connects the DMS, DHMC, and College campuses, while a local public bus system—funded by DHMC, Dartmouth, and the municipalities it serves—offers free rides throughout the Upper Valley. The busiest route, the blue line, includes stops at the College and DHMC, as well as in downtown Hanover and Lebanon. In 2006, more than 146,000 passengers rode the blue line, eliminating an estimated 156,000 auto trips and saving commuters an estimated $341,000.

DHMC's ambulances and grounds equipment are also doing their part to reduce fossil fuel consumption and emissions through the use of sulfur-free biofuel, which yields less carbon monoxide and particulate matter during combustion. "We pay a premium to do so, but we're happy with it," says Leigh. "Our grounds crew reports a very remarkable improvement in the odor of the emissions, which can be an especially importantissue among staff members operating such vehicles over long periods of time."

Carbon footprint
This summer, Leigh will embark on a comprehensive effort to quantify all the natural resources consumed in DHMC's annual operations and maintenance—what's known as a carbon footprint. It's an assessment that's relatively easy to do for one's personal ecological impact, but it's never before been calculated for a hospital. The idea is to come up with a clear measure to serve as a baseline for future improvements, to give administrators and staff the same kind of feedback that a speedometer gives a driver.

"We're going to have an excellent physical environment which is safe, welcoming, healthy, productive, [and]

DHMC had replaced conventional thermometers with mercury-free models like these by the late 1990s, making it one of the first hospitals in the nation to virtually eliminate mercury.

"Before a hospital embarks on
a broad commitment to waste minimization and waste management," says H2E's Brannen, "waste is just trash.
It's out of sight, out of mind." When DHMC instituted a training program called "Let's Talk
Trash," suddenly physicians developed new appreciation for maintenance staff.

economical," asserts Dahlstrom. "And it's going to, among other things, operate with the smallest possible realistic footprint. Every time we make a decision about a change in the facility, a change in our practice, we ask whether we can make a choice that utilizes all of these resources in the right balance."

$200,000

Rebates for energy-saving projects that DHMC has received from Granite State Electric since 2003

26,000,000

Expected lifetime savings in kilowatt hours of electricity as a result of these projects

$2.5 million

Expected monetary savings from that reduction in electricity usage