From 2009 to 2012, H-CAP built a green career ladder in the healthcare sector, through an Energy Training Partnership Grant funded by the U.S. Department of Labor American Recovery and Reinvestment Act. This initiative in environmental sustainability entitled “Frontline Green Careers,” was an innovative program built by H-CAP that brought labor and management together for green systems change, quality improvement, and job development. Through this program, H-CAP intended to impact healthcare’s triple bottom line: People (patients, workers and the community); Planet (the environment) and Profits (costs/institutional viability).

With this sense of agency and validation of their perspective and experience, workers became invested in change. This approach allowed them to draw connections between their work and the successful functioning of the facility as a whole.

Frontline workers that went through this program were trained on how to be more conscious of environmental sustainability in healthcare. Projects included recycling and composting initiatives, transitions to the use of green chemicals, implementation of a rechargeable battery program and a variety of waste reduction efforts, including recycling in the OR, all with significant cost savings to the institutions.

The educational model in Frontline Green Careers was an innovative approach to worker training. In this model, workers learned why there was a need for change, what the impact of that change would be, and they decided along with their supervisors, how that change was enacted. With this sense of agency and validation of their perspective and experience, workers became invested in change. This approach allowed them to draw connections between their work and the successful functioning of the facility as a whole.

We did this by:

  1. Educating the workforce in green practices and bolstering critical thinking skills to support worker engagement and effective practices including recycling, waste reduction, reduced water and energy use, eliminating toxic chemicals where they are not necessary, and improving cleaning practices to reduce Healthcare Associated Infections.
  2. Creating and supporting labor/management projects that help environmental sustainability and save money.
  3. Creating a college certificate program that supports entry into a career in sustainability practices in healthcare and other sectors.

Frontline workers received training in 6 core modules. Up to 6 additional hours of custom training was developed to meet the needs of department level labor/management partners. Worker and supervisor pairs were trained to lead the curriculum through a Train-the-Trainer program.

What did we accomplish?

  • Costs Savings– Project Examples: $28,000 savings thru increased recycling on patient floors; $25,000 savings in combined OR and patient floor recycling project; $4,000 annual chemical costs savings through greener chemicals ; Approx $5,000 annual savings through rechargeable battery use; $8,000 savings through composting program.
  • Culture change: One facility increased Press Ganey scores from 37% to 82% on patient satisfaction with cleanliness; 90% of worker participants say they are better at their job and 71% of supervisors say relationships between workers and supervisors improved.
  • Carbon Footprint—Project Examples: In one hospital, composting took 144,000 lbs waste from landfill and Plastics recycling diverted 4.4 tons of waste.
  • Trained 3000 workers from around the country
  • Labor management partnerships engaged workers and managers in green change and more collaborative relationships
  • More than 100 Peer trainers (front line workers and their supervisors) trained to lead the core curriculum
  • Over 70 participants completed college certificate program
  • New labor-management negotiated step-up positions at 8 employers

See our Project Snapshots here:
Green Project Snapshot–LAC and USC
Green Projects Snapshot–Northwest Hospital and Medical Center


This workforce solution was funded in part by a grant awarded to the Healthcare Career Advancement Program, Inc. (H-CAP) by the U.S. Department of Labor’s Employment and Training Administration. The solution was created by the organization listed above and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, expressed or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, usefulness, adequacy, continued availability, or ownership. The curriculum resulting from this solution is copyrighted by H-CAP. Internal use by an organization and/or personal use by an individual for non-commercial purposes is permissible. All other uses require the prior authorization of the copyright owner.

This Program is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.


Outcomes of the Frontline Green Careers program impacted the Triple Bottom Line qualitatively and quantitatively. We saw the development of a front line workforce conscious of its role in creating a sustainable environment and a quality healthcare system. We saw participants become aware of the need for change and creative problem solving. We saw intriguing and initial outcomes that included the reduction of institutions’ carbon footprint and initial cost savings that could only increase as the programs are sustained and expanded. Improvements in both patient and worker safety and health showed promise. At In several institutions, there was a marked increase in patient satisfaction scores as they related to the EVS department. As the healthcare industry moves forward and seeks to provide quality care at a lowered cost, we believe this type of program will support those efforts.