A sustainable mission

As Gundersen Health System reaches the zenith of sustainability, Jeffrey E. Thompson, M.D., CEO, explains how attaining this goal — the first health care system to do so — really is about patient health.

Photo by Jim Tritch/Gundersen Medical Media

For Gundersen Health System, La Crosse, Wis., energy efficiency and sustainability nirvana is within sight. Gundersen projects that before the end of the year it will achieve total energy independence, making it the first U.S. health care system to do so, its leaders say.

Gundersen, which includes four hospitals and about 75 medical and specialty clinics serving patients in three states, started a program called Envision that provided a broad strategy to offset its energy consumption through conservation and renewable energy projects, most involving local businesses.

In the wake of continually rising energy costs, Gundersen conducted an energy audit in 2008. That led to the application of fundamental yet critical conservation measures that have reached $2 million in annual energy savings.

From there, Gundersen began to explore and utilize an array of renewable energy sources, including solar, wind power and biofuel to generate electricity it either uses or sells to the local power grid. Designing and building energy-efficient facilities is a third key component of the plan.

The result is an estimated $5.4 million and 446 billion Btu of fossil fuel saved since 2008 through conservation efforts and an estimated $2.1 million and 137 billion Btu generated from renewable power sources.

Jeffrey E. Thompson, M.D., Gundersen CEO since 2001, notes that an investment in smart, talented facilities engineers and staff has made it possible. Their ability to decide what projects would work and to reject proposals that did not make sense were critical to staying on course.

Thompson's role cannot be underestimated. Because the health of Gundersen's patients and the communities it serves was a driving force in the plan, his vision for success never wavered. He discusses this journey to energy independence.

Why did you undertake the journey to reach energy independence?

We asked ourselves, "Why are we here as a health care organization?" The answer was that we are here to improve the health and well-being of patients and our communities and if we're going to do that, we need to stop causing harm.

We asked how we are causing harm and one of the ways is by using fossil fuels. So, we came up with a plan to decrease our impact on the environment with particulate matter, carbon dioxide and lots of other things.

And part of the community's need is that we keep the cost of health care down. So, we said we're going to do this and lower the cost of health care at the same time. The goal was built around defining the purpose of our health care organization.

How did you convince your board of trustees that this mission is worth the financial and labor commitment it required?

The board has to agree that the broad mission of the organization is really what we say it is — about distinguishing ourselves through excellence in patient care and education and improving the health and well-being of the community. Once the board commits to the mission, then getting the financial capital and necessary labor are relatively easy.

To move to a bigger level to say that we are going to commit to a goal of being powered by 100 percent renewable energy that we own so we decrease and protect ourselves from energy costs takes a lot of courage and some risk tolerance on the part of the board.

You have to remember that most health care organizations have some savings. We said we would take a portion of our savings and invest locally in energy production involving the community, which will provide income locally rather than putting our money in treasury notes, stocks or bonds. The board felt this was a reasonable investment in the community and a commitment to our mission.

What else does it take to achieve this level of sustainability?

We have engineers, facilities staff, clinical staff, supply chain staff — many people across the organization — who look at everything we do whether it's how we purchase things, how we use things, how we reuse things, how our supplies are disposed.

This takes talented people with a broad breadth of education and experience. Does that involve an investment? Yes, we've invested in some talented people to help us do this.

I can't say enough about having people trained in the engineering sciences. They have helped us immensely because of their persistence in measuring and having good data so we could defend all of our decisions, and also because of their insight into the feasibility of some ideas.

Was the goal always to reach energy independence or did that become the objective after you started conserving energy?

Early on in the 2000s, we asked ourselves how we could become more thoughtful about our sustainability efforts and how we could possibly make money out of recycling — basic things.

By 2008, we said we would produce as much renewable energy as we use across our system. It was a clear goal at that point to say we were going to get there. We did not have a clear pathway, but that was the goal.

Everything that we tried wasn't a wild success. But we felt that if we stayed on this path, we would be able to figure out a way between conservation and thoughtful design of new facilities we built.

We decided to undertake appropriate energy-generation activities that we would do ourselves or partner with other companies to do. We believed that the combination would result in hitting this goal by generating renewable power.

What are you able to do with the revenue from the energy savings?

It helps to contribute to our effort to keep our fees down. We've had 13 years in a row now where our health care fee increase was less than the year before. This helps us to keep those costs down to the businesses, to the individuals and to the families for their health care.

What are the goals going ahead? Is becoming carbon neutral part of your long-term plan?

I think being carbon neutral is a tremendously high goal if you count broadly. Do we have a plan to work on all of those? Sure, and we believe that our next step is to work upstream with teams of other health care organizations to discuss how medical equipment manufacturers and the pharmaceutical companies can reduce the environmental footprint for disposal.

So, we need to think about reducing waste and there are many, many examples of how things are produced and if you anticipate what happens down the road, you can remarkably reduce waste.

Was climate change a factor in your plans to become energy independent?

We have not used climate change as leverage to do this. I didn't want people focusing on the debates of which news station they watch and get wound around that axle.

That's why we framed it as particulate matter pollution, which causes people with lung disease to breathe hard. We shouldn't allow that to happen. We shouldn't put mercury into the environment. Pharmaceuticals should not go into the water stream. We should not waste food. We stressed these kinds of things. If we can produce energy locally and help the local economy, we should do that.

Now we have our business community, our education community, our staff believing that we can do more than one thing at a time; that we can take care of patients and the community while we save money with our sustainability program.

Any advice for latecomers to sustainability?

I always think of conservation as our first fuel. You can save 20, 25 or even 30 percent on energy costs in a short time with conservation.

And you don't have to do this by yourself. There are opportunities to learn from others such as the Healthier Hospitals Initiative that provide free help to get started.

Jeff Ferenc is senior editor for Health Facilities Management.

The Thompson file

CV
Chief executive officer, chairman of the board, and a practicing pediatric intensivist and neonatologist for Gundersen Health System.

Education
He received his medical training at the University of Wisconsin–Madison Medical School, University of California–Davis and Upstate Medical Center in Syracuse, N.Y.

Accomplishments
• During his tenure, Gundersen was the recipient of Healthgrades America's 50 Best Hospitals designation and the 2014 Distinguished Hospital Award for Clinical Excellence.
• Gundersen's Envision program for environmental stewardship, Respecting Choices program for end-of-life planning and 500 Club program for healthy eating have been recognized nationally.
• In 2013, the White House honored him with a Champions of Change Award.

Background
Thompson has worked full time at Gundersen Health System since 1984. He served as executive vice president from 1995 to 2001 and has served as chief executive officer since 2001. He is board-certified in pediatric critical care, neonatal and perinatal medicine, and pediatrics.