The health care industry is inherently energy-intensive due to the continuous operation of hospitals and other standalone facilities.

At Texas Health, we deploy strategies to reduce costs and consumption, improve air quality and reduce greenhouse gas emissions.

Improving Efficiency, Reducing Carbon Footprint

Texas Health retrofits buildings, equipment and lighting to improve efficiency. Each year, we prioritize activities and invest millions in projects that reduce costs and our carbon footprint. We use software that tracks how much energy and natural gas we supply to all facilities, which allows us to identify inefficient zones so we can optimize them.

2017 Performance

We spent about $14 million in building system upgrades and embarked on 63 efficiency projects to reduce energy consumption during the year. We also constructed a new energy-efficient Texas Health Neighborhood Care & Wellness Center in Prosper.

Overall electricity and natural gas consumption decreased 1 percent, falling short of our goal. We attribute this to the expansion of some facilities. We also investigated alternative energy sources, such as solar, thermal storage, wind and green credits.

Energy Use (kBtu/sqft)
Goal: In 2017, our goal was to reduce energy consumption 3 percent per square foot.

Hospitals are among the most water-intensive facilities. With the state’s ongoing risk of drought and rising water rates, it is essential to reduce consumption to save money and preserve this natural resource.

Long-term Water Availability

Local water utilities store and supply surface water for use by our facilities. Groundwater tables are too deep to economically access currently. To ensure long-term water availability, we have controls in place to reduce, recycle and reuse water where we can. We also continuously implement conservation projects to reduce water use in our buildings, cooling towers and landscapes. Texas Health also is part owner of a laundry cooperative, which helps us significantly reduce water used to launder linens, gowns and other materials.

Goal: We set a systemwide goal to reduce water consumption by 10 percent by the end of 2018. We always want to comply with local regulations to ensure wastewater releases are within permissible levels.

Hospitals produce millions of tons of medical, office and electronic waste annually, which often ends up in landfills or is incinerated where legally allowed.

Effective waste management programs greatly reduce disposal risks and costs, environmental impacts to air, land and water as well as risks to human health.

Implementing Best Practices

Texas Health proactively assesses the materials we use so we can identify best practices, change use and disposal behaviors, identify cost-reduction opportunities large and small, and share best practices throughout the system.

Our waste management policies, protocols and training enable us to handle waste responsibly and comply with local laws and regulations. We have a single process for the handling, storage, documenting and disposal of various waste streams. Each hospital also must develop pollution-reduction plans as required by the state of Texas’ Waste Reduction Policy Act.

We seek ways to reduce the use of materials – from medical supplies to copy paper to foodservice items – by purchasing only what we need and then reusing and recycling what we can. Texas Health also hosts community shredding and recycling drives.

To manage hazardous waste, we contract with a national waste disposal company that provides training, and removes chemicals, pharmaceuticals and medical waste directly from our facilities to ensure content and containers are properly disposed.

Goal: Each entity sets site-specific goals to reuse and recycle materials.
We Recycle or Reuse:

According to the U.S. Environmental Protection Agency, 10 North Texas counties don’t meet air quality standards for ozone, which can aggravate the health conditions of people living in the communities we serve. We must do our part to improve air quality and reduce emissions from our operations.

Keeping Emissions Below Permitted Limits

We invest in controls to comply with local laws and regulations, and to keep air emissions below permitted limits. We also ship medical waste off-site for incineration.

Goal: We aim to keep emissions below permissible levels and comply with regulations.

We protect the welfare of our employees and patients to provide a productive healing and work environment.

Identify, Assess and Respond

We designed our environment of care management programs to comply with our own stringent building and operations standards as well as those set by The Joint Commission, Occupational Health and Safety Administration and National Fire Protection Association. We also appoint system representatives to serve on our Physical Environment Workgroup, which meets monthly to discuss physical environment safety concerns and action plans, and to share best practices across all facilities. We conduct routine tours to assess building safety risks to prevent unauthorized access or slips, trips and falls.

Additionally, as part of our safe workplace policy, each hospital has a multidisciplinary threat management team that includes representatives from human resources, employee health, system security and police, and behavioral health. The team meets regularly to assess and identify potentially hazardous conditions related to physical security or workplace violence.

We train employees on non-violent crisis intervention to help them safely defuse anxious, hostile or violent behavior. In response to increasing workplace violence across the country, we are continuously evaluating and improving how we identify, assess and respond to potential threats.

2017 Performance

We spent the year assessing our care environments to address potential risks and threats and reinforced our safety policies and practices with staff. We also standardized emergency codes and alerts and began standardizing physical security and police resources across the system to provide consistency in how we manage building security.

Goal: We seek to provide a safe and healthy environment at each of our facilities.

Effective supply chain management is needed to reduce costs and waste, ensure availability of medical supplies, streamline efficiencies and increase our competitiveness. Severe weather events, product shortages or manmade disasters can delay shipments and potentially interfere with our delivery of safe and quality care.

Procurement Strategy

Texas Health’s supply chain management team is responsible for purchasing superior yet affordable products, equipment and services systemwide. It monitors suppliers’ quality of work, operational practices, and environmental and social impacts to confirm alignment with our standards and compliance with laws and regulations. Our health system takes a multipronged approach to procurement by:

We also help non-acute care providers and other smaller organizations streamline supply chain management and reduce costs through Texas Health Supply Chain Services. THSCS is a for-profit subsidiary that gives companies access to our discounted purchasing contracts, robust materials management information system and operational expertise. This innovative service is helping to financially sustain not only these organizations, but also our own.

We evaluate supplier performance using a quantitative tool based on approximately 30 criteria, including cost, quality, responsiveness and assurance of supply on an annual basis. We also discuss what vendors are doing to reduce their own environmental and social impacts, as well as examine their MWBE practices. If needed, we meet with underperforming suppliers to establish improvement plans. If sufficient progress is not made and we see little change in resolving issues, we may terminate a contract.

Goal: Supply costs are the second-largest expense after labor, making it critical that we conscientiously manage procurement processes to maintain competitiveness, financial viability and operational efficiency. Our 2017 goal was to save $23 million.
2017 Performance

Texas Health saved $24.7 million by reducing the variation of supplies and their use, exceeding our goal.

We also spent approximately $25 million in business to MWBEs, which helped stimulate their business growth.

Also during the year, Gartner named Texas Health one of its top 25 health care supply chains for our efforts to improve human lives at sustainable costs.

Texas Health’s ability to continuously maintain business functions is critical in protecting the health and well-being of its patients, managing business risks, and preserving its reputation and long-term sustainability.

Dedicated System Preparedness

Texas Health has a dedicated System Preparedness and Response team that oversees emergency management, business continuity, safety, physical security and enterprise risk management. We leverage the National Incident Management System national framework and incorporate the Federal Emergency Management Agency’s training resources into our continuity and emergency response planning. This allows us to swiftly respond and quickly recover in case of disaster, delayed shipment of supplies, technology outages or other unforeseeable adverse events.

As one of the few health systems in the nation with a robust emergency management plan, we require each hospital to:

We also participate in regular exercises and drills with area hospitals, emergency responders and other authorities to test our emergency response systems.

As part of our commitment to becoming a high-reliability organization, we designed a patient decontamination standard and policy that outlines the requirements for personnel, equipment and training. We are one of the few health care organizations in the nation to take this type of comprehensive approach to addressing patient decontamination.

Texas Health Security Force Training Academy

In 2018, we will establish the Texas Health Security Force Training Academy, implement an enhanced selection process for security officers, and broaden the role of our security force leaders to include emergency management planning. In addition, our System Preparedness and Response team will expand our capability to deploy to any Texas Health site that is affected by a crisis or business continuity event. They will provide subject matter experts to augment local leadership teams or provide a full incident management team to guide the local response.

Goal: We want to maintain continuity of operations for all critical clinical, financial and operational functions at all times.
2017 Performance

After conducting comprehensive assessments in 2016, Texas Health developed and implemented approximately 400 plans for departments of our wholly owned entities. These plans advance our ability to maintain continuity of operations during adverse events. We also developed four system-level plans to guide preparedness throughout the system in the areas of emergency management, business continuity, preparedness, risk management and physical security.

As part of our commitment to becoming a high-reliability organization, we designed a patient decontamination standard and policy that outlines the requirements for personnel, equipment and training. We are one of the few health care organizations in the nation to take this type of comprehensive approach to addressing patient decontamination.

In response to Hurricane Harvey, Texas Health provided 37 physicians, physician assistants, nurses and medical assistants to care for almost 400 evacuees. We also provided eight incident management staff to support the medical command center located at the largest shelter in Dallas. According to the Texas Hospital Association, nearly 50 Texas hospitals were affected by the hurricane, and incurred about $460 million in operational costs and about $40 million in uncompensated care costs.

Health care phishing, malware and ransomware attacks have reached record-breaking levels in recent years, causing massive disruption and costing the industry millions of dollars to manage.

They also have released the personally identifiable information of millions of patients, making more vulnerable the very people we are working to help.

Protecting Our Network

Texas Health’s comprehensive communications network includes electronic health records, robust Internet and intranet sites, department-specific portals and a web-based emergency notification system. To secure this network, our Cyberthreat and Incident Response Team monitors these systems daily. They also deploy critical tools, strategies and policies to help us repel sustained and targeted cyberattacks, such as:

To provide continuous access to our networks and systems, users can securely access critical systems from any location with Internet access should a power outage or network disruption occur. We also have backup power supplies, data centers and alternative telecommunications channels in place to ensure 24/7 access to information and records.

We evaluate the effectiveness of network security by conducting internal audits as well as contracting with independent specialists. When we discover deficiencies, we develop and implement plans to address them.

To protect medical devices from advanced threats, our information security program monitors new and emerging risks that could potentially impact the care and safety of our patients. We also map how devices communicate so that protection mechanisms can be put in place.

Goal: We want to prevent significant data breaches or outages from occurring anywhere within the system. We also aim to improve our data protection measures and ensure they are well aligned with business strategies, as well as enhance clinical, business and patient access to our systems.
Highlight

Texas Health was named one of the nation’s “Most Wired” health care systems for the 17th time. The survey measures the level of information technology adoption across hospitals and health systems in the U.S.

2017 Performance

No significant data breaches occurred during the year. We completed a multiyear data center transformation project to provide additional offsite backup so that if one system fails, users will automatically be switched to another — with zero downtime or interruption. This helps ensure our most critical systems and information are protected from major natural disasters as well physical security threats.

Additionally, we improved our access to a new clinical network at Southwestern Health Resources and strengthened the security of our patient portal.