On the next HCLDR weekly tweetchat, we welcome special guest host Richard Webster, PhD (@CO2strategist). Richard will be leading us in a discussion on climate change initiatives at healthcare organizations. Please join the community and Richard on Tuesday July 18th at 8:30pm ET (for your local time click here).

Below is the informative blog that Richard crafted to introduce the topic.

Enjoy

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Healthcare has a healing mission and has committed to “do no harm,” yet the healthcare system significantly impacts climate change and human health. Five percent of global greenhouse gas (GHG) emissions are from healthcare.[1] Healthcare requires running energy intensive hospitals and a vast amount of consumables (e.g., personal protective equipment, surgical equipment, pharmaceuticals).[2] For context, the US healthcare sectors carbon emissions surpasses the emissions of the entire United Kingdom.[3] Shockingly, pollutants emitted from healthcare delivery contributes the same level of mortality and morbidity as medical errors.[4] While the medical establishment has a passionate focus on patient safety from our immediate interventions, we overlook the scale of harm done from indirect pollutions that are a result of providing care; we are harming Peter to heal Paul.

The net-zero transition is particularly challenging for healthcare organizations. Firstly, the medical profession is conservative in nature, with the top priority being patient safety. Most industries implementing a net-zero transition are balancing cost and carbon savings, yet in healthcare patient safety is a third dimension that trumps every decision. Consequently, there is extra scrutiny on healthcare spending, as misspent dollars on greening healthcare takes investments away from directly treating patients. Further complicating this system is that many healthcare professionals are on the brink of burn out, after the pandemic and working in an environment with long shifts, low staff retention, and a constant urgency to heal the next patient. Staff that are burnt out are less flexible to system change and rightly struggle with long term planning.

Even exclusively focusing on climate change there are still many possible projects to have an impact. A challenge here is how to balance work on climate mitigation and climate adaptation.(5) Then consider what actions can be taken in these six categories:

1. leadership and governance;
2. healthcare workforce;
3. water, sanitation and waste;
4. energy efficiency;
5. infrastructure, technology and products; and
6. service delivery.

For instance, climate mitigation work within the category of energy efficiency could include installing LED lighting, using heat pumps to cool/warm spaces or adding solar panels. Similarly, climate adaptation work within the leadership category could include drafting a climate resiliency roadmap for your organization. For a longer list of activities see this link.

How healthcare organizations can decrease their impact on the environment is not a one size fits all answer. It depends on where you are currently and where you want to go. Getting started can be hard. There can be lots of barriers to change a healthcare organization. Once a few greening projects have been successful, you can demonstrate that your team can be trusted to see projects through and deliver results. At that point getting buy-in from healthcare leaders can help to streamline project approval and funding.(6) It might even be possible to get your hospital to sign up to a net-zero target?

There is no need to reinvent the wheel, and we should stand on the shoulders of others for greening healthcare. There are too many green healthcare champions to comprehensively list all of them, but below I provide a short list of resources that I find myself returning to frequently:

• Canadian Coalition for Green Health Care
• Health Care Without Harm
• Greener NHS
• CASCADES
• PEACH
• CAPE

It is important to remember that this is a decade long journey not a sprint. To avoid the hero complex and burning out, remember that small incremental improvement sustained over a longtime yield compounding large success; in the moment it often feels like you are pushing against unmovable objects, but trust that you can replicate the success of others, and exceed your own expectations.

Please join us on Tuesday, July 18, 2023, at 8:30pm Eastern (for your local time click here) as we discuss the following topics:

• Q1 What can healthcare organizations do to decrease their climate impact?
• Q2 What is the first action a healthcare organization can take to begin their journey to tackle climate change?
• Q3 Do climate initiatives in healthcare need to have a clear ROI in order to get executive approval, be successful or sustainable? Or can they get off the ground simply because it is the right thing to do?
• Q4 Most people are concerned about climate change.  In healthcare, many agree that climate action is required but struggle to take on extra responsibilities. How can healthcare executives and co-workers support and participate in climate initiatives?

Welcome to our guest

Richard Webster, PhD @

Additional reading:

Climate action, staff engagement, and change management: A paediatric hospital case study (open access) – Richard J. Webster, PhD

A climate resilience maturity matrix for Canadian health systems (open access) – Richard J. Webster, PhD (co-author)

References:

[1] Pichler P-P, Jaccard IS, Weisz U, Weisz H. International comparison of health care carbon footprints. Environmental Research Letters. 2019;14(6):064004.

[2] Rodríguez-Jiménez L, Romero-Martín M, Spruell T, Steley Z, Gómez-Salgado J. The carbon footprint of healthcare settings: A systematic review. J Adv Nurs. 2023;n/a(n/a).

[3] Eckelman MJ, Sherman J. Environmental Impacts of the U.S. Health Care System and Effects on Public Health. PLoS One. 2016;11(6):e0157014.

[4] Eckelman M, Huang, K, Lagasse, R, Senay, E, Dubrow, R, Sherman, JD. Health Care Pollution And Public Health Damage In The United States: An Update. Health Aff (Millwood). 2020;39(12):2071-9.

[5] Thomson D, Varangu L, Webster RJ. A climate resilience maturity matrix for Canadian health systems. Healthc Manage Forum. 2023;36(4):217-23.

[6] Webster RJ. Climate action, staff engagement, and change management: A paediatric hospital case study. Healthc Manage Forum. 2023;36(4):195-8.