Sustainable healthcare | Stanford News

If you were being treated in a hospital, your immediate concerns probably wouldn’t include plastic waste, but maybe they should. Growing awareness of the links between environmental and human health is leading some in the US health care system to question whether their commitment to “do no harm” extends to the natural world.

A surgeon puts a surgical gown in a trash can. (Image credit: Getty Images)

The sector accounts for nearly 10% of U.S. emissions and is one of the nation’s largest generators of waste, about a quarter of which is single-use plastic in the form of syringes, test kits, gloves and more. equipment. Some healthcare organizations, however, have had sustainability successes using automated machines that dispense insulin into syringes instead of individual vials, collecting unused bedside supplies to donate instead only to be thrown away after the patient is discharged and by installing solar panels, among other initiatives.

Below, an infectious disease physician from Stanford University Desiree Labeaud and undergraduate student Navami Jain Join Helen Wilmot, Facility and Sustainability Manager at Stanford Healthcareand Christine Foster, Director of Sustainable Development at Stanford Medicine Child Health, to discuss alternatives to single-use medical items, the need for regulatory changes, etc. Jain and LaBeaud recently co-wrote a comment in AMA Journal of Ethics, How Should American Healthcare Lead Global Change in Eliminating Plastic Waste? Wilmot attended a round table at the White House last June on reducing global warming emissions from the healthcare industry. Foster has presented at various national conferences on the topic of decarbonizing healthcare.

What are some of the most promising solutions for making health care more sustainable?

Wilmot: Every health system should establish a policy that determines sustainability criteria — such as greenhouse gas emissions and chemicals of concern — for goods and services and includes contractual language for vendors to report those criteria. Beyond that, the industry needs a regulatory environment that values ​​reusable products over disposable ones. At the federal level, the FDA should require suppliers to default to reusable items, where appropriate, and require justifications for single-use disposable items.

Jain: One solution that has caught a lot of the spotlight is reusable gowns. A Stanford-led 2020 study provides evidence of their safety, durability and cost savings. Many institutions, including UCLA and UCSF, have successfully used these gowns on a regular basis.

What are the biggest hurdles to making American healthcare more sustainable?

Jain: There is a lack of accountability, both in institutional operations and in the supply chain. In hospitals and other health care facilities, sustainability is not close to a priority, so no one is held accountable for a failure in this regard.

Foster: The lack of sustainability data at the product level creates a barrier to making decisions taking into account the overall carbon impact. Around 77% of the carbon footprint of Lucille Packard Children’s Hospital at Stanford is attributed to the supply chain. Our percentage is higher than the industry average because we have already reduced or eliminated many other sources of greenhouse gases in our operations.

Wilmot: The healthcare system has a number of important priorities that compete with sustainability, such as quality initiatives, cost containment and patient satisfaction. It is difficult to make a change or adjust workflows or modify medical products when there are always other emergencies in mind.

To what extent is staff or public perception an issue in switching from disposable items marketed as more hygienic to reusable items that may be perceived as less hygienic or safe? How can healthcare organizations overcome these concerns?

Jain: Many reservations stem from uncertainty about quality control strategies for reusable products. I believe we owe staff and patients transparent communication about sterilization procedures and evidence backed by product safety studies.

The Beaud: Again, I think awareness is a big part of that. Sustainability and the health impacts of climate must be integrated into the medical program from the start. Grants and prizes to encourage innovative sustainability ideas can be used to motivate healthcare workers to fight this crisis together.

Foster: As we have begun to share information about the impacts of climate on health and the contribution of healthcare to climate impacts with professionals in our community, it has been amazing to see how quickly they are engaging and wanting to contribute. to solutions. .

What other benefits are there to more sustainable health care?

Jain: In our article, we discuss examples of where healthcare systems are recouping millions in savings through waste mitigation and recovery efforts. For example, a US hospital system’s implementation of reusable gowns saved more than $3.5 million over four years. It is estimated that healthcare organizations in Nova Scotia, Canada could save more than $12 million through policies that hold manufacturers and importers accountable by internalizing the environmental costs associated with waste streams.

Foster: Switching to cleaner fuels and eliminating chemicals of concern from the products and equipment we use in the hospital creates a healthier environment for our patients, their families and our staff, as well as for the communities in which we operate. .

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