Texan by Nature is excited to recognize Texas Health Resources as a 2023 TxN 20 honoree for their leadership in conservation and sustainability. Texas Health Resources’ commitment to conservation, their projects, programs, best practices, and lessons learned are an example and inspiration for us all.

Honoree Industry and Size: Healthcare – Enterprise

Company Overview
Texas Health Resources (Texas Health) is one of the largest faith-based nonprofit health systems in the U.S. and the largest in North Texas in terms of patients served (2 million annually). Texas Health is headquartered in Arlington, Texas, and has a team of 25,000 employees in 16 counties across 30 hospital locations that serve as acute care, short stay, rehabilitation and transitional care facilities that are owned, operated, or a joint-venture with Texas Health. The system also has 395 community access points through physician offices, behavioral health facilities, and surgery, imaging, urgent care, and fitness centers. The Texas Health mission is to improve the health of people in the communities it serves and aims to operate sustainably through operational effectiveness, innovative care, and a high-performing culture.

What is Texas Health Resources’ conservation and sustainability mission and why is it important to your culture?
The Mission of Texas Health Resources is to improve the health of the people in the communities we serve and optimizing our environment of care is one way in which we accomplish that mission. Conservation of resources is vital to Texas Health’s long-term sustainability and to the well-being of the people living in the communities we serve. We always strive to be mindful of our footprint, implementing constant sustainability efforts, and consistently looking for ways to improve. 

As a health system, optimizing conservation is much more than simply using less energy and water. It’s about providing the most affordable, accessible and appropriate resources that improve people’s health. Not only is conservation about making strategic investments to operate more efficiently and consume fewer materials, but it is also about reducing health disparities, addressing social determinants of health and improving health outcomes for North Texans who have limited resources – or none at all.

Within our walls, we have taken steps to conserve natural resources. From energy-efficient buildings to repurposing and recycling waste materials and low water-use irrigation, Texas Health is committed to conservation. As a High Reliability Organization, Texas Health works to reduce any strain on both the natural and manmade resources we depend on to succeed. Only through prudent management can we lower operating expenses and the cost of care, achieve community health improvement goals, implement innovative business practices and reduce the potential for harm for generations to come.

Texas Health supports more than 20 school gardens which encourage students to eat more fruits and vegetables and provide opportunities to stay active.

How is conservation and sustainability a part of Texas Health Resources’  business strategy?
At Texas Health, optimizing systems, workflows and processes is essential to delivering reliable, safe and quality care. Reducing unnecessary variation in care saves lives, reduces medical errors, provides a better care experience and lowers costs. 

Texas Health conscientiously manages natural resources and materials to reduce consumption, costs, and environmental impacts. For example, we incorporate energy efficiency into new building design, and we also leverage our buying power to keep a steady supply of lifesaving equipment and supplies while conserving resources and lowering waste. 

We do this in numerous ways, but prime examples are our supply chain management, green building design and state-of-the-art laundry systems:

• Texas Health’s strategic supply chain investments are part of our overall plan to source critical supplies locally and in the U.S. in the most efficient, affordable, and reliable ways. Though the pandemic exposed the fragility of the nation’s healthcare supply chain, Texas Health has continued to build upon its already existing systems and assets to maintain all supplies at optimal levels and in many cases help other businesses to do the same.
• Optimizing building conservation and sustainability is also at the top of our priority list. Texas Health incorporates energy efficiency and water conservation through green building guidelines and design excellence standards on new buildings, retrofits older buildings where possible, and uses state-of-the-art tunnel washers as part of a laundry cooperative, all of which decrease water and energy usage. We also recycle 1.93 million pounds of materials and divert 71,753 pounds of single-use devices from landfills. 

What are Texas Health Resources’ short and long-term goals as they relate to conservation and sustainability?
We are building and operating our locations to reduce waste, energy and water consumption. While our overall system footprint is expanding, these efforts are helping us to minimize environmental impacts. Moving into the future, Texas Health is committed to seeking new opportunities for conserving resources in all areas of their business and community operations.

For example, as a member of a group purchasing organization, Texas Health sources high-quality equipment, medical supplies, and environmentally friendly products at a lower price, saving more than $30 million in procurement costs annually. To stimulate regional economic growth, the system also purchases locally when feasible, and from minority and women-owned enterprises.

Texas Health also will continue to incorporate efficiency into new building design, and retrofits and upgrades older equipment, lighting, and other operational systems to reduce expenses and carbon emissions. To monitor consumption and identify reduction opportunities, we conduct regular energy audits in our facilities. 

To help sustain the water needs of a growing North Texas population, Texas Health conserves water usage through low-flow toilets, waterless urinals, water-efficient irrigation, operational systems and laundry services. 

Texas Health strives to think ahead when it comes to conservation. New construction projects, including Texas Health Frisco in 2019, Texas Health Mansfield Hospital in 2021, the nine-story Jane and John Justin Surgical Tower (the largest expansion in Texas Health history) at Texas Health Fort Worth in 2022, and the renovation of the Margot Perot Center for Women and Infants in 2023 meet green building guidelines. We use the Framework for Design Excellence and the AIA 2030 Commitment goals to incorporate the greatest level of energy and water efficiency, healthy building materials, and occupant wellbeing aspects. 

As a health system, optimizing conservation includes providing the most affordable, accessible and appropriate resources to improve people’s health.

Who at Texas Health Resources’ is leading your conservation and sustainability efforts and what are some examples of employee engagement in conservation and sustainability at your company?
Conservation leaders
At Texas Health, more than 400 employees across the Texas Health system have some aspect of conservation as part of their role. Oversight of our high reliability initiative, clinical care, quality and safety, financial well-being, environmental conservation efforts, and caring for our communities spans multiple areas of the organization. We’re focused on ensuring that we meet the health and well-being needs of the people living within our communities and our employees in the most holistic, safe, and efficient ways possible.

Senior leaders from System Administration, Finance, Supply Chain Management, Real Estate and Engineering, Patient Quality and Safety, and Community Engagement and Advocacy make up the leadership team overseeing most conservation and sustainability initiatives/efforts. They are: Barclay Berdan, Chief Executive Officer; Winjie Miao, Chief Operating Officer; Rick McWhorter, Chief Financial Officer; Brian Craft, Senior Vice President, Hospital Financial Operations; Shaun Clinton, Senior Vice President, Supply Chain Management; David Tesmer, Chief Community and Public Policy Officer; Sunita Koshy-Nesbitt, Hospital Channel Chief Quality Officer; Joshua Floren, Senior Vice President, Hospital Channel; and Brian Holmes, Vice President, Facilities Development/Construction. 

Employee Volunteers

Texas Health employees volunteer at more than 300 North Texas non-profits, including food banks, farmers’ markets, parks, and community gardens.

Texas Health offers a robust Community Time Off (CTO) program where employees can volunteer either virtually or in-person up to one workday a year with a charity of their choice in Texas Health’s service area. 

Annually, Texas Health employees donate thousands of hours volunteering for more than 300 local non-profits using CTO, but most give even more on their own time. A number of those projects are focused on conservation and sustainability, including food banks, meal delivery, farmers’ markets, community gardens, urban farming, tree plantings and park revitalization efforts.

We were overjoyed when our CTO program was able to resume in-person volunteer projects in the spring of 2022. Our Community Affairs Department and Texas Health employees and departments have organized numerous opportunities in the past year, including work with Friends of Shiloh Garden in Denton whose crop harvests help to feed individuals experiencing food insecurity and Recess Refresh projects at Fort Worth elementary schools where employees painted spaces for hopscotch, tic-tac-toe, and basketball— all things that encourage students to stay physically active. 

One of the things I love most about working with Texas Health Resources is that their people live the mission and values in ways that make the difference the community needs. They take corporate social responsibility seriously and pour themselves into volunteerism and philanthropy throughout the year. We have been blessed to have them roll up their sleeves to beautify nonprofit campuses, pack food boxes for hungry families, pack toiletries for youth experiencing homelessness, write encouraging notes to seniors and women who are domestic violence survivors and more. It’s a privilege to have them as a member of the CFT Business Impact Network. They are a great example for other companies of how giving back looks when it’s done well.

– Kymberlaine Banks, Senior Business Engagement Officer, Communities Foundation of Texas

What conservation and sustainability programs and projects does Texas Health Resources lead and participate in?
Blue Zones Project Fort Worth
Texas Health’s Blue Zones Project® Fort Worth (BZP), a community health initiative, is the signature program of North Texas Healthy Communities (NTHC), the outreach arm of Texas Health Resources that is invested in supporting community health improvement. BZP works with the city of Fort Worth, area school districts, city and county governments and community partners to increase health and well-being through a multitude of efforts. From instituting policies that promote well-being, such as No Smoking and urban farming ordinances to encouraging local schools, businesses, restaurants, and community leaders to adopt healthy behaviors, it is estimated that more than 200,000 people benefit from lifestyle improvements through Texas Health’s Blue Zones Project-approved organizations every day.

Urban agriculture
BZP was the primary driver in creating Fort Worth’s Urban Agriculture Ordinance, allowing vacant lots to be converted to urban farms without rezoning and policy amendments allowing more farmers markets, which are necessary to distribute the produce grown in the urban farms. BZP supports the efforts of Grow Southeast and  Southside Farms in Southeast Fort Worth, an area designated as lacking access to healthy food sources. BZP provides funding for infrastructure and equipment which can be difficult for startup farmers to attain, connecting the urban farms to engineering services and other partners, and helping them navigate city departments and policies. Urban farms continue to harvest ample greens, tomatoes, a wide variety of onions and root vegetables. BZP also supports their efforts to sell produce at area farmers markets. 

School gardens
School gardens have been an important part of BZP’s commitment to healthy lifestyles. School gardens come with a host of well-being benefits, including encouraging students to eat more fruits and vegetables, and providing opportunities to stay active. Gardens have also been shown to improve interpersonal skills, lower rates of obesity, and promote healthier habits that last into adulthood. Of the more than 20 schools that have teamed with BZP to establish or maintain gardens, most are in under-resourced communities with higher rates of obesity and chronic disease.

Culled Produce Recovery Project
Every day, fruits and vegetables are pulled from the shelves of grocery stores and thrown into the trash. Some, although perfectly safe and edible, are rotated out for fresher stock, while other items might be overripe or damaged. As a result, thousands of pounds of food waste fill local landfills. Now, some of that unsold produce is getting a second life through the Culled Produce Recovery Project with G.E. Foodland grocery stores to supply organic materials to urban farmers. 

Since its launch in 2021, the program has diverted more than 241,500 pounds of produce and continues to expand to add additional farmers and recipients. 

Double Up Food Bucks
Families dependent on the federal government’s Supplemental Nutrition Assistance Program (SNAP) — a national program funded locally by NTHC/Blue Zones Project® Fort Worth — allows SNAP recipients to double their savings on the purchase of fresh fruits and vegetables at participating farmers markets and grocery stores in Fort Worth. Rolled out in May 2020, the program has processed 64,948 Double Up Food Bucks transactions at participating locations, delivering more than $450,881in benefits to SNAP recipients.

As a high reliability organization, Texas Health works to reduce any strain on the resources we depend on to succeed. Only through prudent management can we lower the cost of care, achieve health improvement goals and reduce the potential for harm for generations to come. We are incredibly proud to be named a TxN 20 recipient for the fifth consecutive year as recognition of our conservation efforts.

– Shaun Clinton, senior vice president of Supply Chain Management

How do you see the future of conservation and sustainability evolving, and what role will your company play in that progress?
For Texas Health, conservation and sustainability remain a focus in all areas of our work — from how we care for our patients with environmentally friendly spaces and products to how we serve our communities in efforts to improve their health and wellbeing. We continue to look for innovative ways to serve our communities through volunteerism and by working upstream to identify social determinants of health (food, shelter, transportation, access to medical and behavioral healthcare) and establish programs and services to meet those needs.

Our work to establish and support urban farms, school gardens, farmers’ markets, and culled produce recovery efforts serve thousands of North Texans by making healthy food choices available in areas where food access, especially fresh produce, is low. In addition, Texas Health’s Blue Zones Project Fort Worth Double Up Food Bucks initiative gives individuals on the Supplemental Nutrition Assistance Program an incentive to purchase double the fruits and vegetables. 

Through our Texas Health Community Impact initiative we join numerous community partners across North Texas to identify health disparities within our communities and offer programs and services to address medical and behavioral healthcare, senior citizen isolation, food insecurity, and physical fitness in youth to name a few. 

Since 2018, Texas Health has awarded $18 million in grants to 25 lead organizations who collaborate with other non-profits and programs and service providers to serve the needs of their communities with a goal to end generational poverty and health disparities. In our Mission to improve the health of the people in the communities we serve, Texas Health knows we can better address health disparities and the socioeconomic conditions that affect overall health by working with community organizations at the grassroots level. 

Robust technologies and data and analytics also are helping Texas Health improve business and clinical performance. Texas Health is continuously working to enhance databases, data exchanges, and dashboards to improve analytics and outcomes. One example is in our labs, where our teams relied on disparate computer systems, outdated reporting and tedious processes to plan for and monitor lab activities across all Texas Health hospitals and outpatient labs. This made it difficult and time-consuming to optimize all areas of the department. After getting costly estimates from third-party vendors to develop a software solution that would automate these processes and calculate multiple data points, the team decided to build their own. In collaboration with Texas Health’s business intelligence experts, they spent 15 months designing, building and testing a dashboard that gives them immediate visibility into multiple aspects of lab operations. After the dashboard went live in 2022, Laboratory Services now has the real-time data to make intelligent, cost-effective decisions that drive improvements. 

How does Texas Health Resources quantify investment and return on conservation and sustainability?
Texas Health proactively seeks ways to reduce waste and optimize efficiency within their hospitals that are operating 24/7 and many of their other buildings that are open several days a week. Not only does this save money, but it also reduces impacts to human health and the environment. 

We incorporate efficiency into new building design, retrofits, and upgrades older equipment, lighting, and other operational systems to reduce expenses and carbon emissions. To monitor consumption and identify reduction opportunities, we conduct regular energy audits in our facilities. For example, retrofitting 1,740 retail locations with interior LED lighting has reduced consumption by 75,000 MWh for estimated savings of $7.5 million in annual energy costs over the past five years.

• To help sustain the growing North Texas population’s water needs, we use low-flow toilets, waterless urinals, and water-efficient irrigation systems. 
• To keep wastewater and stormwater discharges from exceeding local and state limits, we routinely inspect and test our water delivery systems as required by code. We also monitor long-term water availability by staying apprised of restrictions, forecasts, and storage capabilities.
• Participate in the North Texas Healthcare Laundry Cooperative, which allows us to wash linens using 50 percent less water, chemicals, and energy than traditional laundry services. The facility uses the Omni System which dissolves organic materials from water through an enhanced oxidation process, allowing reuse of water that was previously unusable. This system along with new, advanced technology in tunnel washers has reduced water consumption by 50 percent annually.
• Use thermal ice storage tanks to significantly reduce energy consumption needed for cooling. The system creates and stores ice during the night when electricity usage and rates are lower. Through a melting process, the ice is used for cooling during the hottest part of the day when electricity usage is at its highest. As a result, we often turn off power chillers, saving a tremendous amount of money.  
• Keep wastewater and stormwater discharges from exceeding local and state limits and routinely inspect and test our water delivery systems as required by code. We also monitor long-term water availability by staying apprised of restrictions, forecasts, and storage capabilities.
• Conserve materials by buying less, reusing and recycling what we can and responsibly disposing of what we must. To comply with local laws and regulations, we have established policies and protocols that reinforce the safe handling, storage, and disposal of materials. A national waste disposal company trains our staff on the proper handling of medical and other hazardous waste, and removes chemicals, pharmaceuticals, and other materials directly from our facilities.

What is the one lesson that Texas Health resources has learned from your conservation and sustainability efforts that others can take back and think about applying within their own space?
Supply chain within the U.S. healthcare industry has learned that it must value domestic production of key supplies more than in the past. The classic supply chain value equation is that quality, service and cost add up to value, and product availability has always been assumed. 

What we’ve learned over the past four years is that we can no longer assume products will be available when we need them, so we must add availability to the equation which also means expanding and diversifying our resources. 

Why is Texas an important home or base of operations for Texas Health Resources?                                    Texas Health is based in Texas. It’s where we serve a service region of nearly 8 million residents and care for more than 2 million annually. It’s also where our 28,000 employees live, work, pray, and play. We are deeply invested in our state and its healthcare industry, through financial and charitable giving as well as through our employees and community partners.

Serving our neighbors and improving community health is rooted in our mission. As a faith-based nonprofit, Texas Health is committed to providing health services and support that lead to measurable, sustainable improvements in our communities. Protecting North Texans’ financial, emotional, mental, and physical well-being is Texas Health’s calling, which takes great pride in the Lone Star State and in its role as a healthcare leader.

In 2022, Texas Health contributed $874.3 million in community benefits, including charity care, health improvement programming, sponsorships, employee giving, paid Community Time Off for our employees to volunteer, and in-kind and cash donations to external nonprofits and causes.  

Learn more about Texas Health Resources conservation and sustainability efforts here.