2017Inova Sustainability andWellness ReportConnecting your environment andyour health.

Table of Contents

Inova Well

       Goals and Progress.............................4

       Six Dimensions of Health......................5

       Success Stories....................................6

Sustainability at Inova

       Goals and Progress....................................7     

       Sustainability Stoplight Report..........8

       Environmental Focus Areas..............9

              Waste Management.........................10

              Environmentally-Preferable                                     Purchasing.......................................11

              Sustainable Foods................................12

              Water and Energy Management............13

              Alternative Transportation..................14

              Green Buildings...................................14

              Employee Engagement and Climate                     Health..............................................15

               

3

Goals and ProgressWellness at Inova

KEY WELLNESS PRINCIPLES

INOVA WELL MISSION STATEMENTInova Well's mission is to create asustained culture of wellness by leveragingour clinical expertise to provide evidencebased solutions for healthy people, healthycommunity and healthy planet. 

Inova Well collaborates with all other Inovaentities in order to provide personalized,sustainable and evidence based wellnessinitiatives and activities that inspire and activateeach individuals personal wellness success andjourney.

Patient Always

Wellness intersects with Inova’s culturalbeliefs in a number of key ways, including:

Stronger Together

Inova Well's mission is to create a sustainedculture of wellness by leverage our clinicalexpertise to provide evidence based solutions forhealthy people, healthy community and a healthyplanet. 

INOVA'S CULTURE JOURNEY

2017 Wellness Accomplishments

2018 Wellness Opportunities

To improve employee health and well-being through our six dimensions ofhealth.

Invest in our employees with healtheducation and lifestyle skills thatenable them to achieve optimalhealth and wellness.

Positively affect employee moraleand job productivity.

Launched a new wellness portal for Inova employeesand external clients.On-boarded an Account Executive to promote Inova Wellexternally.Facilitated over 5,000 bio-metric screenings, had over10,000 Life Support participants, gave over 17,000immunizations, and had over 7,000 respiratory fittestings for Inova Health System.Served over 32,000 participants within the communitythrough our childbirth, life support, immunizations,screenings, education, and fitness programs. 

Work collaboratively with other Inova service lines tobuild more partnerships,Enhance and grow all Inova Well programs to providebetter comprehensive and evidence-based services.Shift the Inova culture of health and wellness to helpcreate a healthier work environment.Continue to capitalize on the functions of the wellnessportal to enhance health and wellness internally andexternally.

4

The Inova Well program is focused on supporting whole health through our sixdimensions of health.

What We Believe What We Do

Knowing and understandinginformation on your healthprofile is the important firststep in managing yourunique wellness needs.

Health Coaching

Be Aware

Health Coaching offersonline support or supportwith a personal health coachwho is as committed to yourhealth goals as you are.

Health Coaching

Be Aware

Eat WellGood nutrition and healthyeating habits provide afoundation for being healthyand can help reduce the riskof chronic diseases.

Physical fitness can producelong-term health benefitsand help prevent chronicdiseases.

Living life to the fullest iscentered on having ahealthy mind.

A commitment tocontributing to anenvironment that is safe andhealthy for employees andcommunity creates ahealthier environment fornow and for the future.

Get Active

Healthy Mind

Live Green

Eat Well

Get Active

Healthy Mind

Live Green

Multiple online health coaching program; WellBaby, PersonalBack/Quit/Weight Coaches, Fit and Fit Coach and moreIn person 1:1 health coaching to help develop individual wellnessgoals, create a plan and help with each step along the wayDedicated health coaches to support developing a culture ofwellness throughout Inova

Biometric Health Screening for ALL Inova employeesHealth Screening (including bloodwork) for ALL Inova employeesOnline health assessment to ALL Inova employeesVariety of health check-ins with our Health Coaches

Enhancing healthy choice offerings in the cafeterias Reducing offerings of sugar sweetened beverages Registered Dietitian on staff to answer any nutrition relatedquestions and guide employees to other helpful resources

Ability to track participation in a variety of activities includingwalking, water activity, sports, skiing and everything in betweenOn-site fitness walksOn-site fitness classesOn-going team-based challenges

Engaging in altruism through volunteer activities Developing a culture of wellness through the posting of helpful andhealthy comments on the internal social media platformOffering classes and programming with a focus on stressreduction including Virtual Reality and Mindful Gardening

Both on-site and virtual seminars and workshopsSessions about recycling, resource conservation, antibioticresistance, transportation and more Creates a better understanding of what is needed for a healthierand more sustainable environment

5

Success Stories1.

2.

3.

"I've known for a long time that I needed to drop the extra weight I had on. More importantly, I knew that if I wantedto be a part of my daughter's active life I needed to change how I was living my own life. Back in February, westarted a challenge in the office, and at that time I also started the process with my health coach and weighed in at235. I was very overweight and being 31 years old and 5'7" I just always felt sluggish and needed to make achange. This is what caused me to inquire about a wellness coach. The knowledge and experience my healthcoach has is unbelievable, and I've learned so much from him! From the diet plan, what foods to not eat, and whatexercises to do to build muscle and help me along the way. Whatever your goal is, the Inova Well program will doeverything possible to help you reach it. My body and diet has completely transformed under the guidance of theprogram, and as of today I lost 35 pounds and weigh in at 200 with muscle as well. I'm getting closer and closer tomy ultimate goal and will carry all the knowledge I learned from the program for the rest of my life. It's no longer atemporary way of life; it's now a form of living and living healthy."

"Meeting with a health coach was a necessary step for me to moveforward in my decision to improve my health. I needed bothencouragement and information. My coach helped me to identify barriersthat were preventing me from recognizing the impact of a healthierlifestyle...I am more conscious now of my nutrition and exercise plans. Iam so motivated to improve my health now. Thanks Inova Well!"

"The Health Coaching program has helped/guided me in putting into placea healthier lifestyle. I am more aware of the importance of proper nutrition,along with regular exercise and good sleep. I have enjoyed my time withmy health coach as he is straight forward, easy going and alwaysencourages me to keep moving forward!"

6

2017 Sustainability Accomplishments

Waste diversion and recycling (2.02 million lbs.), 2020system energy goal achieved, and pursuit of LEEDcertification on multiple projects (ICPH & IFMC).  Financial savings of more than $1.6 million throughelimination of transportation consulting services,negotiated waste refunds and waste diversion, andpurchase of reprocessed surgical devices.Engagement of 3,000 Inova employeesthrough targeted transportation initiatives, treegiveaways, medical donation events and waste projects.First ever achievement of 20% non-single occupancyvehicle mode split at IFMC.

Sustainability outcomes in 2017 tie directly to ourkey principles and cultural beliefs. These include:

2018 Sustainability OpportunitiesIntegration of sustainability responsibilities and relatedperformance measures across all relevant functions.Convert to “no antibiotic ever” chicken and relatedsustainable food procurement (all sites) in support ofPatient Always and Value People cultural values.  Continue focus on waste segregation and recycling atall IHS sites. Review contractual changes and newstrategies - food composting, blue wrap recycling andStyrofoam ban.Reaffirm support and pursue LEED Silver certificationfor all relevant projects. Incorporation LEED elementsin all smaller projects.Build on progress with employee mode split andrelated transportation demand efforts - new busroutes, marketing, telework and related strategies.Roll out new employee engagement effort tyingsustainability to Inova's cultural beliefs.  

Goals and ProgressSustainability at Inova

KEY SUSTAINABILITY PRINCIPLES

SUSTAINABILITY MISSION STATEMENTInova is committed to establishing anenvironment that is safer and healthier forour patients, employees and community. 

“Do No Harm”, because you can’t have healthy people on a sick planet.

Sustainability provides both short- term and long-term ROIs.

Sustainability is in direct alignmentwith Inova’s cultural beliefs. 

Providing a total healing atmosphere forpatients, which includes an optimal (green) builtenvironment; using green cleaning materialswhich reduce or eliminate exposure to harshcompounds; and providing nourishing, organicand healthy foods to speed up recovery.*

Value People

Sustainability intersects with Inova’s culturalbeliefs in a number of key ways, including:

Patient Always

Employees are engaged when they know theiremployer cares about their well-being. A healingenvironment provides benefits to employeesthrough improved productivity, less absenteeismand overall job satisfaction. In addition,sustainability programming offers engagementopportunities which foster employee retention. 

INOVA'S CULTURE JOURNEY

7

TRA

NSP

OLE

SS W

AST

EG

REE

NIN

G T

HE

OR

HEA

LTH

Y FO

OD

CLE

AN

ER E

NER

GY

WAT

ERB

UIL

DIN

GTR

AN

SPO

RTA

TIO

N

CATEGORY METRIC STOPLIGHT

Solid Waste as % of total waste

Hazardous as % of total waste

% of cleaning chemical spend ongreen general purpose, bath,glass, carpet, and floor cleaners

56% 70% 100%

% spend on sustainable foods

% spend on local foods

% meat raised without ABX

% spend on healthier beverages

% food waste reduction

Energy use intensity (EUI)

% change in EUI from baseline

ENERGY STAR score

% offsite renewable energy

% onsite renewable energy

Gallons per square foot

Building projects pursuing LEED

Alternative transportation mode split 20% - IFMC9% - IMVH - -

5 - -

56 gal/sq.ft. 46 gal/sq.ft. 23 gal/sq.ft.

274.9 226 136

-20.7% -9% -32%

- 54 89

0% 24.7%

0% 13.5%

26% 9% 36%

21% 10% 38%

10.6% 35% 70%

34% 55% 85%

0% 19% 39%

9.9%

1.8%

Sustainability Stoplight ReportInova Health System

NATIONALAVERAGE

SYSTEMDATA

NAT'L 90THPERCENTILE

Recycling as % of total waste

RMW as % of total waste

11%

12%

76%

<1%

28%

6.1%

-

-

51%

2.4%

Compliance rate of collectedvs.purchased reprocessed devices

Total savings from reprocessingmedical devices

40%

$642,090

-

-

-

-

-

-

8

1. Waste Management

2. Environmentally-Preferable Purchasing

3. Sustainable Foods

4. Water and Energy Management

5. Alternative Transportation

6. Green Buildings

7. Employee Engagement & Climate Health

Environmental Focus Areas

9

Waste Management by the NumbersWaste Management Progress

In 2017, all sites across thesystem experienced somelevel of contamination intheir waste streams. 

In 2017,  the Office ofSustainability initiatedcross-functional wasteoverhaul to determinecauses of contaminationand implement solutions.    These efforts haveresulted in consistentprogress towards "clean"recycling at all OUs.

In addition to the costsavings associated with asuccessful recyclingprogram, the Office ofSustainability negotiated aseries of rebates forcontamination fees. 

Operational and contractmanagement partiesmust be fully vested inInova's recycling programsin order to reduce wasteand increase progress in2018.

Hazardous Waste RMW Recycling Solid Waste

2014 2015 2016 20170

1020304050607080

Year

Percentage

Inova Health System Year Over Year Waste Trends

2017 Inova Waste Streams

Compare the above industrybenchmarks to Inova's actual2017 waste stream breakdown,at right. RMW is 12% and SolidWaste is 76%, while Recycling is11% of total--14% below theindustry benchmark. The totalwaste tonnage for Inova:

The chart below shows a year over year breakdown of Inova's wastestream percentage trends. Inova’s greatest opportunities are inreducing RMW and Municipal Solid Waste, while increasing recycling.

Recycling: 25-30% Solid Waste: 60-65% Regulated Medical Waste: <10%Hazardous Waste: <1%

Industry benchmarks for hospitals'waste stream tonnage as apercentage of total are as follows:

Recycling, 11%RMW, 12%

Haz Waste, 1%

Solid Waste, 76%

Recycling: 1,011.9 tonsSolid Waste: 6,731.4 tonsRegulated Medical Waste: 1,018.9tonsHazardous Waste: 62.04 tons

Minimizing regulated medical waste (RMW), hazardous waste,and solid waste, while increasing reuse and recycling is crucialto reducing Inova’s environmental impact and operational costs.

Waste Management

10

EPP by the NumbersEnvironmentally-PreferablePurchasing Progress

Inova’s approach toenvironmentally preferablepurchasing includesmaking progress in keyimpact areas includingGreening the Supply Chainand Greening the OR.  Inova continues work inenvironmentally-preferablepurchasing by regularlyconvening both vendorsand supply chain staff thattouch these areas.  

The goal in 2018 is todevelop a road map andframework that aligns allsupply chain functions andduties with sustainabilityrequirements. 

Hospital supply chain teams have an opportunity to help shift the healthcaremarketplace by using their organizations’ purchasing power to demand safer,healthier, more environmentally preferable products from their supplier partners. 

Environmentally-Preferable Purchasing (EPP)

The greatest cost savings for Inova resulting from our EPP program hascome from our medical device reprocessing efforts. In 2017, Inova saved$642,090 in reprocessing program savings alone. Inova realized anadditional $20,597.75 cost savings from diverting 90,341 pounds ofmedical waste from area landfills through reprocessing.

In 2016, IHS achieved a 27% green spend rate. In 2017, that investmentincreased to 56% percent. Industry benchmarks for green spend oncleaning products suggests a 90% spend on green products compared tototal, signaling opportunity for expansion in this program area for 2018. 

2017 Inova Reprocessing Data

Reprocessing Savings Waste Diversion (lbs.) Waste Savings

IAH

IFMC

IFOH

ILH

IMVH

$5,477

$229,279

$152,034

$161,936

$93,364

12,424

35,341

23,270

15,598

3,708

$2,832.67

$8,057.75

$5,305.56

$3,431.56

$845.42

Total $642,090 90,341 $20,597.75

2017 IHS Green Spend on Cleaning Products

Green Spend Conventional Spend Percentage Green Spend

$102,307 $81,543 56%

11

Sustainable Foods by the NumbersSustainable Foods Progress

In an effort to capitalize onthe healing potential offood, the Office ofSustainability worksdiligently to ensure thefoods Inova servespositively contribute toevery patient’s journey towellness.  In 2017, a new financialmodel was implementedand big effort was spenteducating vendors onrequirements. 

Moving into 2018, we arecommitted to achievingsustainably and locally-sourced food goalsincluding rBGH free dairyproducts.   Given the estimatedannual $20 billion inexcess direct health carecosts stemming fromantibiotic resistance in theUnited States, we are alsodedicated to servingantibiotic-free meat andpoultry to our patients andin our cafeterias. 

In 2016 and 2017 we experienced a transition period where Inovaadopted more rigorous standards around food procurement—particularly regarding antibiotic free meat and poultry. The Office ofSustainability has been working with Morrison, U.S. Foods and the Officeof Supply Chain to implement these new requirements. 

The greatest opportunities and areas of focus for 2018 in ourSustainable Foods program include increasing our percentage of localfood purchases compared to total spend, and exclusively purchasingpoultry raised without routine use of antibiotics. 

2017 Local Food Purchases

Local Spend Total Spend Pounds of LocalFood Purchased

$743,369 $2,589,131 -

2017 Sustainable Purchases

Total Program $ Total Non-Program $ % Sust. Spend

Cage Free Shell Eggs (HFAC) Coffee

rBGH Milk rBGH Yogurt

ABX-Free Chicken ABX-Free Turkey

Sustainable Seafood Cert. Humane/ABX-Free Beef

Cert. Humane/ABX-Free Pork

Total

$44,264 $60,911

$187,928 $72,540  $148,991 $74,635 $31,353  $45,891 $5,484

$138,759 $216,187 $54,350 $38,980 $577,003 $194,952 $134,452 $386,132 $176,318

24% 22% 78% 65% 21% 28% 19% 11% 3%

$671,997 $1,917,133 26%

Inova is committed to procuring and serving nutritious, sustainable foodsto improve the health and wellness of both the planet and our patients. 

Sustainable Foods

12

Site EUI

2012 2013 2014 2015 2016 2017200

275

350

Energy Efficiency by the Numbers

Water Management ProgressSustainability, FacilitiesManagement, andEngineering worktogether to implementwater conservationpractices and efficientequipment. 

 As Inova continues toexpand, water-efficienttechnologies will becrucial to sustained watermanagement strategies.

Water Management by the NumbersWater management is an essential component of Inova’ssustainability program, and we strive to make our waterconsumption as efficient and sustainable as possible. 

Gal/sq.ft.

60.8258.42

60.97

52.9955.79 56.4

2012 2013 2014 2015 2016 201740

55

70

Inova Year Over Year Water Consumption (Gal/sq.ft.)

In maintaining 24-hour operations, healthcare facilities consumelarge quantities of energy and water. Conserving these resources, andutilizing them more efficiently, is key to Inova's sustainability efforts.

Water Management & Energy Efficiency

Inova employs a combination of energy reduction andenergy efficiency strategies to reduce our system-wideenergy footprint by 20% by year 2020, from a 2012 baseline.

2020 EUI goal: 277

In 2017, Inova exceededthe 2020 goal of a 20%Site EUI reductioncompared to 2012baseline.   Initiatives in 2017included focus onoperational remedies,LED lighting and greenbuilding projects. 

Moving forward, in orderto maintain and exceedthis goal, continualinvestigation of energyefficient measuresshould be explored innew building projectstaking place at Inova.

Energy Efficiency Progress

IHS Year Over Year Site EUI (Energy Use Intensity) Reductions

13

Alternative Transportation by the Numbers

Alternative transportation reduces Inova’s carbon footprint and positivelycontributes to better air quality and climate mitigation in our communities. Healthybuildings result in healthier occupants, and we are committed to greening ourbuildings for patients, visitors, and staff. 

Alternative Transportation & Green Buildings

In 2017, the Office of Sustainability assumed oversight of all transportationinitiatives across the system including County mandates for TransportationDemand Management. The office was able to hire a new transportationlead who will work with staff at all hospitals to develop programming thatresults in more alternative transportation trips. Specific efforts included:

Employee-focused transportation program offerings that includeemployee shuttles, pre-tax transit benefits (WageWorks), preferredparking for carpoolers and telework options for eligible staff. 

Employee Commuter Fairs in partnership with the Office of Sagetyand Security, Human Resources and Fairfax County's Department ofTransportation.

Initiation of the “Car-Free Challenge” at specific operating units,resulting in 455 car-free trips taken by IFMC employees to and fromwork. 

Alt. Transportation ProgressEmissions fromtransportation areresponsible for 27% of theUnited States’ totalgreenhouse gas emissionsprofile.   This environmental burdentranslates directly to poorpublic health outcomes—particularly for Inova’s servicearea. Washington, D.C.received failing grade forsmog in the American LungAssociation’s 2017 State ofthe Air Report. As a result,the Office of Sustainability iscommitted to reducing mileson the road. Inova’s transportationprogram maintainscompliance with FairfaxCounty Department ofTransportation proffers forTransportation DemandManagement (TDM), andworks to reduce single-occupancy vehicles comingonto our campuses. 

Green Building ProgressThe manner in which abuilding is constructed,operated and maintainedcan have a significant impacton both the environmentand people that interactwithin that space.

Inova continued to make progress in green building efforts across thesystem. Specific projects included:

Green Building Opportunities

IFMC Operating Room (OR) renovation that is pursuing LEEDcertification, IFMC Professional Services Building (PSB) that includes anumber of LEED elements.

ILH Tower that is incorporating a variety of green elements.

ICPH has multiple projects that are looking at LEED certifications,including LEED Gold, along with the WELL building standard. 

Inova plans to build on these efforts in 2018 through  a new greenbuilding standard that will ensure all projects, large and small, aredesigned and built to support our mission of healing. 

14

Employee EngagementEmployee engagement at Inova continued to be a significant focus in2017, resulting in a series of events and activities across the campus. Asummary of those activities is listed below. 

Transportation Events - Participated in multiple events throughoutthe year, engaging close to 2,300 employees through various surveys,lunch tables and Bike to Work Day events. 

Car-Free Challenge - Organized and recruited teams at IFMC toparticipate in an employee car-free challenge to get staff out of theircars. The challenge resulted in 455 car-free commutes during themonth of October, fostering friendly competition amongdepartments.    

Earth Day Tree Giveaway - Continued partnership with local non-profitthat provides tree seedlings for employers in the region. Staff gaveaway 500 seedlings to Inova employees along with information aboutenvironmental and wellness programming.

Employee Committees/Project Support - Helped develop and supporta cross-functional stakeholder group that was tasked with addressinga major waste contamination issue at IFMC. Initiatives led by thegroup helped reduce contamination to almost zero, saving IFMCthousands of dollars in waste fees. Other projects included expansionof recycling within various departments.   

Employee Engagement Progress86% of workers believe it isimportant that theiremployer is responsible tosociety and the environment.(55%) feeling that it is “veryimportant”. (Project ROI)

75% of workers wouldrecommend their company ifthey feel it is environmentallyresponsible vs. 43% if it is not.(Project ROI)

Sustainability engagementevents across Inova are agreat way to support thesebeliefs and enhance staffretention, recruitment andwell-being.

Climate Health ProgressWeather disasters in 2017amounted to an estimated$306 billion in damage.(NOAA's National Centers ForEnvironmental Information)

Spread of infectious diseases,more heat-related hospitaladmissions and higher ratesof cardiovascular illness areall scenarios in a warmingcllimate. 

Inova will continue to lead onthis issue to ensure thatpatients continue to receiveexceptional care. 

The nexus between climate health and public health is becoming moreintertwined with Inova clinicians seeing the impact on patients first-hand.These experiences, coupled with an inherent belief To Do No Harm, led anumber of Inova clinicians to take action on this issue. They formed agroup called, Virginia Clinicians for Climate Action (VCCA). VCCA held aninaugural education event at the IFMC in April of 2017, educatingparticipants about how the changing climate influences the health ofVirginians.

The Sustainability Office also produced a series of climate and healthbrochures that educate various patient groups about the impact of achanging climate on their health. These brochures are available fordistribution on our website or in print form. 

Climate Health

Employee Engagement & Climate HealthEmployee engagement has a direct impact on staff retention and well-being. A highpercentage of workers, especially Millennials, look for opportunities to help theircompany become more sustainable (Inc. Magazine). A changing climate has thepotential to impact delivery of service through storm-related damage and anincrease in climate and health related admissions.  

15