It is an ongoing struggle for many Canadian health care organisations to achieve a realistic balance between cleaning and disinfecting to reduce health care acquired infections (HAIs) and other unwanted organisms that can be harmful to patients, staff and visitors, while simultaneously being kind to the environment. They must provide clean and safe treatment and healing environments that are aesthetically pleasing to positively impact the patient experience, yet do so on an ever-shrinking operating budget.

In response to these conditions The Ottawa Hospital was incited to get innovative with its purchasing policies and vendor/supplier relationships concerning cleaning and disinfecting products and services.

The Ottawa HospitalThe Ottawa Hospital (TOH) provides residents of Eastern Ontario with compassionate world-class health care from three bilingual facilities in the national capital area. Combined, the Civic, General and Riverside campuses total in excess of four million square feet of treatment and healing space and house approximately 15,000 health professionals and support staff, making it one of the largest employers in Ontario. In addition, TOH provides educational opportunities across all health care disciplines in partnership with the University of Ottawa and other affiliated universities, community colleges and training organizations.

With its size and complexity comes, not unexpectedly, a tremendous demand for hundreds of different cleaning products used for health care treatment, research, maintenance, housekeeping, laundry and elsewhere.

In recognition, TOH established a Green Team with members from various organisational departments including engineering and operations, and purchasing, tasking it with a review of purchasing policies and vendor agreements with a goal of advancing towards more sustainable health care practices and establishing a model for other health service providers to emulate.

Supplier RelationsWith a working budget of over $733M, TOH wields tre-mendous leverage within the Canadian cleaning products industry and this has not gone unnoticed by the TOH Green Team which has developed a framework regarding which chemicals it will tolerate in its cleaning products, and the ones it will not. Each must be aerosol, chlorine, fragrance, and allergen-free with a preference for EcoLogo-certified products.

Suppliers wishing to have their products considered for use at TOH must show they meet environmental standards as set forth in TOH’s Requests for Proposal (RFPs), in addi-tion to meeting all other relevant criterion applicable to best practices and stringent cleaning protocols.

Once selected, suppliers are engaged on an ongoing basis as part of TOH’s continuous improvement process with feedback on products continually gathered from frontline employees, patients and family members. This vital informa-tion helps the organisation identify opportunities for product and operational changes, and is used by management to select the best products possible for cleaning and disinfect-ing efficacy and the safety of staff and patients.

Supplier feedback starts with local representatives and may include district managers, research and development staff, and senior executives where necessary. This engagement strategy facilitates the working together of all stakehold-ers to ensure the safest, most innovative and sustainable products are put to use in TOH’s healing environments. The process can, however, sometimes be rather lengthy should it involve reformulations, lab testing, beta testing under ac-tual job conditions, the development of product packaging, assembly, etc.

Ultimately, TOH strives to support suppliers/vendors willing to act as both subject matter experts and solution architects, desirous of turning them into “partners for innovation” rather than simply providers of goods.

The Ottawa Hospital Purchasing its way to Green

Green Best Practice Case Study #3

The Canadian Coalition for Green Health Care is Canada’s premier integrated green health care resource network, a national voice and catalyst for environmental change. www.greenhealthcare.ca

www.greenhealthcare.ca 2012 2 CCGHC-CS-2012-1E

The Canadian Coalition for Green Health Care is pleased to acknowledge support received from the Ontario Trillium Foundation, an agency of the Government of Ontario.

The Ottawa HospitalPurchasingThe earth-friendly procurement policies of TOH are guided by Ontario legislation and directives from the Local Integrat-ed Health Network (Champlain LIHN). Under these policies, TOH spends over $1M annually on cleaning chemicals and supplies. However, while provincial policies drives how goods and services are procured, the health care organisa-tion’s internal environmental services quality improvement structure plays a vital role in collecting data from internal clients such as the nursing and clinical leadership teams, which is then used to gauge the success and viability of alternative products and strongly influences future purchas-ing decisions.

Pilot ProjectsLike many hospitals, TOH runs trials to test the efficacy and efficiency of each alternative cleaning product under consideration. In part, this is done by testing for the pres-ence of pathogens on the test surface following a pre-scribed cleaning protocol using a selected alternative or ‘green’ cleaner. Should the product fail to pass the test, it is rejected and is not approved for use. Such trials are neces-sary to protect the health and safety of hospital patient, staff, and visitors.

In addition to testing for in-house use, TOH staff also is also gathering test data to share with other Canadian health care institutions to further the body of knowledge available to them on environmentally-sound best practices in clean-ing and infection control.

The TOH Green Team’s vision is for an extensive and diverse compliment of safe and effective alternative clean-ing products available for use throughout Canada and they are doing their part to assist manufacturers and suppliers through stringent testing and ongoing feedback.

There are also many companies producing green cleaners that have not sought EcoLogo and Green Seal certifica-tions, despite their products being environmentally-friendly and safe. To lend support for these uncertified alternatives, TOH has conducted pilot projects on many of them using, following testing guidelines set forth by EcoLogo and Green Seal, to help make a business case for these products. By doing so, TOH hopes to influence the green cleaning mar-ket by broadening product options and helping to cultivate a stronger alternative product market in Canada. It has also conducted similar pilots on a variety of European prod-ucts which are certified by their own respective third party groups, but not certified for North America.

ConclusionThe Ottawa Hospital is positively impacting the growth of Canada’s green cleaning landscape. Their proactive Green Team, and other key decision-makers, have implemented a robust quality improvement framework that allows the hos-pital to select alternative cleaning and disinfecting products, test their efficacy and where appropriate adopt them into best practice.

They continue to support the burgeoning Canadian green cleaning products marketplace while looking to broaden the variety of safe products available for themselves and other Canadian health service organisations. Through in-house trials, market leverage, and embracing suppliers as partners for innovation, TOH is moving green cleaning from a fringe issue to mainstream best practice.

ContactJessica Heiss, BID, LEED APCoordinator, Sustainability & Building IntegrationEngineering & OperationsTHE OTTAWA HOSPITAL1053 Carling Ave.Ottawa, ON K1Y 4E9(613) 798-5555 x12970jheiss@toh.on.cawww.toh.on.ca