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Kaiser Permanente Case Study. Alternatives Assessment Meeting December 2, 2004 Lynn Garske Environmental Stewardship Manager. Overview. Kaiser Permanente is the nation’s largest nonprofit health plan. 8.2 million members. 431 medical office buildings. 30 medical centers.

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kaiser permanente case study

Kaiser Permanente Case Study

Alternatives Assessment Meeting

December 2, 2004

Lynn Garske

Environmental Stewardship Manager


Kaiser Permanente is the nation’s largest nonprofit health plan

8.2 million members

431 medical office buildings

30 medical centers

  • $25 billion annual revenue
  • 136,500 employees
  • 12,300 physicians
  • 9 states and Wash DC
environmental stewardship at kp
Environmental Stewardship at KP
  • Environmental Stewardship Vision:
    • We aspire to provide health care services in a manner that protects and enhances the environment and health of communities now and for future generations.
  • Focus areas:
    • Green Buildings, Environmentally Responsible Purchasing, Sustainable Operations
why sustainability
Why Sustainability
  • Alignment with corporate mission: improve the health of the communities we serve.
  • Industry practices generate waste, pollution and consume natural resources
  • Recognized link between building design and health outcomes
  • Impact of building materials on indoor air quality and environmental health
  • Planned growth 2004-2013:
    • 25 new hospitals, replacements or significant additions
    • 100 new medical office buildings (MOBs)
alternatives assessments
Alternatives Assessments
  • Medical Products:
    • PVC/DEHP-free products for neonatal units; latex-free and PVC-free exam gloves; mercury-free measurement devices
  • Safer chemicals:
    • Replacing mercury-based fixatives; selecting greener cleaners; recyclable solvents
  • Green Buildings:
    • carpet
    • hard surface/resilient flooring
    • casework
evolution of effort
Evolution of Effort
  • Clinical (with formal protocols) to non-clinical (we invented protocols)
  • Initial work on building materials required consultants; today we’re able to conduct most of the activities internally
  • Key component is objective, independent, transparent verification of vendor claims and test results
framework for assessing building materials
Framework for Assessing Building Materials

Sourcing Mfg Use Post-Use

  • Sourcing (product content)
    • free of PVC; free of PBTs and carcinogens; post consumer; security of supply
  • Sustainable manufacturing
    • waste; energy; water; TRI
  • Use
    • CHPS 1350; Green Seal; our own air sampling
    • performance; aesthetics
  • Post use
    • recyclability; reuse; take back
overview casework project
Overview – Casework Project
  • Project context
  • Results
  • Details – limited LCA – 7 vendors
    • Sourcing
    • Manufacturing
    • Use
    • Post-Use
project context
Project Context
  • Goal:
    • To improve indoor air quality of the built environment by reducing harmful emissions.
  • Scope:
    • Particleboard (PB) and Medium-Density Fiberboard (MDF) that are the foundations of finishings and furnishings.
  • Project:
    • To identify alternative materials to traditional PB and MDF bound with urea formaldehyde binders using LCA criteria.
review team
Review Team
  • Environmental Stewardship – Research, vendor contact
  • Cabinet Shops – Performance testing, expertise
  • Contracting – Pricing and acquisition
  • NFS Green Buildings Liaison
early research results pb mdf

Urea Formaldehyde – traditional

Lignin – not yet viable for desired applications

Phenol Formaldehyde – not subject to Form. Reg. due to low emissions

Polymeric diphenylmethane diisocyanate - pMDI – low exposure limits for raw product, no detectable emissions after curing


Recovered/recycled wood

Forest Certified Wood – recovered/not

Wheat residuals

Rice residuals – local plants don’t mfg. product

Sugarcane bagasse – not in production

Paper – Mfg. out of business

Early Research Results – PB/MDF
Did not undergo LCA

Enviroboard - rice, wrong product – thick board

Weyerhauser – recovered wood, no response

Temple-Inland, FSC – formaldehyde binder

Acadiaboard Duracane, sugarcane bagasse – out of business

CanFibre – AllGreen, recovered wood, unable to contact

DuraGreen, sugarcane bagasse, out of business

Underwent LCA

Sonoco – paper/lignin, out of business

Phenix Bioply – newspaper, pMDI

SierraPine Medite – recovered wood, pMDI

Collins Companies – FSC wood, urea form.

Dow BioProducts Woodstalk – wheat, pMDI

Rodman Industries Resincore – recovered wood, phenol formaldehyde

Sorm, Inc. – wheat, pMDI

life cycle analysis sourcing
Life Cycle Analysis - Sourcing
  • PBT’s, carcinogens – binders, pesticides
  • Rapidly renewable – wheat, rec. wood
  • Security of supply – capacity available
  • Packaging – minimal, strapping
  • Transportation – rail, truck
  • FSC, SCS certified – recovered wood/not
  • Free of added formaldehyde - binder
  • Sustainable agricultural practices - wheat
lca sustainable manufacturing
LCA – Sustainable Manufacturing
  • Waste minimization
  • Water minimization
  • Non-renewable energy minimization
  • Reduced emissions during manufacturing
  • Environmental data:
    • US EPA - Toxics Release Inventory - http://www.epa.gov/triexplorer/
    • Scorecard - http://www.scorecard.org/
    • Environment Canada - http://www.ec.gc.ca/pdb/npri/npri_home_e.cfm
  • Worker injury data
lca use iaq and performance
Indoor Air Quality

California High Performance School (CHPS) 1350 emissions – whole unit testing – http://www.chps.net/

CHPS Carcinogen standards

Green Seal http://www.greenseal.org/recommendations.htm

Building Green Inc. http://www.buildinggreen.com/menus/subtopics.cfm?TopicID=5






Water resistance


Cabinet Shop findings

Wheat PB

Recovered wood MDF


LCA – Use: IAQ and Performance
lca post use
LCA – Post Use
  • Closed loop recyclable
  • Readily down-cycled
  • Supplier facilitates end of life disposition
lca general criteria
LCA – General Criteria
  • Environmental Statement, Mission
  • Facility locations
  • Dimensions
  • Quality assurance
resources fiberboard isocyanates
Green Seal Choose Green Reporthttp://www.greenseal.org/cgrs/CGR_PB&MDF.pdf

ISOCYANATES by Eric LeBretonhttp://www.tc.gc.ca/canutec/en/articles/documents/isocy.htm

Isocyanates - Risk Assessment and Preventive measures, Nordic supervisory authorities, - Copenhagen 2000 http://www.arbeidstilsynet.no/publikasjoner/rapporter/rapport1eng.html

OSHA info - http://www.osha.gov/SLTC/isocyanates/

Preventing Asthma and Death from Diisocyanate Exposure NIOSH ALERT: 1996DHHS (NIOSH) Publication No. 96-111 http://www.cdc.gov/niosh/asthma.html

report on particleboard/mdf http://www.fiberfutures.org/pages/fiberlinks.html

Resources – Fiberboard, Isocyanates
kp decision on casework
KP Decision on Casework
  • Pursuing RFP on 3 most promising products
    • all are free of added formaldehyde
    • 2 wheat-based products
    • 1 post industrial wood product
    • all are less expensive than current product!
  • For contracted casework, develop specs and pursue through our GPO
  • Overall effort considered big win by the KP Green Building Committee