Twenty pounds. That's the weight of the very first load of recyclables processed by Metro Health Hospital in Wyoming, Mich., long before it became the state's first LEED-certified hospital. Today the facility boasts a 48,500-square-foot green roof, motion-sensitive lighting systems and a recycling program that diverts 110 tons of municipal waste from the landfill each year. But it was that 20 pounds that made a lasting impression on John R. Ebers, LEED AP, CEM, the hospital's sustainable business officer. "It served as the blueprint for the rest of our efforts," he says. "Looking back, starting small really taught us a lot." Here are some other insights to consider when growing your greening program.

1. Listen and learn. "People think I'm the person to come to for ideas," says Mr. Ebers, "but I'm amazed by how often the best ideas come from the floor." In fact, it was staff in his hospital's radiology department who alerted him to inefficient energy use in the area's file room. They told him the room's light shone constantly, even though staff rarely lingered to review files. Mr. Ebers consulted an electrician, who discovered the occupancy sensor linked to the lighting system was programmed at 30 minutes, its highest setting. A simple adjustment dialed that back to 5 minutes, meaning the storage area's light now switches off soon after the room is empty.

Mr. Ebers suggests you assess areas in your facility to determine which are active throughout the day — and which aren't. Visit staff and managers in each department; ask them when foot traffic is at a peak and when activity slows considerably. Install occupancy sensors to automatically switch off lights in low-traffic areas. Even if you've already implemented the motion technology, make sure it's working to maximize your energy efficiency. Motion detectors work off bandwidths spreading out in cone shapes typically 5 to 25 feet in length. Adjusting the bandwidth determines how often a motion sensor is activated; in low traffic areas, you want to reduce the cone's reach, says Mr. Ebers.

2. Dial down the lights. Taken alone, reducing the lighting output of a single bulb results in minimal savings. Factor energy reductions over several hundred lamps, however, and the savings quickly mount. Mr. Ebers suggests you switch out antiquated light bulbs with more energy efficient models in order to raise your facility's Energy Star rating, a classification sponsored by the U.S. Department of Energy and Environmental Protection Agency.

Mr. Ebers says switching out his hospital's T12 tube lights with T8 models draws 12 watts less per bulb. He also recently replaced the halogen overhead bulbs in the hospital's elevators with energy-saving LED lights and removed lamps from areas that were over-lit. For example, after discovering the lighting in one of his hospital's stairways emitted close to 50 footcandles when only 15 were required by code, he removed 2 lamps to cut the hallway's light intensity in half.

3. Demonstrate the need. The Carroll Hospital Center in Westminster, Md., recycles close to 2,000 lbs. of blue wrap each month, thanks to a powerful demonstration conducted by Kate Painter, RN, BS, CAPA. "We saved the blue wrap discarded in the OR over a week's time," says the hospital's director of surgical services. "It filled a 4-foot by 4-foot dolly, with plenty left over." When staff walked by the mountain of blue, they caught a firsthand glimpse of why a recycling program was needed. Today, the hospital's surgical teams place blue wrap on a designated shelf in OR pass-through cabinets. Staff on the other side of the wall pull the wrap and place it in a clear bag in the hallway for later removal to an assigned dumpster. From there, an outside company picks up the wrap and melts it down to recycle its plastic fiber.

Ms. Painter says disposing of red- and brown-bag wastes costs about $880 and $100 per ton, respectively. Her staff's recycling efforts, including diverting blue wrap, reduced red-bag waste by 37% in the first quarter of 2009 and sliced 80 tons off brown-bag totals, improvements Ms. Painter says saves her hospital $76,500 annually.

4. Make it easy. The key to recycling success is making the program easy on the end user, says sustainability engineer Seema Wadhwa, LEED AP, who helped launch and cultivate a green culture throughout the Falls Church, Va.-based Inova Health System. It shouldn't take an additional 10 steps to identify the items that need to be segregated and to place them in the proper collection bin, she explains.

Ms. Wadhwa advises you to walk through your ORs, observe your staff in action and talk to them about where recycling receptacles should be placed; the bins or bags should be easily seen, easily identified and easily accessible. Her hospital system hangs green bags on standard metal holders in soiled supply holding areas so staff can quickly segregate recyclables when waste is taken out of the OR. Ms. Wadhwa also conducted in-services to show surgical teams what can and can't be recycled in the OR, and assigned green champions to manage the staff's performance.

5. Team up. Green teams populate each of the Inova Health System's 5 hospitals and meet monthly to discuss ways their facilities can better meet sustainability's triple bottom line: people, planet and profits. "Those are the pillars," says Ms. Wadhwa. "You need to understand what going green truly means. It's about helping to conserve resources, but in addition to looking at what impact a greening program will have on the environment, you also have to look at its return on investment."

The investment — in both time and resources — that you put into recycling in the OR, for example, will be returned on the back end when you divert poundage from the regulated waste stream, which can be 6 to 10 times more expensive to dispose of than municipal trash, according to Ms. Wadhwa.

Inova's recycling program has been a huge success — in 6 months, the health system reduced its segregated waste by 19% — thanks to effective staff education, well thought-out implementation and constant monitoring. Ms. Wadhwa says sustainability's positive impacts can pique anyone's interest, no matter their stake in the process. "Whether you care about patient and staff safety, the environment or your fiscal performance, you can lend your support to the greening movement," she explains. "Whatever your role, it makes sense and it's the right thing to do."

6. Start trying. A couple years ago the Texas Institute for Surgery in Dallas formed a green team to assess the facility's environmental impact. Its president, Debbie Hay, RN, BSN, CASC, says the exercise led to the implementation of several green ideas, including the launch of a single-stream recycling program, placing recycling bins in each OR, using HVAC systems controlled by a computerized time management system to limit energy output, implementing electronic medical records and planting more ground cover around the facility to reduce watering and mowing.

Ms. Hay says her staff's greening efforts are paying off, even if she doesn't have facts and figures to prove it, because she believes sustainable success lies in the effort. "Start trying," she advises. "It's not as hard or expensive as you might think to do the simple things. Once you implement a few green ideas, your staff will come back to you with even more. Sustainability feeds off itself."