Texan by Nature is excited to recognize Texas Health Resources a 2024 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 Name: Texas Health Resources

Honoree Industry and Size: Healthcare, Enterprise

Company Overview:
Texas Health Resources is one of the largest faith-based, nonprofit health systems in the United States and the largest in North Texas in terms of number of patients served – more than 2 million annually. Headquartered in Arlington, Texas, we have nearly 29,000 employees in a service region of nearly 8 million people across 16 counties in the Dallas-Fort Worth area, including the most populous Dallas and Tarrant counties.

Texas Health serves more than 2 million annually across 16 North Texas counties.

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. Our conservation statement is Texas Health invests in keeping our environment of care safe, healthy, and efficient to provide an exceptional healing experience for the people we serve. 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 continuous sustainability efforts, and consistently looking for ways to improve. 

We take great pride in our efforts to conserve natural resources. In healthcare, however, conservation goes beyond 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.

What steps is Texas Health Resources taking to address global natural resource challenges, and how are these efforts integrated into your overall business strategy?
Healthcare facilities have substantial resource needs due to their around-the-clock operations, requiring significant energy, water, and materials to operate. Aligned with our Mission, we have a social responsibility to mitigate the environmental and public health impacts stemming from our operations. We do this in numerous ways, including through medical device recycling, laundry cooperative, low-flow toilets, supply chain management, and green construction methods.

Sustainable building design is one of the ways Texas Health is reducing emissions.

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 Texas Health Resources?
Conservation leaders
More than 400 employees across the Texas Health system have some aspect of conservation — either full-time or part-time — as part of their role. Oversight of our High-Reliability Organization 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, Engineering, Patient Quality and Safety, and Community Engagement and Advocacy make up the leadership team overseeing most conservation and sustainability initiatives/efforts at Texas Health. They are Barclay Berdan, Chief Executive Officer; Winjie Miao, Chief Operating Officer; Rick McWhorter, Chief Financial Officer; Brian Craft, Senior Vice President of Hospital Financial Operations; Shaun Clinton, Senior Vice President of Supply Chain Management; David Tesmer, Chief Community and Public Policy Officer; Sunita Koshy-Nesbitt, Hospital Channel Chief Quality Officer; Joshua Floren, Senior Vice President of  Hospital Channel; and Brian Holmes, Vice President of Facilities Development/Construction. 

Volunteer efforts
Texas Health proudly contributes impactfully to our communities. In 2023, we contributed $1 billion in charity care and community benefit, including health improvement programming, sponsorships, employee giving, in-kind and cash donations to external nonprofits and causes, and paid Community Time Off (CTO) for our employees to volunteer.

In 2023, during our 25th anniversary year, every employee received our new “Texas Health & Community” T-shirt, which we all love wearing when volunteering at community events. In 2023, 10,000+ employees participated in our CTO program, giving 10,655 hours to more than 300 nonprofits with more than 700 projects across our service area. Projects ranged from food banks and urban farms to homeless shelters and vaccination events in serving the diverse needs of our communities.

Some of those projects included conservation and sustainability-specific work, including 567 hours to 113 conservation-related projects that include Gardening to Feed the Hungry, Opal’s Farm, Wings of Hope, Beautifying White Rock Lake, The Great American Cleanup, Weekday Work at the Extension Farm, and Farmer’s Assisting Returning Military among others.

“We are proud to be recognized as a conservation leader by Texan By Nature. We continue to build and operate our locations, among other efforts, to reduce waste, energy, and water consumption. Our efforts are helping us to minimize environmental impacts. Through sustainable, purpose-driven strategies, we are helping make North Texas a healthier place to live, work, play and pray.”

– Barclay Berdan, Texas Health CEO

Texas Health Resources employees at a Community Time Off event at the North Texas Food Bank.

What conservation and sustainability programs and projects does Texas Health Resources lead and participate in?
Our for-profit subsidiary, OnHand, powered by Texas Health Supply Chain Services, helps care providers and smaller organizations make their supply chains more efficient, affordable, and reliable. Participants receive access to Texas Health’s discounted purchasing contracts, robust materials management information system and operational expertise. Following the COVID-19 pandemic, Texas Health assisted several businesses in obtaining the supplies they needed, including supplies required to safely reopen and resume operations. Together, we make the commitment to keep the healthcare ecosystem moving forward so our communities can be safe and resilient

What strategies does Texas Health Resources use to educate and raise awareness among employees, customers, and stakeholders about the importance of conservation and sustainability?
Texas Health uses multiple channels for conservation education and transparency, including the following:

Social Purpose Report
Each year, Texas Health releases a Social Purpose Report, which offers a comprehensive look at our efforts to advance sustainability, enhance community health, and address risk identification and mitigation in environmental, social, and governance areas. Our 2023 Social Purpose Report provides an overview of the challenges and achievements impacting our people, organization, consumers, and the communities we serve.

Diversity, Equity, and Inclusion Transparency Report
Texas Health publishes an annual Diversity, Equity and Inclusion Transparency Report that covers our efforts to create an inclusive environment for our patients, employees, and the communities we serve. The report covers our supply chain management efforts, including those encompassing conservation of natural resources and the development of diverse suppliers.

Community Health Needs Assessment
As a leading faith-based nonprofit healthcare system, Texas Health is committed to improving the health and well-being of the people in the communities we serve. In addition to providing hospital care, we educate people about health and provide them with resources to prevent illness, maintain health, and improve their overall well-being. To provide programs for the issues of utmost concern in the community, Texas Health completes a Community Health Needs Assessment (CHNA) every three years and publicly posts the report on its website. This assessment allows Texas Health to better understand the health status and needs of the community and use the knowledge gained to implement programs that will benefit the community by:

• Defining gaps in community health and developing strategies to assist in closing those identified gaps.
• Informing the community about health services and other resources available regionally.
• Developing partnerships and collaborations that enhance the impact of select initiatives.

Community education and involvement
Through Texas Health Community Hope, which encompasses our social impact initiatives and programs, we’re addressing the root causes of health disparities and the social and environmental conditions that affect overall health and well-being. Texas Health supports numerous projects that educate children and adults about the conservation of natural resources while also creating sustainable ways to combat social determinants of health, including food insecurity. Affiliating with under-resourced schools, faith communities, workplaces, and neighborhoods identified by Texas Health’s Community Health Needs Assessment, Texas Health Community Hope fosters equitable and affordable access to healthy foods. These efforts focus on: land development and policy support for urban agriculture; creation and sustainment of fresh produce pantries; a culled produce initiative that diverts usable produce to the community and unusable to urban farms for composting; creation and support for school learning gardens; and partnership with the USDA’s Supplemental Nutrition Assistance Program (SNAP) to make fresh produce more accessible and affordable to underserved families.

School learning gardens
Texas Health’s Wellness Innovation Grant program is working with more than 20 North Texas schools to refurbish indoor and outdoor gardens and areas where students can learn and stay physically active. Other efforts include walking school bus programs, literacy, movement activities, and campus wellness. 

Internal communications
Internally, we educate our employees about health and well-being through stories on our Intranet — MyTexasHealth. Topics range from information about our conservation and community health efforts to volunteer opportunities and health and wellness benefits and resources.  

Can you share specific examples of successful partnerships or innovative collaborations Texas Health Resources has formed with other organizations to enhance sustainability and conservation outcomes?
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. Thanks to the Culled Produce Recovery Project, initiated by Texas Health in 2020, some of that unsold produce now gets a second life. The program engages three G.E. Foodland grocery stores, recovering inedible organic materials and diverting them to urban farmers for compost. Produce that is still fit for consumption is delivered to area schools and food pantries. To make this happen, Texas Health partners with Compost Carpool, a local company with a unique mission for transporting food waste and other recyclable items. 

In 2023, the program was expanded to include additional organic composting sites (waste) and community-based partners and locations (edible produce), such as Good for You Pantries (program providing no-cost fresh produce and healthy staples in schools and community centers). As a result, more than 221,800 total pounds of produce was recovered in 2023. Of that, 44,996 pounds were rescued and redistributed to Good For You and other pantries, up from 13,765 pounds in 2022. Local farms received 176,879 pounds for composting.

“Through Texas Health Resources’ commitment to enhancing the well-being of families across the Dallas-Fort Worth metroplex, we have been brought on board to assist in vital community initiatives. These include diverting green waste from overburdened landfills, supporting urban farmers by purchasing unsold produce at farmers markets, supplying local food pantries with fresh ingredients, and offering plant-based cooking demonstrations to empower individuals with the skills to prepare nutritious meals using available resources. Texas Health has been an invaluable partner, helping us further our mission to serve and uplift our community.” – Ursula Nuñez, Co-Founder, Mind Your Garden Urban Farm

Steven and Ursula Nuñez, founders of Mind Your Garden Urban Farm

North Texas Healthcare Laundry Cooperative
We 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.

How does Texas Health Resources quantify investment and return on conservation and sustainability?
Energy
In our efforts to reduce emissions, Texas Health has undertaken substantial investments in sustainable building design, advanced lighting technologies, efficient heating and cooling systems, and medical equipment. We also complete retrofitting projects to lower energy consumption and utility costs. We aim to reduce square-foot energy consumption by 1% annually, and we identify reduction opportunities through routine auditing. 

These investments have yielded positive outcomes. Despite expanding our building footprint by nearly 28% since 2012, we have kept our energy consumption per square foot at just 12.4%. In 2020, we began measuring Scope 2 GHGs based on our energy purchases. Our system has increased by 1.3 million square feet in the last three years, but we have reduced our emissions per square foot by nearly 5%.

We will explore additional monitoring and reduction strategies as we continue to strengthen our action plans.

2023 Highlights

• Reduced year-over-year energy consumption by 2.7% and cut energy use per square foot by 1.7%, exceeding our goal. 
• Generated 126,967 metric tons of carbon dioxide equivalent of Scope 2 emissions, nearly 1.3% less than in 2022. Find additional data in our Performance Data document.
• Began exploring renewable energy sources to diversify our portfolio and lower GHGs and the system’s reliance on fossil fuels. We are examining options that are logistically and financially feasible.
• Was recognized for the fifth consecutive year by Texan by Nature, which annually honors the top 20 companies in the state for their commitment to conservation.  

Water
Population growth, drought, and agricultural demands continue to strain our state’s water supplies. Texas Health regularly monitors long-term water availability, restrictions, forecasts, and storage capabilities to refine its water management strategies. As conscientious water stewards, we invest in water-efficient plumbing, irrigation, and laundry systems. Additionally, we inspect and assess water delivery systems to prevent wastewater and stormwater discharges from exceeding local and state limits. We aim to reduce annual water consumption by 1% per square foot.

2023 Highlights

• Factoring in the growth in square footage since 2015, our efforts have conserved 544.1 million gallons of water — an amount sufficient to fill 824 Olympic-sized swimming pools.
• Reduced overall water consumption by 0.7%. Water use per square foot increased slightly to 0.3%, falling short of our goal. Find additional water data in our Performance Data document.

Waste Management
Health systems consume numerous materials for operations and care delivery, generating various waste streams, including medical, office, food, chemical, electronic, and pharmaceutical waste. At Texas Health, we are committed to material conservation through strategic measures such as mindful procurement, the use of environmentally friendly supplies, reuse and recycling practices, and responsible disposal. 

Our policies and protocols emphasize the safe handling, storage, and disposal of materials to maintain the well-being of our workforce and comply with applicable laws. A national waste disposal company trains our staff in waste management best practices and removes chemicals, pharmaceuticals, and other hazardous materials from our facilities.

To avoid landfilling waste, Texas Health recycles or reuses: 

• Single-use devices such as pulse oximeters, harmonic scalpels, ECG leads and cables. We return these to the manufacturer for reprocessing so they can be safely used again. Through a program with the National Forest Foundation, we earn points for each single-use device we divert from landfills. The more points we earn, the more trees are planted to restore vital ecosystems.
• Solid waste such as paper, cardboard, electronics, cans, and glass.
• Sharps containers and bins.

2023 Highlights

• Recycled nearly 1.2 million pounds of cardboard at seven hospitals, and nine hospitals recycled nearly 311,000 pounds of mixed materials, such as cans, paper, and plastic.
• Collected and reprocessed 221,684 pounds of medical supplies and diverted 49,410 pounds of single-use devices from landfills. 
• Avoided generating an estimated 595,975 pounds of greenhouse gases by reusing sharps containers from September 2022 to August 2023. This is the equivalent of energy used in nearly 33 homes for one year. Additional waste data can be found in our Performance Data document.
• Received the Stryker Gold Environmental Excellence Award for waste-diversion practices. 

How do you see the future of conservation and sustainability evolving, and what role will Texas Health Resources play in that progress?
The evolution will most likely involve the role that technology will play in conservation and sustainability. It has always played a role, but as we move forward with “smart” technology, it will greatly assist in managing and maintaining our environments in a sustainable way. We’ll find ourselves relying on different types of hardware and software to make the right choice, the easy choice. As a healthcare provider, we’ll need to leverage this technology to help us understand where we should utilize reprocessed items, upgrade equipment, and reduce our overall footprint by moving less into the waste stream, as a few examples. Technology will also allow us to pinpoint the areas of our community that would benefit most from a focused effort around things like a community garden or food bank.

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?
The best lesson anyone can take away from the efforts around sustainability and conservation is that you do not need to try to do everything at once. Pick a few small projects, gain momentum, and scale up efforts as more stakeholders become involved.

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 region of nearly 8 million residents and care for more than 2 million annually. It’s also where our 28,500 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, community partners, state organizations, and government relations efforts.

Is there anything else you’d like to share that makes your strategy and approach to conservation and environmental sustainability unique?

Healthcare facilities have substantial resource needs due to their around-the-clock operations, requiring significant energy, water, and materials. Aligned with our Mission, we have a social responsibility to mitigate the environmental and public health impacts stemming from our operations. We do this in numerous ways, including through medical device recycling, laundry cooperative, low-flow toilets, supply chain management, and green construction methods.

In 2023, Texas Health gave back to the community through numerous innovative health and wellness projects, programs, and initiatives, some of which are unique to our healthcare system. For example, we work upstream in our community health improvement efforts to identify the root causes of social determinants of health — lack of access to healthy food, medical care, mental health services, and transportation — and work with community partners to design programming. Those efforts include transforming vacant city lots into urban farms that grow produce to be donated to food pantries and educating elementary students through school learning gardens. Through our Texas Health Community Impact (THCI) initiative, we collaborate with community partners to provide job programs, nutrition classes, resiliency training, and medical, dental, and mental health services to thousands of under-resourced North Texans. The THCI initiative has allocated more than $23.2 million in grant funding since 2019 for these programs and projects. 

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 the calling of Texas Health, which takes great pride in the Lone Star State and in its role as a healthcare leader.

In 2023, Texas Health invested $1 billion back into the North Texas community through charity care and community benefits.

One of our THCI-supported programs includes:

THRIVE North Texas
In 2019, Texas Health allocated grant funding for THRIVE (Together Harnessing Resources to Give Individuals Voice and Empowerment) North Texas, a program that has helped improve the mental health and resiliency of students by offering behavioral health screening, resiliency training, and greater access to healthy foods.

The first THRIVE program was in Sanger, Texas, where 39 percent of residents live at or below the poverty level, and because the town has no grocery store, is classified as a food desert. For the food access part of the THRIVE program, community partners, led by Texas Health, collaborated to sustainably address food access through the implementation of two food pantries in Sanger, where more than 500 families are served annually. One of those pantries is a grocery store located on the Linda Tutt High School campus, which stocks fresh produce, refrigerated items, dry goods, and household cleaning supplies. The produce is partially sustained by Community Strong Farms in Sanger with assistance from the high school agriculture class.

A highlight of the campus grocery store is that students can work in the store, and positive behavior earns points to shop in the store. Though points aren’t required for shopping, earning them is a strong motivator for students, including some who volunteer to work in the store, which is open to the entire Sanger community.

THRIVE Sanger has been so successful that the Texas Health Resources Foundation is raising funds to expand the program to 10 additional schools by the end of 2025. Programs have already been implemented at three schools located in Lewisville ISD, Fort Worth ISD, and Terrell ISD. 

Find out more about Texas Health Resources’ conservation and sustainability efforts here.

Glossary

Scope 2 GHG – Indirect greenhouse gas (GHG) emissions are the result of an organization’s energy use, e.g., emissions generated from the electricity we use in office buildings.