Cambridge Memorial Hospital Achieves Environmental First

Sound environmental management practices have earned Cambridge Memorial Hospital (CMH) the title of North American’s first ISO 14001 certified hospital. This level of certification by the International Organization for Standardization (ISO) recognized CMH as the North American leader in the areas of environmental awareness, waste reduction and sustainability programs within the context of a hospital setting.

An environmental management system (EMS) is a structured five-step common sense approach to management that enables a facility to manage its environmental impacts, responsibilities and risks. Hospitals, by their very nature, are massive consumers of resources including water, electricity and fossil fuels. The potential for negative environmental impact from a facility of this type is considerable and CMH, a 277-bed community hospital located in Cambridge (Ontario), was no exception. But convinced that her hospital must set a local example of judicious environmental stewardship, CEO Helen Wright set out with her team to “be an excellent community hospital that contributes to making our community as healthy as possible. If we were to be credible, we had to not only talk environmental responsibility but also demonstrate our commitment.”

The first step towards their goal began in 1998 with the creation of a policy that outlined the environmental intentions of the hospital and addressed their commitment to continual improvement and the prevention of pollution.

Step two, the planning stage, involved auditing all hospital operations and activities in order to determine if/where any negative impacts upon the environment were occurring. The inventory of negative impacts was then ranked in order of significance and reviewed in light of regulatory and legislative compliance. From here, environmental objectives & targets were developed and an environmental action plan for the year was crafted.

The implementational & operational stage followed with all identified programs, objectives and targets being implemented. Training needs were identified plus internal and external communications procedures established. EMS procedures were also documented and procedures for operations with environmental impacts were reviewed together with a complete examination of emergency preparedness and response systems.

The monitoring and reviewing of all established programs and procedures occurred next in stage four – checking and corrective action. Those responsible for the EMS were charged with tracking and record keeping on the environmental performance of the objectives and targets including the identification and remediation of deviations from established procedures. Audits were also conducted to identify any discrepancies in the process.

Management review formed the last and most critical step in the process. It was here that senior management reviewed all policies, procedures and progress of the environmental programs and provided approvals and input for further environmental performance.

Throughout the entire process, as simplified above, it was incumbent upon CMH, as a participant in the ISO 14001 standard, to be continually striving to improve its environmental performance.

Why go to these lengths to put your environmental house in order? According to CEO Wright, the answer is simple. “It’s the right thing to do for so many reasons.”

Operational: From an operational perspective, proper segregation of hazardous and general waste via an efficient recycling program can divert thousands of tonnes of waste from landfill sites and significantly reduce tipping and disposal fees.

In 1999, for example, CMH enjoyed the following successes as a result of its Environmental Management System Action Plan:

  • 27.5 tonnes of white paper diverted from disposal;
  • 40% increase in recycling materials collected as a result of the introduction of 22 recycling container stations throughout the Hospital;
  • 21% reduction in the volume of biomedical waste generated;
  • 50 staff trained in mercury spill response and emergency procedures for internal chemical spills;
  • commitment to become a mercury-free hospital through its involvement in the Health Care Without Harm Mercury Free Medicine Campaign.

Continued improvements throughout 2000 brought forth even more accomplishments with the diversion of approximately 60 additional tonnes of mixed paper, and 40 tonnes of corrugated cardboard, from disposal. These and other recyclables such as cans, bottles, plastics, etc., added to the success of the recycling programme with an increase of roughly 284% in recyclables collected over 1999 levels. There was a 20% reduction in the amount of biomedical waste generated in comparison to 1998 data. In addition, CMH now boasts 230 staff trained in EMS awareness, 75 staff trained in environmental awareness, 13 staff trained in mercury spill response and emergency procedures and 222 staff trained in environmental initiatives during orientation.

Environmental impact has also been reduced by participation in the following programmes:

  • Intravenous Bag Recycling Program: 3.9 tonnes of polyvinyl chloride (PVC) and 1.5 tonnes of high density polyethylene (HDPE) diverted since 1996.
  • Stewardship Initiatives: suppliers of office products take back corrugated containers used in the shipment of office products and suppliers of printer toner cartridges engage in a spent cartridge take-back program.
  • Nickel-Cadmium (Ni-Cd) Battery Recycling: Since June 1999, CMH has had a program to recycle Ni-Cd batteries collected from medical instruments, medical devices and maintenance equipment. The batteries were recycled through Charge Up to Recycle, a voluntary industry funded Ni-Cd rechargeable battery recycling program.
  • Fluorescent Lamp Recycling: Since the end of 1999, CMH has diverted 20-40 fluorescent lamps per month from landfill, and has diverted 644 lamps to date.
  • Minimized the use of Disposables in Operating Room: Operating staff responsible for material requisition have minimized the use of disposables such as table covers and drapes required in surgical procedures. These disposable products have been replaced by reusable gore materials.

Economic: Waste generated by CMH has been reduced by approximately 28% in total volume between 1993 and 1999 bringing with it savings in avoided waste disposal fees. The biomedical waste reduction project, for example, implemented in 1999 achieved a $5000 saving and the shutdown of the on-site biomedical waste incinerator in May of 1998 achieved a 5% reduction in energy usage.

Corporate: From a corporate standpoint, developing an EMS is an effective and prudent way for directors and corporate officers to perform ‘due diligence’ as they carry out the responsibilities of their office. According to Wright, “this is one concrete step that any hospital can take to fulfill a mission such as ours.”

Community: Environmental programs such as those just mentioned, initiated by CMH’s ‘Green Team’ have not only precipitated more environmentally conscious staff but have assisted in improving the hospital’s image within the community. New goals continue to be set as Green Team members work with facility staff to develop action plans and improved training opportunities. Team members also participate in planning and prioritizing new environmental initiatives and orchestrate special environmental days such as Healthy Living, Green Transportation and Garbage Free Lunch while encouraging the hospital and its community to embrace positive environmental change.

“Most importantly, it’s the right thing to do for our community and its citizens, ” says Wright. “As recognition grows that environmental factors are exerting an increasing influence on the health of our citizens – air pollution causing an increase in the incidence of asthma, pesticide use linked to cancer, or mercury contamination to adverse mental health effects.”

For details on ISO 14001 certification, contact the Standards Council of Canada ( or the International Organization for Standardization (

For further information on how you can contribute to a cleaner, healthier and more energy efficient planet, call 1-800-363-9056 (ext. 36) or check out the ‘Energy Partnership” link at the Canadian College of Health Service Executives’ web site or contact Mary-Jane Hanley, Environmental Specialist, 1-519-621-2333 ext. 1720