By Philip Susser and Govind Mattay; Posted October 2nd, 2017
With the devastating impact of climate change beginning to hold a more tangible space in the global consciousness, there is an ever-pressing need for the healthcare sector to innovate and adapt to a new era of environmental accountability. While accounting for 17% of the GDP, the US health care system is also responsible for 10% of greenhouse gas emissions, 12% of acid rain formation, 9% of criteria air pollutants. The population health impact of these perverse environmental contributions are staggering. A 2016 study found that 470,000 disability adjusted years of life (DALY’s) were lost associated with health care related pollution. To put that in context, preventable medical errors resulted in a similar number of DALY’s lost – a source of mortality that has historically received much negative press, and was consequently addressed in the Affordable Care Act.
The major challenge that stems from this particular source of morbidity and mortality is that the health care system is inherently complicated, with a supply chain that includes many different products coming from a wide variety of producers. Other industries have had an easier time adjusting due to the greater simplicity of their production processes. These industries have successfully addressed issues of supply chain management by creating certain “indexes” to track the impact of their products on the environment. The Higgs index, developed in 2012, is used by fashion and footwear companies to track a product’s environmental impact. Mindclick, a supply chain sustainability company, is working to develop a similar system for the healthcare system.
A culture shift in medicine requires hospital executives to recognize the immense health, environmental, and surprisingly, economic benefit of moving towards more sustainable health care delivery. Hospitals have begun to take steps to incorporate sustainability into their models by lowering anesthetic gas waste, minimizing food waste, single use reprocessing devices, and reducing operating room packaging. A 2012 commonwealth fund showed that up to $15 billion in savings could be achieved by taking measures such as these. It will be increasingly important to eliminate the commonly held misconception that these types of measures increase costs — and are only meant for brand image —, and solidify that they in fact dramatically reduce operating costs.
The reprocessing of single-use medical devices has proven to be very successful in both reducing environmental footprints and operating costs for hospitals. Single-use medical devices include surgical instruments such as scalpels, forceps, and scissors, as well as cardiac catheters, pulse oximeters, and tourniquet cuffs. The disposal of these devices is highly regulated and incurs costs that are up to 10 times greater than the disposal of regular waste. Instead of disposing single-use devices, many hospitals are deciding to send them to third-party vendors that reprocess the devices by sterilizing, testing, and repackaging them. The reprocessing process is also highly regulated by the FDA, which ensures the safety of using the reprocessed devices. Many devices can be reprocessed multiple times. Once reprocessed devices can no longer be used, most are recycled instead of being sent to a landfill. The beneficial effects of this practice are enormous. For a 200 bed hospital, reprocessing can eliminate up to 15,000 pounds of landfill waste and cut costs by a million dollars per year.
Hospitals have also begun to focus on reducing energy consumption, as current estimates indicate that hospitals use about 8% of the nation’s energy. Since lighting contributes to a significant portion of hospital’s energy costs, many are beginning to look toward alternative, efficient options such as LED lighting. Hospitals have also invested in annual infrared scanning inspections to identify faulty electrical circuits, which can unnecessarily consume energy. Up-front investments such as these can significantly reduce energy consumption to both reduce costs and improve sustainability for hospitals in the long-term.
The Healthcare Sustainability Club aims to educate future leaders in healthcare about the detrimental environmental effects of current practices and to introduce potential methods to improve the environmental impact of the healthcare industry. Our goal is to get students from a variety of backgrounds to begin to discuss the economic and environmental benefits of sustainable practices. We want future physicians and hospital executives to prioritize environmental sustainability and to innovate new ways to improve our environmental impact.