1. Health and Climate
Jeff Thompson, MD

2. About us… Integrated Delivery System 7,600 Total Employees
795 providers employed
61 clinics / 6 hospitals
Western Campus of the University of Wisconsin Medical School
Residency, Fellowship and Medical Education Programs

3. National Recognition System-Wide Recognition
Healthgrades Distinguished Hospital Award-Clinical Excellence™ 9 years in a row ( )
Places Gundersen Health System among the top 5% of hospitals in the nation
Healthgrades America's 50 Best Hospitals™ (2016)
Places Gundersen Health System among the top 1 % of hospitals nationwide – for the third consecutive year
Healthgrades Outstanding Patient Experience Award™ (2016)
Places Gundersen Health System among the top 5 % of hospitals in the nation
Advisory Board National ‘Excellence in Engagement’ award
Top 25% of healthcare organization
Top 100 Hospitals Five Year Performance Improvement Leader – Thomson Reuters
Top 100 Hospital – Thomson Reuters
Top 100 Integrated Healthcare Network – Verispan
National Research Corporation 2012 Path to Excellence Award for Top Performing Organization for Rate a Doctor
Service-Line Recognition
Healthgrades 2016 Excellence Awards™ for Critical Care, General Surgery, Coronary Intervention, Gastrointestinal Care & Pulmonary Care
Places Gundersen Health System in the top 5% for overall pulmonary services
National Heart Care Specialty Center designation by BCBS
Norma J. Vinger Center for Breast Care – First Breast Center of Excellence by the National Quality Measures for Breast CentersTM Program.
Bariatric Center of Excellence Designation by American Society for Bariatric Surgery
Healthgrades 5-star ratings in 19 categories
2009 Dartmouth/IHI/Brookings – Best value of 309 Medicare regions
2009 Commonwealth Fund Top Integrated Systems
2010 Delta Group – Ranked # 1 in 3 clinical categories (overall hospital care, overall surgical care, and major cardiac surgery) of 118 academic centers
Healthgrades rankings among the top 5 percent in the nation in eight specialties and among the top 10 percent in the nation in another two.
Healthgrades Joint Replacement Excellence Award
2 years in a row placing Gundersen Lutheran in the top 10% nationally

4. environmental stewardship
Be the best regionally
and nationally on
environmental stewardship
and sustainability

5. Why Healthcare Providers Should Care
Healthcare Vertical Market
Environment of Care
Why Healthcare Providers Should Care
Pollutants from fossil fuels and disposed waste cause:
Cancer, liver disease, kidney disease, reproductive issues
Cardiovascular deaths and stroke1, respiratory disease
According to the U.S. Department of Energy, hospitals are 2.5 times more energy intensive than other commercial buildings2
Pharmaceuticals and equipment have even bigger carbon footprint
Energy costs will eventually escalate
Reducing waste results in an improved bottom line
Population Health
Experience of Care
Per Capita Cost
Sustainability
1Source: American Heart Association Scientific Statement: DALLAS, May 10, 2010
2Source:
Presented as part of CSTOP 201

6. We are the problem…but we can change
Emissions(1,2,3,4)(lbs.)
2008
Sulfur Oxides(1)
230,144
Nitrogen Oxides(1)
194,911
Carbon Dioxide(3)
72,386,372
Mercury(1)
2.10
Particulates(1)
435,291
2008…
Electrical power from coal from Wyoming
Heat from natural gas from Texas
Sources:
1US EPA AP-42
3U.S. EPA eGRID 9th edition Version 1.0 Year 2010 GHG Annual Output Emission Rates:

7. Our Journey The why: Decrease pollution Decrease operating costs
Improve our local economy
Strong corporate citizen and a servant organization

8. Why would a board allow this plan?
Consistent with mission
Best use of portion of savings
Good ROI (7.7 years)
Safer than stock or bond market
Local investment
Timing
Early successes

9. Notable Sustainability Accomplishments
Recycling rate above 40%
Reduced cafeteria food waste by 80%
Keeps approximately 18 tons of food from going to landfill each year
Donation program for leftover food totaling more than 6,000 meals in 2014
Reduced hazardous waste by 83%

10. Hazardous Pharmaceutical Waste Reduction
Disposal cost down 93% ($140,000)

11. Conservation

12. Energy Conservation Energy Conservation should be our first fuel
$2M Investment , $1.3M Savings/Year

13. GHS Energy Efficiency Aggregated Facilities EUI - Utility Purchased Energy (kBtu per square foot per year)
53% improvement since 2008

14. 1st U.S. Health System Heated, Powered & Cooled by Local Renewable Energy

15. Where is the Financial Payoff
Financial Successes
Conservation
+/- Wind Farms
Landfill Biogas
Biomass Boiler
Geothermal Field
Dairy Biogas
Solar Hot Water (dialysis)
Education / Opportunity
Solar Hot Water Project (Daycare)
Brewery Biogas
Solar PV Panels (improving)

16. 2014: Ceased Fossil Fuel Investment
Organizational Investment Portfolio
Return
Cash
T-Bills
Bonds
Stocks
5.8%
Energy Infrastructure Investment
5% of total
10 – 12%
2014: Ceased Fossil Fuel Investment

17. Why Is Biogas / Biomass Good for WI?
Improves air quality vs. the current mix of grid production fuels
Reduces negative health impacts for our communities
Wisconsin currently imports ~$15B* of fossil fuels annually
Significant job potential for the local economy if we use “homegrown” power sources
Plentiful low value, renewable, local resources that can be utilized
Landfill gas, breweries, cheese whey, municipal WWTPs, livestock manure, food waste, forestry residues, crop residues, etc.
Digesters can divert landfill loads
Organic wastes can be processed in digesters
Improved manure management helps our dairy industry viability
Improved water quality helps our state’s tourism industry
Wisconsin has many simultaneous heating and power loads
Biomass and Biogas projects are great for combined heat and power opportunities
High capacity, base load production vs. other intermittent renewables
Generation blends with current agricultural landscape
Improved rural grid voltage through distributed generation
*Source: Wisconsin State Energy Office

19. We are the problem…but we can change
Emissions(1,2,3,4)(lbs.)
2008
2015
% Reduction
Sulfur Oxides(1)
230,144
23,445
(90%)
Nitrogen Oxides(1)
194,911
21,570
(89%)
Carbon Dioxide(3)
72,386,372
6,175,307
(91%)
Mercury(1)
2.10
0.29
(86%)
Particulates(1)
435,291
40,504
2008…
Electrical power from coal from Wyoming
Heat from natural gas from Texas
2015…
90% regional sources
Sources:
1US EPA AP-42
2Practice Greenhealth’s Energy Impact Calculator:
3U.S. EPA eGRID 9th edition Version 1.0 Year 2010 GHG Annual Output Emission Rates:

20. COP21 Paris December 2015
Power of the Pope, the President, the People Clarity of whose to blame, who gets hurt. Big Tech, Big Pharma, tiny NGOs, tiny original peoples Who doesn't get it...the final two....

21. COP21 Paris December 2015
Most outlandish demand....pay oil states to leave oil in ground. Most disappointing of the doables....Health deletions. Best quote... Saudi Prince "the Stone Age did not end because of a lack of stones.”

22. We did not set out to be the greenest health system or stop climate change. We set out to make the air better for our patients to breathe, control our rising energy costs and help our local economy.

23. What will you say to the next generation?

24. Jeff Thompson, MD Executive Advisor, CEO Emeritus