Sustainable health care has the triple aim of maximizing benefits (and minimizing or mitigating costs) in environmental, economic, and social realms.
According to a 2012 Commonwealth Fund study “Can Sustainable Hospitals Bend the Health Care Cost Curve?” (S. Kaplan, et al.), U.S. health systems (especially hospitals) leave costly environmental footprints. In this report, the authors cite estimates that U.S. hospitals use 836 trillion British thermal units of energy and spend over $10 billion on energy annually–resulting in 8% of all U.S. greenhouse gas emissions and 7% of our total carbon dioxide emissions. Hospitals also generate 6,600 tons of waste every day (resulting in more energy consumption, as well as methane gas production) and utilize large quantities of toxic chemicals. They identified model ‘greening the hospitals’ initiatives across the U.S from the Healthier Hospitals Initiative and Health Care Without Harm’s Practice Greenhealth program. Based on the costs/benefits of these model hospital programs, the Commonwealth Fund researchers estimate that such interventions could result in health care savings in excess of $5.4 billion over five years. Good for the economy and good for Mother Earth and good (health promoting) for patients, staff, and the community.
Debbie Wilson, a New Zealand nurse, doctoral candidate, and Sustainability Officer with the Manukau Health District in Auckland, tells the story of how she and a few other environmentally-conscious nurse colleagues “rugby tackled the hospital CEO” in the hallway one day to present their concerns to him. “He rather liked it because he’s Welsh.” I assume she is referring to the rugby tackle health policy/advocacy approach and not to any inherent Welsh environmental enlightenment. But their rugby tackle worked and they now have a robust sustainability program underway. They began by working to raise awareness of the issues with hospital and clinic staff, which included measuring their baseline environmental footprint: (measurement + transparency= awareness). They’ve set their goal of a 20% footprint reduction by 2017 and are now in the process of writing a systems-wide sustainability policy. Nurses and health policy/health in all policies and advocacy at work!
I met Debbie Wilson last week at the University of Otago’s public health summer school where she was one of the key presenters. In talking with her afterwards, she told me about the model greening of hospitals initiative at Seattle Children’s Hospital. I admit that I didn’t know much about this model program that is quite literally in my own backyard.
Seattle Children’s Clean, Green Initiative was launched in 2007 and has already won Environmental Excellence national awards. Of note among their multiple and comprehensive greening the hospital programs are: 1) switching to environmentally (and health) friendly cleaning products; 2) providing monetary incentives for staff members to walk/bike/bus it to work; 3) piloting a switch to organic cotton hospital linens (including lab coats); and, 4) reducing food waste/increasing composting and recycling in their hospital kitchen (as well as increasing use of fresh, locally-sourced fruits and vegetables).
JOSEPHINE ENSIGN 