Nursing and climate change: You can make an impact

Lightbulb charge

Earlier this month Tom Thompson, Gundersen Health System’s sustainability coordinator, and Phoebe Breed, RN, Surgical and Digestive Care Unit, presented at the all RN/LPN staff meeting about Gundersen’s nursing and climate change grant.

The goal of the winning grant proposal is to apply some of the same sustainability and environmental practices nurses use at work (through the guidance of Envision) in their homes to broaden the impact Gundersen’s nurses can make on the environment.

Here are suggestions for implementation at home.

  • Unplug older appliances or use a power strip for a more convenient “turn off” option.
  • Turn off the lights when you don’t need them! One light on for eight hours each day can cost up to $20 in one year.
  • Change your light bulbs. You can save $135 in the lifetime of an LED Energy Star certified light bulb compared to incandescent light bulbs.

See how you can make a difference.

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Scheduling exhaust fans – an easy way to save money

Have you ever taken a walk on the rooftop of your hospital or clinic to see what is up there? You might be amazed at the amount of heating, ventilation, and air conditioning equipment that is placed on rooftops. This is often a good place to install mechanical systems since rooftop space is not in high demand. Exhaust fans can range in size and shapes from a very small unit such as those you might find in your home to fans the size of the one in the photo above. Sometimes you may find small exhaust fans mounted to duct work through exterior walls of buildings. Their functional purpose is to exhaust air from inside the building. They are frequently used remove fumes, odors, particles, etc. from inside the building and thus improve the indoor air quality for occupants. In certain applications, such as pharmacies that mix chemotherapy drugs, isolation rooms, labs, etc. exhaust fans may serve an important safety or infection control function. There are many fans that serve restrooms and cafeteria cooking areas.

Exhaust Fan

However, “out of sight” typically means “out of mind” and when energy use is invisible to us we usually don’t manage it very well. When Gundersen Health System began its Envision® program in 2008 we started with an intense energy efficiency effort. One of the steps we took was to inventory our exhaust fans. We found that we had over 300 exhaust fans serving our six largest facilities … approximately 1,500,000 square feet of mixed-use inpatient, outpatient, and medical office buildings. That was a surprising number of fans, but what was even more surprising was that most of these exhaust fans were operating 24 hours per day, 7 days per week even though most were serving areas that were unoccupied for at least 10 or 12 hours each day. If you think about it, nobody leaves their bathroom exhaust fan running when they leave their home for the day. Why should we have these exhaust fans using energy when it is not needed? Energy waste costs money which is passed along to patients, contributes to disease, and harms the environment.

Electronic controls can make automatic scheduling of fans easy so they can be turned off when they are not needed–although they are frequently installed without electronic controls. However, some fans may have electronic controls and others may make sense to retrofit with new controls so they can be scheduled. On one of our buildings, our fan inventory revealed eight fans similar to the one in the photo that could be automatically scheduled and instantly provided an annual energy savings of more than $5,000. This is an easy way to improve health, save money for patients, and improve the environment.

The experts at Gundersen Envision can help you uncover a number of quick payback energy conservation measures in your organization. Contact them today at


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Insulation: An Easy Opportunity to Improve Energy Efficiency

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Pipe insulation 1Pipe insulation 2

This photo was taken with a thermal imaging camera that utilizes infrared technology (thermography) to measure the temperatures of surfaces on subjects in the photograph. The colors in the image enhance the viewer’s ability to distinguish cool and warm areas of the surfaces in the image. The warmest areas are white or yellow and the coolest are deep blue or purple.

The photograph shows two steam lines in a mechanical room serving an outpatient facility with a surgery center and sterilizer. The pipe on the left has an uninsulated check valve and the pipe on the right has insulation covering a similar valve. As you can see from the scale in the photo, the exterior surface of the left side steam pipe is approaching 156 degrees Fahrenheit. This heat is wasted and lost to the interior of the building and must then be cooled by the buildings air conditioning systems which wastes more energy and money for patients. Mechanical rooms are often hot because of pipes, connections, pumps, and valves like these are uninsulated. Sometimes the insulation is skipped as a cost savings measure in a construction project. Other times, maintenance staff may remove insulation to conduct necessary work. If the insulation is difficult to remove or replace, they will often leave it off so that they can conduct their work more easily the next time.

Insulation continues to be one of the best opportunities for improving energy efficiency which will improve health, improve the environment, and save money. Insulation is usually out of sight and out of mind. People are often numb or indifferent to wasteful use of energy and even in the case of heat, which we can feel, we don’t usually question why it is hot inside a space. When we can see energy being used we are much more likely to question why and take action to prevent or remove waste. Insulation will often have paybacks approaching three years. It is a good investment and can be tailored to fit your capital improvement budget. Do what you can when you can.

Recently, new styles of easily removable insulation have been developed to make it easier for maintenance staff to conduct their work without compromising the insulation and its energy benefits. An example of this is shown in the photo on the right. Walk through you facility and mechanical rooms and look for un-insulated pumps, valves, connections, pipes, etc. and pay attention to the temperature in your mechanical rooms…you may have an easy opportunity for improvement.

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Greenhouses: How they work


Greenhouses are prefect for someone wishing to grow plants year around. But how do they work? Greenhouses are usually made of glass or plastic. Why? Because greenhouses use solar radiation to trap heat inside and the glass/plastic allows heat to enter easily into the building structure. This design helps create an artificial environment to sustain plants inside when it is too cold outside. The heat from the sun enters through the roof and warms the plants and soil inside. As the heat around the soil begins to rise it is replaced by surrounding cool air which immediately starts to warm up. This system rapidly warms the greenhouse.

In temperate climates (growing season and a dormant season in which temperatures can get below zero) additional heat sources may be needed, including heat fans. As plants absorb the energy of the sun, they do not emit it quickly but instead retain it, which is another reason why the greenhouse stays so warm. There is a chance of overheating occurring, which is why vents need to be installed near the roof to let lighter/hotter air escape and near the floor where cool air can enter. Greenhouse plants also need plenty of water. To make it easier, drip irrigation systems are commonly used, along with overhead sprinklers.

Greenhouse sizes vary. The larger the greenhouse, the more expensive it will be. Greenhouses can be purchased or built. Building a greenhouse used to be difficult but now there are materials you can buy that are specifically designed for building a greenhouse. Keep in mind that greenhouses are also beneficial to the environment because they reduce fossil fuel use by allowing us to grow local vegetables and fruits during cold months rather than having to import them. If you would like to improve the environment and have plants and vegetables available to you year round, consider investing in a greenhouse!

Learn more at

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The Blue Wrap project


At Gundersen Health System we use blue wrap to wrap surgical instruments and trays prior to sterilization. In the past, once the surgical instruments and trays were in the OR, they were unwrapped prior to surgery and the blue wrap was thrown away. Considering that up to 22,000 pounds of blue wrap was being used each year, there was a lot of waste being produced. One of the fixes to this problem was investing in reusable hard cases for the surgical trays. However, since this was not possible for every surgical instrument, we knew that there must be a way to reuse and recycle the blue wrap.

Blue wrap is not made of cloth, it is actually polypropylene plastic (otherwise known as a # 5 plastic). Number 5 plastics can be recycled into items such as caps for bottles or medicine bottles, however we did not want to recycle all of the blue wrap, we also wanted to reuse what we could. We formed a partnership with the Coulee Region RSVP (Retired Senior and Volunteer Program), which is made up of volunteers age 55 and over. Their volunteers handcrafted the blue wrap into items such as tote bags and aprons (as pictured above), and wheel chair and walker bags that are used in the therapy department. The program started in the summer of 2011 and it is still going strong today. By reusing blue wrap we avoid purchasing items such as tote bags, which has enabled us to save money in departments throughout the health system. The most significant savings have been in the Breast Center where we have saved approximately $4,000/ year. This money can be redirected back into patient education materials. How does the blue wrap project relate to sustainability? By reusing and recycling the blue wrap, materials are kept out of the waste stream. In addition, we developed a long-lasting partnership with a wonderful volunteer program.

We can help you create sustainability projects at your organization. Find out how.

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Aviation planning, lights, ensure aircraft safety near wind turbines

Corey Zarecki FAA Light

The photo on the left shows Corey Zarecki (Director – GL Envision Engineering and Operations) on top of the north tower nacelle on Gundersen Health System’s Cashton, WI, wind project.  He is standing next to the Federal Aviation Administration (FAA) light which is also shown in the right photo.  Since wind turbines are tall structures it is necessary to notify the FAA when planning a project.

As part of the permitting process for a wind turbine project, the FAA will conduct an aeronautical study to determine whether or not the turbine will present an obstruction hazard to aircraft navigation.  If the location is determined not to constitute a hazard it is still required to have the turbine properly marked and lighted to enhance visibility for pilots and reduce the likelihood of a safety incident.

For sites with multiple turbines, the FAA lights are synchronized for all turbines so the entire project blinks at the same time.  This makes the multiple turbine site less distracting to pilots and you may notice the synchronized FAA lights if you drive past or fly over a wind farm at night.  During construction and prior to power being provided to the turbine, FAA lights can be powered from an on-site generator, solar or by battery.


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Do you purchase bottled water? Buy a water bottle instead


Do you drink bottled water on a daily/weekly basis? If so, is it because you have to, or is it your personal choice? If it is a personal choice, perhaps it is time for you to choose a different alternative. Bottled water is convenient and for the most part it is easy to find. However bottled water has many negative effects on the environment. Did you know that although most bottled water claims to be from fresh spring waters, about 25-40% of it comes from municipal sources (tap water)? Bottled water also produces around 1.5 million tons plastic each year which is close to 50 million gallons of oil needed to produce the plastic. Although plastic bottles can be recycled, over 80% are thrown away. This is bad for the environment because plastic takes a long time to decompose in the landfill.

What is a good alternative to bottled water? Buying reusable water bottles made of either glass, metal or even plastic. The plastic for reusable water bottles is different than the one time use bottled water because it is durable (lasts longer), dishwasher safe, and in many cases it is BPA free. Reusable water bottles are also a one-time payment, whereas bottled water has a price for every bottle purchased. But what if you don’t like the taste of the tap water at your house, or even at work? Consider getting a water filter that can be attached to your sink or one that can be stored in your fridge. This will clean the water of any impurities and in most cases improve the taste. Or try adding in natural flavors to your water such as basil, lemon, lime, or various other fruits, which will not only add a new flavor to your water but will also provide you with important nutrients for a healthy body. Bottled water may be convenient, but if we want to make a positive difference on health, costs, and the environment, it is time to discard bottled water, and turn to something that is reusable!

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Gundersen Health System and the Farm2School Program


Gundersen Health System is an active member of the Farm2School Program. What is this program? The Farm2School program helps to build and establish partnerships between K-5th grade schools and local farmers to encourage healthy eating and proper nutrition among students and their families. This program is unique to each state and it can be found in all states. La Crosse County participates in the Farm2School program and Gundersen’s Certified Executive Chef (C.E.C) Thomas Sacksteder supports this program by visiting local schools during the school year to educate students on healthy eating and recipes. This program also includes a “Harvest of the Month” in which one local food is selected and promoted throughout schools. Chef Thomas uses the “Harvest of the Month” in the recipes he showcases to students. Chef Thomas has received many awards because of the success with the Farm2School program.

Chef Thomas also received two grants from the American Culinary Federation (ACF) “Chefs Move to Schools” program. This program enables chefs and schools to form a partnership to encourage healthy eating and proper nutrition for students. This program was started by First Lady Michelle Obama and White House Senior Policy Advisor for Healthy Food Initiatives, Sam Kass, in May, 2010. These grants have supported a project created by Chef Thomas called the “Chef Thomas Bean Challenge.” Students are given packets of beans at the start of the summer and are encouraged to plant them. In 2013 his challenge reached 5,500 students.

How does the Farm2School program relate to sustainability? The Farm2School program educates students about eating healthy local food. Showcasing local foods supports local farmers and the environment. How does this help the environment? Food purchased by local farmers does not have to travel as far, which saves fuel and energy which in turn is better for the environment. Buying local also supports the local economy and provides people with fresher food. If you are part of an institution or an individual interested in partaking in this program check out the helpful links below!

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Tips on Food Waste Reduction

food 1food 2

Food is the number 1 material sent to the landfill. Because of this, education on food waste reduction is essential. What can you as an individual do in order to reduce food? Here are some tips on food waste reduction:

  • Learn to properly cut fruits and vegetables to reduce scrap waste.
  • Plan meals for the week and write a grocery list of things you will need (this will help to avoid buying food on impulse).
  • Check expiration dates and use food before it expires.
  • Check your fridge temperature to ensure your food will stay fresh. The preferred temperature is between 35 and 38 degrees F (1.7 to 3.3 degrees C).
  • Clean your fridge regularly.
  • Use fruits that are going soft by making them into smoothies or pies, likewise with vegetables (make soup).
  • Use leftovers for a different meal the next day—don’t throw them away.
  • Rotate food in your cupboard (new to the back and old to the front) to properly ensure that everything is used in a timely manner.
  • Buy individual/loose fruits and vegetables instead of packaged to ensure that you are not buying more than you will eat.
  • Properly freeze food like bread to use it at a later date.
  • Start a compost pile in your backyard made up of food scraps, or try starting a neighborhood composting pile that is accessible to everyone.
  • Set goals for yourself and your family/friends—challenge yourself to reduce food waste.
  • Donate food that is still good but you know you will not use.

Not only can individuals make a difference, large organizations like hospitals can also reduce food waste. This could include conducting a food waste audit or finding the most cost efficient route for transporting and collecting food.

According to the EPA, 13% of greenhouse gases in the US are associated with growing, manufacturing, and transporting food. Even fat, oil, and grease can be turned into raw material such as soap and bio diesel. Make the landfill a last resort as pictured in the diagram above.

At Gundersen Health System, we aimed to reduce the amount of food sent in the waste stream in 2010. By measuring the amount of leftover food, we decreased food waste by 550 pounds in 7 weeks, which averaged about a 50% improvement! We also donate leftover food to the Salvation Army.

If you would like to reduce food waste, follow these tips and check out our video on properly trimming fruits and vegetables featuring Gundersen Health System Chef, Thomas Sacksteder, Certified Executive Chef (C.E.C), to learn how!

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Search for renewable energy sources close to home


This photo shows wood chips from a saw mill in western Wisconsin that Gundersen uses as a fuel in its new biomass boiler. The biomass boiler project supplies 38 percent of the health system’s energy needs with a renewable source of energy. When you look for renewable energy sources it makes sense to search for the assets that are abundant in your region. The Upper Midwest region of the U.S. does not have oceans from which to capture tidal energy nor does it have an abundance of sunlight nor does it have geothermal steam near the surface of the earth’s crust. However, Wisconsin and neighboring states are blessed with numerous sources of biomass such as trees, grasses, animal waste, and agricultural crops.

New technologies have developed that enable cleaner combustion of biomass fuels as an alternative to fossil fuels. These fuel sources can become a significant source of renewable heat and electricity production in the United States which could allow our country to become more energy independent and reduce the negative effects of mining and burning fossil fuels.

Often, biomass fuels are commonly thought of as waste products or residues from other primary operations and can commonly be purchased at relatively low cost compared to other fuels.  For instance, this particular sawmill processes hardwood logs from western Wisconsin such as red oak, white oak, walnut, hickory, etc. The milling machinery is very efficient at producing boards of lumber from the rough logs and various byproducts such as chips, fines, sawdust, and ground bark can be recovered and utilized in a clean and productive manner. In the past, byproducts such as these may have been sold into a lower value application such as animal bedding or landscaping material. In some cases, producers may have had to pay to have the byproduct removed. Utilizing these sources of fuel can improve the economics for both the producer of the biomass fuel and for the purchaser.

Some fuels classified as biomass may present challenges to boiler equipment and/or require expensive emissions control systems. It is important to consider the sources to make sure they are free of chemicals and treatments such as glues, paints, heavy metals, varnishes, etc. to avoid challenges and expense in minimizing emissions and optimizing boiler performance. Some natural sources of biomass may also contain high levels of sulfur or alkalinity, which may present other challenges, so a thorough review of the source is necessary before launching a project.

Standards and programs have also been developed in recent years to promote ethical harvesting techniques used for biomass fuels. One example is Wisconsin’s Woody Biomass Harvesting Guidelines.

A couple of  great resources for understanding the best fit for your application and gaining help for a project are the U.S. Forest Service’s Wood Energy Resource Center. 

And the U.S.D.A.’s  Biomass Crop Assistance Program.

Learn more about renewable energy by attending Envision’s Renewable Energy Project Development seminar, September 23-25. Register today!

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