Health system sustainability centers: a prescription for climate disasters

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Over a decade ago The Lancet identified climate change as the greatest threat to global health this century. In September, in an unprecedented editorial published simultaneously in more than 200 medical journals, the global medical community called for “urgent action to limit the rise in global temperature, restore biodiversity and protect health.” One concept presented in this editorial stands out as having the potential to catalyze sustainability across the global economy: sustainable health systems.

The U.S. healthcare industry, including healthcare systems, pharmaceutical companies, and manufacturers of medical devices and supplies, is responsible for 8.5% of greenhouse gas emissions in the United States. It is unacceptable that the healthcare industry is contributing to a public health crisis.

As the United Nations Climate Change Conference known as COP26 takes place in Scotland, humanity has its last real chance to coordinate international efforts to keep warming below 1.5 and minimize the impact. of climate change.

Creating sustainable health systems is one way for the health sector to reduce its contribution to climate change. Sustainable health systems actively seek to eliminate the damage of health care on the environment; they consider the impact of every medical decision on global public health. Sustainable health systems are now possible and they can disseminate sustainable practices across international supply chains. Here is the path: “Sustainability centers” in health systems.

A big solution for a big problem

Although “offices for sustainability” already exist in some health systems, even the best of them are too small. Health system-based offices for sustainability typically employ only a few people and their efforts are concentrated within the health system, implementing well-established effectiveness interventions. While these efforts are important and must be continued, they will not effect the transformational change needed to reduce the impact of climate change and pollution on human health.

Climate change and the destruction of nature pose existential threats to humans: malnutrition, desertification and mass migration. These crises usually hit those with the fewest resources first and most. Sustainability Centers will harness the resources and energy of the healthcare sector to address these great global challenges for all. The Massachusetts General Hospital Center for the Environment and Health, the premier healthcare facility-based center whose mission is to integrate sustainability into all aspects of the hospital through research, education and operations, is a good place to start, but it’s time to think bigger.

Sustainability centers should be modeled on the success of the distributed network of cancer centers – multidisciplinary institutions that co-locate all aspects of cancer care to manage disease holistically. Instead of oncologists, surgeons, researchers and pharmacists, the sustainability centers will have clinicians, engineers, educators, researchers and policy experts, all focused on minimizing the human impact on the patient. climate and climate impact on humans.

Sustainability Centers can grow out of offices for sustainability by focusing on initiatives of increasing size and complexity that propagate sustainable concepts to all corners of the healthcare system. When recruiting multidisciplinary staff for the Sustainability Center, the initial goal should be to empower champions of clinical and administrative services to educate, identify opportunities, and fund health system-focused projects. Once a multidisciplinary staff exists in a sustainability center, efforts can become more sophisticated, such as transitioning the health system (and the surrounding community) to renewable energy, encouraging widespread adoption of remote monitoring and telehealth, and the promotion of regenerative agriculture through advocacy and service of these foods. to the sick.

Increase the impact

Many healthcare systems have already shown interest in sustainable initiatives through Leadership in Energy and Environmental Design (LEED) certification for the design and operation of sustainable buildings. More than 390 healthcare buildings are already LEED certified. The benefits of LEED certification go beyond saving energy to improve employee engagement and reduce employee turnover and injuries. These positive results in terms of financial and human resources provide critical insight into the potential benefits of a transition to sustainable health systems.

Sustainability centers can take advantage of LEED design principles to transform hospitals into climate education institutions. Paths between buildings can pass through gardens with local plants and pollinators. Green roofs visible to patients in surrounding towers can demonstrate permaculture techniques. Parking lots covered with solar panels can generate electricity and protect cars from heat. Facilities like these will be integrated into the local environment and designed to minimize and mitigate diseases associated with climate change. Sustainable health systems will include cost-effective and sustainable projects and technologies to entice visitors to add them to their homes.

Once a health system has integrated sustainability enough into its mission and actions to be considered a sustainable health system, sustainability centers will shift their energy to newer and bolder initiatives. The centers will research (or create) products and services designed in a sustainable manner. For healthcare system emissions that cannot be eliminated, sustainability centers will fund renewable energy projects with responsible local organizations instead of anonymous carbon offsets and excess renewable energy certificates. The sustainability centers will also advise health system investment strategies to include environmental, social and governance concerns that have outperformed the broader market over the past decade.

Finally, the Sustainability Centers will incubate and disseminate climate research. Climate research will range from basic science to urban planning to translational clinical research. Research from the Sustainability Center will impact industries beyond healthcare, in the same way that investments in military technology like GPS have revolutionized our world. Healthcare systems can test prototype technologies in a variety of settings with the ability to quickly scale to an entire campus of clinics, offices and research buildings. Sustainable health systems can be the testing ground for sustainable technologies of all types.

The United States spends $ 3.8 trillion (4.3% of global GDP) on health care. This huge amount of money supports the geographically diverse networks of US healthcare systems. By creating sustainable health systems, the Sustainable Development Centers will transform the global economy. Multinational corporations will have to compete on the basis of sustainability measures to earn their share of the trillions of US dollars in healthcare. Multinationals will be forced to prove that their suppliers are sustainable, exposing large swathes of the global supply chain to the science of sustainable design and manufacturing. Diffusion of these products across sustainable health systems could then generate economies of scale that would reduce prices and make these sustainable products and services competitive in other industries.

While the potential of sustainable health system development centers to transform the global economy is great, the likelihood of this happening without initial regulatory facilitation and government support is unlikely. For health system sustainability centers to develop, scale and catalyze the necessary emergency climate action, we need a regulatory environment conducive to reducing emissions and waste, and similar reliable funding. to that of the National Cancer Institute to initiate sustainable development centers.

The Emergency Action Earth Needs

Climate change is not as controversial as it is sometimes portrayed. A 2018 Pew Research Center survey found that 59% of Americans see climate change as a major threat to our country. A 2019 American Psychological Association survey found that 72% of Americans are motivated to make changes to fight climate change. Sustainability centers for sustainable health systems across the country can capitalize on this motivation and work to reduce the threat.

As an intensive care physician, I am used to making complex life and death decisions with limited time. The existential problem of climate change is just that kind of challenge. The resources and the technology exist to save life on Earth as we know it, but we need the will to implement the solutions. Sustainability centers in healthcare systems across the United States (and ideally around the world) can accelerate the adoption of sustainable business practices globally while actively educating the public on the relationship between climate and climate. health and promoting sustainable products and technologies. This is the emergency action the Earth needs.


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