Texas Health Environment of Care
Community Responsibility & Sustainability Report

Our Environment

Physical Environment

Texas Health’s physical environment encompasses campuses and facilities, hospitals, clinics, corporate and administrative offices, and surgical, health and imaging centers. We monitor these facilities to detect and address potential issues so that we can maintain compliance with stringent health and environmental protection standards.

To help keep facilities secure, multidisciplinary threat management teams assess and identify potential issues related to building security or workplace violence. Based on their findings, we implement security controls and train employees to reduce potential risks.

Texas Health uses industry leading tools and guidance to reduce environmental impacts, and makes investments in these critical areas:

  • Energy Use

    The health care industry is inherently energy-intensive due to the continuous operation of hospitals and other standalone facilities. To reduce both costs and related impacts, Texas Health:

    • Invests millions annually in efficiency projects.
    • Designs new buildings and retrofits others to be more efficient.
    • Operates efficient HVAC systems and equipment.
    • Purchases renewable energy.

    In 2016, Texas Health continued adding buildings to its portfolio, which impacts annual energy and water consumption. We spent about $5.5 million in building system upgrades and embarked on 44 efficiency projects to reduce consumption. Overall, electricity and natural gas consumption decreased 5.3 percent, just shy of our 6 percent goal.

    We plan to install new software to regulate how much energy, water and natural gas we supply to all facilities in 2017. We also will continue investing in more efficient equipment and strategies to improve efficiency systemwide.



  • Water

    Texas faces the ongoing risk of drought and water rates continue to rise, which is why we use water wisely to preserve this natural resource. Each year, we invest in making our buildings, cooling towers and landscapes water efficient and even co-own a laundry cooperative to reduce water use.

    For example, Texas Health Harris Methodist Hospital Forth Worth saved 13 million gallons of water over eight months alone by making a large cooling tower more efficient.

    In 2016, water use increased 5.46 percent due to the addition of several buildings to our system footprint. In the coming year, we plan to establish a water conservation program and complete a water system audit to reduce water use and consolidate metering.

Waste Management

Hospitals produce more than 5.9 million tons of medical, office and electronic waste annually1, which often ends up in landfills or is incinerated where legally allowed. Texas Health reduces or recycles waste to comply with regulations, protect the environment and reduce costs. Our stringent waste management policies, protocols and training enable us to handle waste responsibly.

Texas Health contracts with a national waste disposal company that provides waste-handling training, and removes hazardous chemicals, pharmaceuticals and waste directly from our facilities. We also:

  • Recycle office waste, such as paper, boxes, plastic, aluminum, packaging and steel. We also host community shredding events.
  • Distribute older furniture and medical equipment to smaller clinics in need rather than disposing them into a landfill.
  • Recycle computer components, medical equipment, telephones, printers, servers and other electronics.
  • Reduce linen weight to reduce laundry water and energy use and associated costs.

In 2016, we drafted a systemwide policy to provide a single process for handling, storing, documenting and disposing various waste streams. We also implemented a systemwide pharmaceutical waste program that formalizes collection processes and helps to ensure content and containers are properly disposed. Finally, each hospital completed a pollution-reduction plan as required by the state of Texas’ Waste Reduction Policy Act.


2016 Health Facilities Management Sustainable Operations Survey
  • Air Quality

    As a large health care system, we understand the impact our operations can have on emissions that can aggravate health conditions linked to poor air quality. We implement regulated controls, monitor emissions and ship medical waste off-site for incineration. In 2016, we continued to comply with all local, state and federal air quality regulations.

Supply Chain Management

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. Additionally, our supply chain staff identifies ways to increase efficiencies and reduce costs, find backup sources should they be needed, and mitigate natural or manmade risks to our supply chain.


  • Supply Chain Strategies

    Our health system takes a multipronged approach to procurement by:

    • Leveraging our buying power to source quality products at a lower price.
    • Testing quality prior to purchasing to see that our quality, safety and satisfaction standards are met.
    • Standardizing the products and services we use to deliver quality care more consistently and cost-effectively.
    • Purchasing locally (when practical and cost-efficient) to stimulate regional economic growth and from minority and women-owned enterprises (MWBEs) to help develop these businesses.
    • Buying healthier and environmentally friendly products and services when feasible.
    • Distributing, storing and disposing materials responsibly.
    • Requiring ethical and lawful business practices of our business partners.

    A key way we help non-acute care providers and other smaller organizations streamline supply chain management and reduce costs is 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.

  • Performance Management

    Texas Health evaluates 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.

  • Cost Containment

    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. We do this while also selecting the highest quality materials and services to deliver outstanding patient care.

    Texas Health proactively assesses material use and waste 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.

    In 2016, Texas Health saved $30.2 million by reducing variation of supplies and their use, exceeding our $28 million goal. We hope to save another $30 million in 2017. We also awarded $29.5 million of business to MWBEs, which helped stimulate their growth.

Business Continuity

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. We designed our business continuity plans to minimize the impacts of unexpected events and execute a quick recovery in case of a natural or manmade disaster, delayed shipment of supplies, technology outages or other unforeseeable factors.

  • Emergency Management

    Preparing for continued operation during a disaster is a key responsibility to our community. Texas Health participates in functional exercises with local partners and conducts internal drills, as well as communication exercises with area hospitals, emergency responders and other authorities to test our emergency response systems. We leverage the robust National Incident Management System, which includes the Hospital Incident Command System to maximize patient and staff safety when activated.

    Additionally, each Texas Health hospital:

    • Completes a hazard vulnerability analysis annually to proactively identify issues.
    • Reviews and tests its emergency operations plan, roles and responsibilities as well as conducts ongoing risk surveillance and reporting.
    • Trains select staff on emergency response and communications, and how to maintain compliance.
    • Assesses lessons learned to improve surge capacity, fire response, communication, decontamination, patient tracking, evacuation and business continuity processes.

    In 2016, Texas Health significantly enhanced how it maintains continuity of operations for all critical clinical, financial and operational functions within each entity. We achieved this by conducting 21 days of intensive assessments and interviewing 459 leaders throughout the system.

    We also formed a System Preparedness and Response team comprising professionals in emergency management, business continuity, safety, physical security and risk management. During the year, the team:

    • Collaborated with Texas Health entities and external agencies to make the system and North Texas communities more resilient to disasters and crisis events.
    • Completed internal risk assessments to align planning and training activities.
    • Replaced decontamination equipment within all Texas Health hospitals to help protect patient and employee safety.
    • Conducted campus security assessments, trained employees on safe behavior and adopted new strategies to increase fire safety and building evacuation awareness systemwide.

    In 2017, we will continue embedding systematic approaches to be robust, reliable and resilient and to move the bar higher on our preparedness.

Information Protection

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. We must protect and preserve information exchanged through these channels to operate legally and responsibly while simultaneously allowing employees to distribute the health and operational data they need to effectively perform their jobs.

To combat the growing number of computer-based threats and other vulnerabilities, we:

  • Deploy proven technologies, monitor all alerts, and address all possible breaches and threats in a coordinated and responsible manner.
  • Install firewalls, intrusion detection tools, email monitoring and filtering capabilities.
  • Encrypt health information and credit card data, and automate security patches.
  • Limit access to information based on employees’ roles.
  • Collaborate with industry peers and the U.S. Food & Drug Administration to help ensure medical devices are protected from advanced threats.

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.

In 2016, no significant data breaches occurred. Texas Health spent the year:

  • Strengthening security controls on medical devices and database infrastructure.
  • Enhancing anti-phishing protections and conducting penetration tests to verify that security controls could repel sustained and targeted cyberattacks.
  • Improving incident response capabilities by creating a Cyberthreat and Incident Response Team that monitors daily cyberthreats and incidents.

In 2017, Texas Health will improve access to information within the newly established clinical network at Southwestern Health Resources. We also plan to develop and optimize security strategies for consumers, Internet of Things and future data protection.

  • Backup and Recovery

    Texas Health’s innovative disaster recovery program strives to support the delivery of highly reliable access to data. In the event a facility’s direct network connection is not available, users can securely access critical systems from any location with Internet access. We also have backup power supplies, data centers and alternative telecommunications channels in place.

    In 2017, we will complete our 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.