Numerous Army military treatment facilities (MTFs) were honored for outstanding sustainability achievements at the CleanMed 2019 Conference held recently in Nashville, Tennessee. 2019 marks the tenth straight year for Army Medical Command (MEDCOM) MTFs to receive Practice Greenhealth (PGH) Environmental Excellence Awards; however the program has expanded substantially from a few innovative and forward-leaning MTFs to cover 29 MTFs in the contiguous U.S., Alaska, Hawaii and Europe.PGH is a national membership organization that partners with healthcare professionals to provide sustainability solutions which collectively reduce the industry's contributions to climate change, benefits the health of patients, employees and communities, safeguards the environment and maximizes resource efficiency.Each year, MEDCOM collects data and conducts analysis to track progress and compare performance to peers through the PGH environmental excellence awards platform. Progress is tracked in mercury elimination, reduction in solid waste and chemicals of concern, recycling, sustainable procurement and food, greening the operating room, energy and water conservation, building performance, carbon footprint, and leadership. This year, 29 MTFs and three Army health systems submitted applications winning a total of 40 awards.Carl R. Darnall Army Medical Center (CRDAMC) was selected as one of the Top 25 facilities out of over 380 organizations reporting data for the second year in a row. The Top 25 Environmental Excellence Award is PGH's highest honor for hospitals, and the competition for these top spots increases each year as hospitals continuously innovate. CRDAMC's committed leadership, quality data, and innovative practices illustrates how sustainability is a core part of its organizational culture.In FY17, CRDAMC switched its housekeeping contract to a company that provides over 98% environmentally preferable cleaning products. The facility also installed a cleaning product dispensing system with a built-in metering tip to ensure precise, consistent dilution of products, saving $32,000 over the last two fiscal years. CRDAMC and Brooke Army Medical Center (BAMC) were identified as Circle of Excellence Honorees for Chemicals, demonstrating willingness to address toxicity through purchasing, change of products, services and equipment, and training and outreach.Evans Army Community Hospital (EACH), Ireland Army Health Clinic (IAHC), Madigan Army Medical Center (MAMC), and Moncrief Army Health Clinic (MFAHC) each achieved Greenhealth Emerald Awards for two years in a row. The Emerald award recognizes the top 20% of Partner for Change applicants and is focused on advanced sustainability programs and cross-functional excellence. This is the sixth consecutive year for EACH to achieve Emerald.In 2018, EACH increased the collection of single use devices (SUDs) to be reprocessed by the contractor by 9%. In an effort to reduce water consumption and the use of chemicals of concern, EACH will save over 9.7 million gallons of water over the life of 200,000 square feet of carpet by using a dry cleaning method. Additionally in 2018, EACH increased its green procurement by 6.5% and conducted a green procurement training off-site for Supply Chain Management and Logistics employees.IAHC received Emerald for the second consecutive year. This facility continues to lead in annual refuse cost reduction (43%) and waste reduction (24%) through additional consolidation of waste collection containers, a collaborative relationship with the waste removal contractor, staff, and housekeeping, resulting in reducing collection containers down to two. They are reducing plastic with the installation of 10 bottle filling water fountains and promoting awareness to bring reusable eating containers.MAMC and MFAHC are both Greenhealth Emerald Honorees for the third consecutive year. At MAMC, the MTF used the Military Nutrition Environment Assessment Tool to assess the staff and patients' access to healthy foods, targeting specific vending machines, kiosks, and restaurants that offered limited healthy options. MAMC presented the assessment to leadership and recently added five vegetarian menu items to the 21 day cycle menu and a vegan sausage option to one of the specialty bars. Not only do the vegetarian items offer healthy options for staff and patients, they have a lower environmental footprint than traditional animal-based protein.Excelling in energy efficiency is an example why MFAHC achieved the Emerald award. In fiscal year 2018, MFAHC exceeded its goal to reduce energy consumption by 5%, resulting in a cost avoidance of $1.59 Million and a 17% overall reduction in energy consumption. MFAHC increased building efficiency through: 1) resealing the windows; 2) installing occupancy sensors; 3) upgrading electrical switchgear; 4) implementing heating ventilation and cooling setbacks; 5) conducting regular airflow inspections and equipment maintenance; and, 6) educating building occupants on the inefficiency of space heaters.Partner for Change recipients for the 2019 awards cycle are as follows: Bassett Army Community Hospital, Bavaria-Medical Activity, Blanchfield Army Community Hospital, BAMC, Dwight D. Eisenhower Army Medical Center, Guthrie Army Health Center, Irwin Army Community Hospital, Keller Army Community Hospital, Kenner Army Health Clinic, Kimbrough Ambulatory Care Center, Landstuhl Regional Medical Center (LRMC), Lyster Army Health Clinic, Martin Army Community Hospital, McDonald Army Health Center, Munson Army Health Center, Raymond W. Bliss Army Health Center, Reynolds Army Health Clinic, Tripler Army Medical Center, and Weed Army Community Hospital (WACH).As the Department of Defense's first certified Platinum Leadership in Energy and Environmental Design (LEED) medical facility, WACH generates all of its energy from solar power and other renewable energy systems. It also uses xeriscaping, a form of landscaping with native plants and storm water runoff, eliminating the need for a permanent irrigation system. The hospital is outfitted with low-flush and low-flow fixtures that use 30% less water compared to the minimum standard.The hospital's net-zero energy use is estimated to eliminate more than 9,000 barrels of annual oil consumption, equating to $700,000 in annual avoided energy and water costs at Fort Irwin. WACH is also beginning to eliminate the use of blue wrap in the operating room (OR), replacing it with sterile reusable containers. LRMC's practice of recycling formalin, xylene, and alcohols in the OR saved 280 gallons of new solvent purchases and saved $9,530 in fluid management costs. LRMC's use of 13 suction devices in the operating room has reduced blood waste by 25%, saving $35,000 per year in regulated medical waste disposal costs.At CRDAMC, the nursing staff are given service days to meet annually with their surgical service providers to review the surgical preference cards, which minimizes the amount of wasted surgical equipment in the OR. Updates are made as needed throughout the year. CRDAMC staff are also providing continuing education on air pollutant emissions associated with anesthetic gases. Greening the Operating Room Recognition Award honorees include Bayne-Jones Army Community Hospital, BAMC, CRDAMC, EACH, and MAMC. CRDAMC also received the Making Medicine Mercury Free one-time Award.MEDCOM's sustainability program leverages best practices reported in the PGH applications to enhance performance across its portfolio and develop leaders in delivering world-class healthcare solutions with minimal environmental footprint to support those who serve in the defense of our country.