Why Sustainability in Healthcare?

Written by Jason Fischer, MBA

Health care in the past century has advanced significantly and there has been a movement towards using plastic and disposable products during the rapid expansion of care. Plastics and disposables were adopted to reduce costs, focus on infection reduction, and ensure efficiency of processes, however as we continue to see and learn more about the downstream impact of these solutions, it is critical that health care leads by example and honors the physician Hippocratic Oath to “Do No Harm.”

Worldwide, health care contributes approximately 4.6% of greenhouse gas emissions. That number, when solely focusing on greenhouse emissions within the U.S., quickly inflates to 8.5% showcasing the resources we pour into care and allowing us to imagine the impact of waste downstream of care provided (Seervai, et al.). Food waste, plastic waste, anesthesia gases, energy use/generation, and more drive emissions output in health care.

As we continue to experience climate extremes including record heatwaves, our clinicians will continue to see its impact on respiratory, renal, and cardiovascular disease. Heart disease contributes to approximately 60% of heat-related deaths; however, “That likely represents a significant undercount, [according to] Dr. Sadeer Al-Kindi, an environmental cardiologist at Houston Methodist Hospital. In Texas, recent modeling suggests heat plays a role in approximately 200 deaths attributed to cardiovascular disease each year --” (Gill).

At Houston Methodist , we define sustainability as the responsible use of resources to conserve the environment AND protect health and well-being. The recent addition of our Office of Sustainability does not negate the fact that Houston Methodist has long supported sustainability across our organization including the following examples:

• Pursued reusable sharps containers to reduce the amount of plastic waste in our landfills
• E-waste recycling to reduce negative impact from our IT operations
• Digital health records to reduce paper consumption while increasing medical record security
• Recycled and refurbished medical equipment including blood pressure cuffs, pulse oximeters, and other equipment to support a circular economy
• Central utility plant renovations to conserve energy and lower costs to ensure our ability to continue providing services for our communities

The next phase of development for Houston Methodist’s sustainability efforts focuses on a three-prong approach:

1. Organizational collaboration aimed at developing functional conversations and establishing a steering committee as a systemwide organization to gauge knowledge, interest, and opportunities
2. Organic initiatives aimed at business unit education and employee engagement to establish a foundation around sustainable culture from the bottom up
3. Strategic partnerships aimed at determining local, regional, and national non-profits, governmental, and businesses’ appetite and aptitude for sustainability to support a vision of “collaboration-as-a-service” with Houston Methodist

Other ongoing initiatives driven by our Center for Critical Care, functional leaders, and the first Green ICU initiative in the United States aimed at reducing our emissions and ensuring a sustainable health care option for our greater Houston communities and beyond include:

• Switching from single dose inhalers to nebulizers
• Partnering with pharmacy for shared insulin supply to reduce waste
• Exploring ways to determine least impactful dialysis process
• Defining best practices to support lab order waste
• Nature incorporation into built hospital environments exploring the possibility of circadian rhythm lighting to reduce inpatient delirium
• Building processes for evaluating vendor sustainability and green supplies
• Research at the intersection of nature, health/wellness, and sustainability through The Center for Health & Nature, a joint venture between Houston Methodist, Texas A&M University, and Texan by Nature

The overarching charge of health care is no easy feat. Adding a layer of environmental sustainability considerations and logistics may appear to be a daunting task and it is. At Houston Methodist, we view this as imperative as we strive for positive health outcomes for our communities. And, if done in a thoughtful and well executed way, sustainability efforts will produce a wide range of benefits for any organization including financial and operating efficiencies while supporting a growing green economy.

?

References

1) Seervai, Shanoor, et. al. “How the U.S. Health Care System Contributes to Climate Change,” explainer, Commonwealth Fund, Apr. 2022.?https://doi.org/10.26099/m2nn-gh13 .

2) Gill, Jillian. Houston Chronicle. 14 Aug 2023. https://www.houstonchronicle.com/health/article/houston-heat-dangerous-people-heart-18294888.php#:~:text=Sadeer%20Al%2DKindi%2C%20an%20environmental,disease%20each%20year%2C%20he%20said .