Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire. Photo: Ken Gallager, Wikimedia Commons.

George Harvey

The sustainability program at Dartmouth Hitchcock Medical Center (DHMC) in Lebanon, NH goes back to 1996, when the staff started taking a hard look at waste management. Waste is a particularly difficult problem for medical facilities, because a lot is produced, and it is very important that disposing of waste does not spread diseases. For environmental reasons, the decision was made at that time not to incinerate waste, which produces air pollution, but to sterilize it in an autoclave, despite the fact that it is more expensive.

Encouraged that things could be improved, people at DHMC identified ways to reduce environmental footprints. They looked at electric power, heat, waste, transportation, food, land use, and more. The hospital went from using number six fuel oil to natural gas, switched to more environmentally-friendly cleaning products, and increased the use of fresh, local, organic food. DHMC started getting recognition from organizations like Practice Greenhealth. It received LEED silver certification.

In 2015, the board of trustees adopted a set of sustainability goals for 2020. Some of these were intentionally demanding, but worthy, “stretch goals.” Zac Conaway, DHMC’s Manager of Waste, Recycling and Training, and Chair of DHMC’s Environmental Sustainability Council, said, “A lot of that looked at GHG (greenhouse gas) emissions.” But even “purchasing medical furnishings to be environmentally sustainable” was on the long list of things under scrutiny.

Among the goals was installation of solar photovoltaics. Work on this came quickly when Norwich Solar Technologies installed a 134-kilowatt solar array, offsetting a 10% share of DHMC’s electric use.

DHMC has not stopped pushing to improve its efficiency and its environment. Installation of setbacks for HVAC in operating rooms and offices saved about $75,000 per year. The medical center has been turning to heat pumps and is looking to end the use of fossil fuels. The Jack Byrne Center for Palliative and Hospice Care has new geothermal heat pumps, which heat both for the building and hot water. Propane is still in use, but only for backup. Conaway explained, “All new construction buildings are to have heating that comes from sources other than fossil fuels.”

Among the most interesting projects that DHMC undertook was how to deal with food waste. They composted 162 tons of food scraps and food-related waste in 2018. Three vendors supply food in four eating areas, and they are trying to compost everything feasible. The plastic clamshell containers that used to be used to present some cafeteria food have been replaced by bio-degradable packaging. The compostable waste is sent to the Lebanon Solid Waste Facility, where it is composted in a traditional windrow system. The compost is used as fertilizer in parks and recreation areas.

DHMC is looking at growing its own produce, as well. A quarter acre is presently being used for a vegetable garden, though there are hopes that this might be increased to as much as two acres. Work to raise the food is provided by volunteers, largely through Willing Hands, a local non-profit group that focuses on getting food from local farms to people who need food assistance.

The work of providing for sustainability at medical facilities has turned to political action in many places, and DHMC is not exceptional in this way. In addition to having its own sustainability staff, DHMC has a government relations staff who represents the needs of the medical center in Concord, NH and Washington, DC. It is working with the Regional Greenhouse Gas Initiative and pushing for a cleaner environment, Conaway said.

Many of the stretch goals for 2020 will be achieved; some have been already. This year, the trustees are considering how to continue the process. They are starting work on a new ten-year program, with goals for the next decade, 2020 to 2030.

One thing DHMC is doing will surely get more attention from G.E.T. in the future. The medical center is working on its environment through sustainable landscaping. Rain gardens and living roofs are among the things that are of special interest. Its cattails and pond are especially appealing, and our hope is to do an article on landscaping at DHMC in an upcoming issue.