Health Care Sustainable Procurement: toxic-free health care begins with the supply chain

by Mellissa Nguyen, Vizient Senior Program Services Manager, Environmentally Preferred Sourcing

Kevin Lewis, Vizient Consulting Director, Supply Chain Services

The facts are clear, painting a picture of growing toxic chemicals in humans. The United States (U.S.) Environmental Protection Agency has warned that babies born in the United States today have on average more than 280 industrial chemicals in their bloodstreams at birth. The Green Science Policy Institute reports that at least 95% of American children and 99% of American adults have chemicals such as polyfluoroalkyl substances (PFAS) polluting their bloodstreams on any given day. Many of these industrial chemicals have been linked to negative impacts on human health and development, such as cancer, endocrine, genetic and immune system disruption, as well as damage to the brain, lungs, kidneys, liver and reproductive system. Elevated levels of PFAS in the bloodstream have even been found to increase the risk of suffering severe complications from COVID-19.

More than 85,000 synthetic chemicals are being used throughout the U.S. today, yet only 1% have been tested for safety to human health. At least 140 chemicals in use today—in packaging materials, construction, flooring, food production, cookware, children's toys, sporting goods, furniture, electronics, textiles, automobiles, cosmetics, medical supplies and equipment—are linked to negative health impacts.

A global supply chain and a patchwork of international regulations can leave manufacturers and suppliers confused about which chemical safety standards to follow. And ambiguity and a lack of consistent regulation of unsafe chemicals can create opportunities for uncertified and counterfeit products to easily enter the market that may contain these unsafe chemicals.

Health care organizations can combine their collective voice and purchasing power to drive changes in the marketplace. They can look for groups such as the Healthcare Anchor Network and their group purchasing organization. These changes include products that do not contain chemicals of concern, increased transparency from suppliers, and encouraging suppliers to be even better stewards of the environment through safer chemical management and reduction of carbon footprint.

Health care organizations are finding success through the adoption of policies to screen unsafe chemicals in the supply chain as both patient and staff safety initiatives, as well as moral and ethical responsibilities. Sustainable procurement requires a commitment at the leadership level, with a champion at the department level who can develop and implement a methodology. Lack of that commitment threatens any sustainability program.

Including updates about sustainability efforts with growth in key performance indicators during business reviews and monthly meetings with senior leadership is an effective way to normalize sustainability as part of business operations and enhances the visibility of such initiatives. Creating a standardized approach to incorporate the impact of sustainability initiatives with financial, operational and clinical impacts successfully highlights sustainability and the risks of the alternatives as a collaborative effort rather than a competing priority. Providers should make their approach scalable and data driven. This approach should enable facilities to evaluate, monitor and remove harmful chemicals from their supply chain at the organization, facility, department, category and individual product levels.

For example, a children’s hospital in the northwest converted to a PVC-free and phthalate-free IV bag, not only providing a more environmentally friendly option but also one that saved them $260,000 annually. With the contract for the incumbent supplier expiring, the facility identified an alternative supplier who offered bags that did not have these chemicals of concern.

Polyvinyl chloride (PVC) is a hard plastic usually combined with phthalates (i.e., DEHP), which can leach out of the plastic products and be absorbed into the human body. Phthalates have been linked to asthma, allergies, cognitive and behavioral problems as well as disruptions to reproductive development in adolescent males.

The hospital made the successful conversion by conducting a value analysis, resulting in the annual cost savings and a new supplier for IVF bags that do not have chemicals of concern. Sustainability impact was a key element in evaluating these new IVF bags, in addition to financial, operational and clinical impact. This successful product conversion created a blueprint for future category conversions for other products in the hospital’s supply chain that contain PVC and phthalates.

In another example, with Vizient’s help, a 620-bed nonprofit community hospital on the West Coast was able to integrate purchasing data with environmentally preferred attribute data to screen for unsafe chemicals at the item level to protect high-risk patients from unsafe chemicals in the supply chain. The effort, outlined in a recent case study, provides a detailed analysis and scalable methodology evaluating unsafe chemicals in 74 unique products from 18 different suppliers across six high-risk patient care product categories.

The study shows how industry standards for sustainability and creative thinking can be used to evaluate if products in the supply chain meet safer chemical standards and help with waste reduction efforts and come from socially responsible suppliers. Most importantly, the study shows how all products can be scrutinized for sustainability, eliminating the need to consider products as “green” or “not green” through a data-driven, standardized approach with multidisciplinary key stakeholder involvement.

Our next blog in this series will explain why 360-degree value analysis is a game-changer regarding sustainable procurement for the health care sector.

If you need assistance, Vizient can provide the necessary framework for your hospital or health system to implement and maintain an environmentally preferable purchasing program that supports your hospital sustainability efforts. We also offer the broadest environmentally preferable purchasing portfolio in the industry, with more than 450,000 contracted environmentally preferred products. More information is available at the Vizient website.