UAMS Campus Operations Sustainability Report

2017

UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES

CAMPUS OPERATIONS

SUSTAINABILITY REPORT

TABLE OF CONTENTS Leadership Team . . . . . . . . . . . . . . . . . . . Pg. 1 Vice Chancellor’s Message . . . . . . . . . . Pg. 2 Mission Support . . . . . . . . . . . . . . . . . . . . Pg. 5

Strategic Objectives . . . . . . . . . . . . . . . . Pg. 6 Building Portfolio Management . . . . . Pg. 7 Innovations . . . . . . . . . . . . . . . . . . . . . . . . Pg. 8 Sustainable Operations . . . . . . . . . . . . . Pg. 9 Community Impact . . . . . . . . . . . . . . . . Pg. 10

Summary . . . . . . . . . . . . . . . . . . . . . . Pg. 12

LEADERSHIP TEAM Vice Chancellor

Mark Kenneday

Assistant Vice Chancellor, Administration

Phil McNeill

Assistant Vice Chancellor, Operations & Maintenance

Robert Ray

Executive Assistant

Debra L. Smith

Financial Manager

Ben Jackson

Industrial Engineer

Arun Krishnasamy

Director, Centralized Administration Director, Decision Support Services Director, Engineering & Operations Director, Occupational Health & Safety Director, Operational Support Services Director, Parking Operations Executive Director, Planning, Design, and Construction Director, UAMS Police

Karen Jackson Bill Johnson Marlon Joiner Carol Price Sherie Brown Shelli Garcia Art Kjos Chief Robert Barrentine

EXECUTIVE SUMMARY Process and performance improvement initiatives have been the theme for Campus Operations (CO) in FY17. All CO departments have been developing charters that represent improvements in all aspects of their customer service initiatives and service levels. The division leadership have attended Lean Leader training and change agents within their departments are being trained to assure success. The goals for this transition are improved sustainability and resiliency to assure we provide the greatest level of customer service and proper support to the missions of the institution.

Campus Operations takes our responsibilities in these areas very seriously and we understand that our actions directly correlate to the missions of UAMS. As a support service function, our ability to optimize facilities assures our patients and families, students, researchers and faculty can maximize their success. This is the foundation of CO’s responsibilities within an academic medical center and Level 1 trauma center. All Arkansans benefit from the care UAMS provides, the development of future healthcare providers, and the innovations of our research scientists. It is an honor that CO is entrusted with our responsibilities and allowed to actualize in our roles.

For the past nine years we have published our Campus Operations Annual Report. The report itself has been in transition each year. We have bent the existing reporting curve from a lagging indicator of our activities to a leading beacon for our investments. This year we are jumping to the second curve for operational transparency. This method of Sustainability Reporting presents our investments in activities that drive our reliability. Sustainability is not just about green initiatives within Campus Operations, but also includes ongoing commitment to continuous UAMS provision of health, education, innovation. This commitment fuels for our desire to exceed our constituency’s expectations. This is a new course and exciting from the perspective of goal attainment and outcome management.

Our future is bright and Campus Operations, along with all UAMS departments, is developing strategies today that will bring operational success in the future.

CO’s history has been to support the missions by working diligently within the confines of our resources. We have lagged in critical areas of reinvestment 2

into our existing facilities. The results have been generally acceptable, but not outstanding and certainly not defined as sustainable. The path of “run to fail” is not an acceptable strategy for our campus. This resulted in some harsh outcomes this year from multiple failures of utility and power distribution systems. These failures placed our missions at risk. This year we will invest substantially in our aging infrastructure to improve reliability and resiliency. Campus Operations has developed plans to partner with mission fulfilling divisions to ensure that their operational needs are met consistently, especially in regards to how these critical systems are managed.

Part of this plan highlighted issues with our electrical services for the older portions of the campus. Much of the electrical distribution system is 65 years old and past its useful life. This year we will begin replacement of all electrical equipment dating back to the early development of campus, including systems connected to the Arkansas State Hospital and Arkansas Department of Health. A direct electrical feed will be added to assure constant connection for the hospital.

This will protect it from failures associated with other buildings on our campus.

These are expensive investments and will not result in upgraded aesthetics, but will bring reliability to clinical operations.

FY18 brings an exciting new path. It’s my commitment that Campus Operations will continuously to improve the products and services we provide. Service management is different than manufacturing. This is why Lean and Six Sigma (LSS) improvement strategies have merged. LSS starts with the elimination of waste and development of process; “leaning up”. Where we diverge from manufacturing is in the process of service delivery, the latter being a people based competency rather than machine based. Once we have our processes improved we will move to performance improvement.

Please review this first CO sustainability report and let me know if we are on the right track. We are on a journey of process and performance improvement. Your feedback, both positive and negative, will be evaluated to assure we are meeting your expectations.

We are always at your service.

Mark Kenneday, MBA, CHFM, FASHE, CHC, CM-Lean Vice Chancellor, Campus Operations University of Arkansas for Medical Sciences

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MISSION SUPPORT Campus Operations provides services to support the education, health care provision, and research missions at UAMS. These cost-efficient solutions address a variety of issues throughout the integrated operations. Four departments within the division deal primarily with Environment of Care issues: Engineering & Operations (E&O), Occupational Health & Safety (OH&S), Operational Support Services (OSS), and Planning, Design, & Construction (PDC). Building maintenance, utility provision, environmental compliance, workplace safety, sanitary compliance, and construction projects throughout UAMS are just some of the services provided by these groups.

Two additional departments, Parking Operations and the UAMS Police, provide customer service to both internal and external clients. Enforcing laws and policies, offering alternative transportation programs, providing safety escorts to and from parking areas, supporting the Emergency Preparedness plans, and maintaining controlled access areas of campus are some of the contributions these departments make.

Billions

Millions

Campus Operations delivers an economical alternative for our customers while achieving consistent results. The division employs a mix of project management methodology to achieve quality outcomes at a competitive price. Total Project Alignment is used to streamline PDC projects. Lean and Six Sigma techniques are administered throughout the support services portfolio. Cost reduction and efficiency improvements are vital for supporting services like Campus Operations.

The amount spent within Campus Operations and overall UAMS expenses has increased over the past 10 years (see graph). The key difference between the two trend lines is the accelerated growth of overall UAMS spending. The campus doubled its operational spend Expense per Year between FY08 and FY17.

Campus Operations expenses $21 $1.8 expanded by only 45% during $18 $1.5 this time. This lack of funding growth makes providing $15 $1.2 the UAMS support services $12 $0.9 challenging. The subsequent FY08 FY10 FY12 FY14 FY16 chapters in this report will reflect on the outcomes of Campus Operations UAMS these initiatives and outline plans for future endeavors.

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STRATEGIC OBJECTIVES Campus Operations ardently supports the mission at UAMS through strategic objectives. Implementation of the balanced scorecard (BSC) as the accountability Strategic Objectives model mirrors similar initiatives throughout thestrategic institution.

Process improvement Campus Operations ardently supports the mission at UAMS through objectives.

Implementation of the balanced projects will result from amodel thorough analysis of baseline scorecard (BSC) as the accountability mirrors similar initiatives throughoutperformance. the institution. Process improvement projects will result from a thorough analysis of baseline performance.

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BUILDING PORTFOLIO MANAGEMENT UAMS continued to expand throughout the State of Arkansas. In recent years, UAMS has added land and buildings in Magnolia, Texarkana, Ft. Smith, Jonesboro, and Central Arkansas. Campus Operations helped facilitate this growth. In 2015, the division brokered a deal with the Department of Human Services to acquire approximately 11 acres south of 7th street. This property includes Rick’s Armory, the brigade building, and Fullerton Hall. Plans are being considered for the best future use of these sites. Other opportunities around Arkansas are being evaluated for possible uses.

Property acquisition is only one aspect of the division’s support for the institution. Sustaining existing and future infrastructure becomes increasingly vital each year. Traditionally, UAMS has continued to occupy older buildings until funding is available for financially responsible alternatives. This fact is illustrated by the graph to the left, which shows that 21% of the square footage currently in use at the Little Rock campus was built prior to 1965. This emphasis on longevity brings sustainable designs and operations to the forefront.

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Three significant initiatives will be launched in FY18. The first will upgrade or replace many critical pieces of infrastructure. An additional benefit of this investment will be the reduction of overall energy usage. The second is a request for qualifications (RFQ) from outside firms. The most qualified firm will develop a master facilities plan for UAMS. This plan will encompass current and future space for mission support while addressing underlying infrastructure issues.

Campus Operations supports this effort and looks forward to working with the third party vendor. The Facilities Additions by Decade third major initiative is the development of the Pine 12% & Cedar corridor. UAMS initiated a memorandum of 9% understanding (MOU) with 6% the City of Little Rock to 3% develop this border of our campus. Future plans for this 0% area will include additional parking and potential sites for clinical or research expansion.

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INNOVATIONS The Planning, Design, and Construction (PDC) department continues to use Integrated Project Delivery centered on lean processes. This technique provides productivity improvements through collaboration between frontline staff and facility designers. End users are deeply involved in the development of projects from conception to occupancy. This ensures patients, families, and care providers have a streamlined experience during their time on campus. One recent example is the Regional Programs’ Ft. Smith clinic which showcases improved patient flow.

The Ft. Smith clinic’s design also incorporated national benchmarks for sustainable architecture. These design elements are promoted by the United States Green Building Council to ensure that projects minimize environmental impacts.

Parking Operations implemented innovative ways to provide superior services to customers. Automated gates at lot entries and exits are fully operational.

Adjustments in the technology behind these gates has led to better utilization of limited parking spaces. Additional parking spaces were acquired in FY17 when 100 parking spaces were leased from DHS near the corner of Hooper Dr. and 7th St. Enhancements were made to the Rick’s Armory parking lot, and its utilization has increased. Improved shuttle routes have reduced the commute times and provided staff stationed at Westmark with a faster option that doesn’t involve walking across Markham.

Improvements have been made to prepare for potential emergent situations. A new emergency notification system was installed during FY17. The new system allows information to be texted directly to staff and students. This technology will get necessary information broadcast promptly and efficiently. The outside sirens have been upgraded to coexist with the new notification system.

The new Fort Smith Clinic

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SUSTAINABLE OPERATIONS Changes implemented over the last several years have increased energy efficiency as measured by the Energy Star rating system. The Primary Data Center in Little Rock was re-awarded Energy Star’s certification in 2016, and is the only center in the State of Arkansas to hold this certification. Being verified as a leader in sustainable utility consumption underwrites our commitment to the local community. Monetary savings generated from utility usage reduction will continue to fund further LEED-designed projects around campus.

The bio-hazardous waste program has been another successful initiative for Campus Operations.

The division has three concerns within this initiative: Compliance, Safety, and Cost Efficiency.

Occupational Health & Safety (OH&S) is tasked with ensuring that storage and handling of bio-hazardous waste meets all compliance regulations. OH&S also provides safety training that has successfully reduced the number of sharps injuries, including those from disposal of used sharp instruments.

The third objective of this initiative is to reduce costs associated with bio-hazardous waste. Cost reduction for red-bag waste is typically handled by the Operational Support Services (OSS). This waste is expensive to remove from our facility. Training and lean initiatives have reduced the quantity of regulated medical waste by 30% cumulatively since FY10. This is a reduction of over 1.7 million pounds of waste, or $455,972 using FY17 costs. This volume reduction offsets a 33% price escalation during the same time span.

A food recycling program coordinated with our vendor Organix entered its second year during FY17. This refuse is diverted from the general UAMS waste stream into specialized containers for reuse in agricultural settings. To date, over one hundred and twelve thousand pounds of food waste has been removed from general waste disposal. This reclamation is equal to the annual amount of trash recycled by 205 people annually in the United States. (U.S. Environmental Protection Agency)

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COMMUNITY IMPACT

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The two central energy plants on campus continue to pay great dividends for UAMS. Rewards from this investment are evident financially and through quality of life improvements. Electrical usage per UAMS employee (FTE) has been reduced by 19% since the FY11 baseline. FY17 represented the lowest electrical usage since the campus expanded in the early 2010s. While the actual number of British Thermal Units (kBtus) removed is impressive, it is easier to conceptualize if converted to household items. For example, this is equal to the total energy consumed by 2,406 Arkansans during 2015. (U.S. Energy Information Administration) To put this in a different perspective, UAMS has removed the 22 equivalent 110 of over seven million Reductions per FTE gallons of gasoline from the State’s 80 utility system, or enough power to 20 22 110 run a 27-watt light bulb constantly 18 50 20 80 for over a million years…assuming it would last that long. The financial 18 50 savings from this is a realized cost kBtu Lbs of Emissions reduction of 23% based on the FY11 spend. The actual savings are likely kBtu Lbs of Emissions higher given price fluctuations over the half decade.

There are different ways to quantify the benefits from the addition of two 2.0% central energy plants over the past 10 1.5% years. As displayed in this graph, the percentage of expenses represented by 1.0% 2.0%utilities has steadily declined from the 0.5% 1.5%peak in FY10. The successful return on the utility capital investment isn’t strictly 1.0%limited to cost. Emissions from power generation activity were reduced by 7% per FTE cumulatively over the same time 0.5% period. This equates to the annual emissions of 8,334 passenger vehicles being removed from the State of Arkansas. (U.S. Environmental Protection Agency) These successes underline the division’s commitment to improve health, health care, and well-being of Arkansans.

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Campus Environmental Services (CEVS) continued to support the community 250 through instructional outreach during FY17. Each year this team partners with 200 Project Search for an internship program by providing instructional opportunities for individuals with150 developmental disabilities who desire sustainable, competitive employment. Many100 of these participants obtain employment at UAMS after their internship. The CEVS team also facilitates group trainings for individuals in Little

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FY 11 FY 12 FY 13 FY 14 FY 15 FY 16 FY 17

Utilities as a % of Total Expense

Rock each year. These outreach opportunities provide entry-level training for homeless and near-homeless families within the community. FY17 also saw three of our full-time staff graduate from accredited colleges and move on to pursue postgraduate education.

The Landscaping team contributed to the greater

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The Landscaping team contributed to the greater community through their work.

22outside the Winthrop 110 include Major projects through for this group the entrance community their work.replanting Major projects for P. Rockefeller Cancer Institute and establishing a new Employee Green Space near this group include replanting the entrance outside20 the Outpatient Center. To80 get to the newest green space, walk south past the Outpatient Pharmacy, take a right Cancer and walkInstitute down the and hallway. When you come the Winthrop P. Rockefeller 18 50 to a set of glass doors, go through those. There will be a set of stairs on the right. establishing a newatEmployee Green Space the The garden is located the top of the stairs.

In all,near the Landscaping team planted over 12,000 flowers andTo 8,000 the 107 acre Little Rock campus Outpatient Center. getplants to thethroughout newest green kBtu Lbs of Emissions in FY17.

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planted over 12,000 flowers and 8,000 plants

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after their internship. The CEVS team alsoremain facilitates group trainings Thefts the most frequent crime for individua

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time staff graduate from accredited colleges

mmunity through instructional outreach during FY17. Each year this and move on to pursue postgraduate

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SUMMARY Campus Operations continued making positive contributions for UAMS during FY17. This was evident through cost reduction initiatives that thrived throughout the division. Customer service improved and delivered superior results.

Each year brings new and unique challenges. Campus Operations strives to successfully overcome these obstacles while developing plans for sustainable future operations. The division’s goal is a future of sustaining the mission-fulfilling sections of UAMS while providing a cost-efficient solutions. Campus Operations looks forward to providing services throughout the next phases of medical provision, education, and research.

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