations establish and implement smoke-free outdoor air policies which prohibit smoking both inside and on the grounds of their facilities.
Sustainability in the workplace
One of our sustainability and social responsibility (SSR) goals is to harness the energy and commitment of the more than 45,000 Northwell Health employees by engaging them in SSR initiatives to help build a culture of sustainability and social responsibility. We want to help build commitment to the values of environmental stewardship, inclusion and volunteerism so that our employees can become advocates for change in their own families and communities. It will help us retain the best staff and provide the best care for our patients.
Diversity and inclusion
Recognizing the importance of being sensitive to the different needs and expectations of the communities it serves, Northwell is enhancing its diversity awareness, inclusion and health literacy efforts to ensure that race, ethnicity and language are not deterring residents from accessing healthcare services.
Human resources goes paperless
Northwell’s commitment to enhancing technology and productivity has spread to Human Resources with the introduction of employee self-service, a new technology that has helped shift Northwell away from relying on paper processes to serve employees’ needs better. It eliminated millions of paper files including printed paystubs. Additional Human Resources processes will also go paperless over the next few years, not only saving trees, but also improving customer service and operating efficiencies. Our paperless approach will make things much easier for employees and dramatically change the way we do business internally.