By Erin Cristales, Vizient
From left, Shane Dunne, Terry Duffina, Aparna Dial and Cristina Indiveri at their 2023 Vizient Connections Summit panel, “The New Healthcare Imperative.”
The first official gathering of the new healthcare decarbonization coalition — which includes providers, suppliers and NGOs such as Stanford Health Care, Johnson and Johnson, and Health Care Without Harm, as well as Vizient — took place at the annual CleanMed conference in April. The room was packed with industry stakeholders ready to tackle a substantial challenge: climate change, and more specifically, the severely problematic scope 3 emissions produced by the healthcare supply chain.
This year’s Vizient Connections Summit further built on that momentum, with several meetings and power huddles focused on reducing emissions and waste across the industry. In fact, one such session — titled “The New Healthcare Imperative: Advancing Sustainable Collaborations” — included four members of the decarbonization coalition, all of whom work for organizations on the forefront of environmental sustainability: Aparna Dial, senior director of sustainability and facilities management at The Ohio State University Wexner Medical Center; Terry Duffina, director of the Sustainability Program Office at Stanford Health Care; Shane Dunne, sustainability manager for Memorial Sloan Kettering Cancer Center; and Cristina Indiveri, associate vice president of core tenet programs at Vizient.
Their panel took place just hours after David Entwistle, president and CEO of Stanford Health Care, addressed the more than 4,000 Summit attendees during the event’s opening keynote. Climate change is an urgent world challenge that demands innovative solutions, he said, adding that “Climate is everybody’s business, and it affects our business — climate is everyone’s bottom line.”
“The good news is this: Addressing this crisis is an opportunity to make patients healthier and our health systems stronger,” Entwistle said. “Doing sustainability right means investments and improvements in efficiency that pay off over time. I’m a big believer that the right thing to do can also be the smart thing to do fiscally.”
Dial and others also emphasized the business case for sustainability in their remarks (to learn more, read the blog "Three Ways Sustainability Can Drive Immediate Cost Savings Across Health Systems"). This is no easy journey, the group agreed. But it’s one that will ensure the viability of healthcare institutions for years to come.
“Summit 2023 is changing the narrative,” Duffina said. “It’s changing the conversations providers and suppliers are having together around sustainability and that is extremely powerful.”
Much of that conversation centered around how organizations can begin, or advance, their journey to increased sustainability. Below, the experts share some advice on the best ways to proceed.
Frame the importance of sustainability in terms of both human and financial health
Dial: You have to look at sustainability in a holistic way and communicate the multifaceted benefits. A couple of key points to make include:
- Enhanced patient care and improved patient outcomes. If you have cleaner sources of energy, that leads to less pollution which leads to lower rates of respiratory issues — and that means fewer visits to the hospital.
- Financial benefits through reducing resource use, waste generation and streamlining your supply chain. You can use those savings toward patient care outcomes, research or even updating antiquated infrastructure, all of which lead to long-term viability, resilience and adaptability. It’s about future proofing your organization.
Look, I’m an engineer by trade, so I always think it’s crucial to make the business case for sustainability. The Governance and Accountability Institute tracks sustainability reporting among the S&P® 500 — in 2011, 20% of firms created a sustainability report, and in 2022, 96% did. You can see how Wall Street has evolved its thinking and where it’s moving. Companies that are heavy emitters are trading at a 15% discount compared to those with sustainability goals.
Dunne: It really comes down to having a discussion around how to reduce your environmental and climate footprint, advance patient health and drive community benefits, all while looking to reduce your costs and resource consumption. Sustainability is not a “nice to do” anymore — it’s a strategic imperative that has a value add for the industry and our organizations.
Duffina: Relating your sustainability activities back to the impacts on human health is important because it aligns the mission of our industry and the mission of sustainability. Healthcare is unlike any other industry for exactly that reason.
Indiveri: The rapidly warming climate is being regarded as the single greatest threat to global public health. Over 200 medical journals, including The Lancet and the New England Journal of Medicine, warn the time to act is now — otherwise, there will be catastrophic consequences that are impossible to reverse. That is because climate change and carbon emissions create significant adverse health outcomes including asthma, cardiovascular disease, food and water impacts, and even death.
Start small and build from there
Duffina: When you’re looking at all the different aspects of sustainability, it’s so easy to get overwhelmed and shut down because it feels too big to solve. But here are a couple of things to keep in mind as you get started:
- Every organization can do something. You don’t need a sustainability professional, or a whole team of sustainability professionals, to make a difference. What you do need are some champions in your organization who understand the impact of this work, and you need support from leadership.
- Do a baseline greenhouse gas assessment. This is true for providers and suppliers. Even if you only do a limited assessment for scopes 1 and 2 and find opportunities to reduce that inventory, you’re going to make a difference.
Sustainability takes time — there isn’t going to be a 10% reduction in greenhouse gas emissions your first year out of the gate. You’re going to have to build some systems and policies that will enable that work to happen later. In our first couple of years, our Sustainability Program Office focused on building that infrastructure. We have a framework now for sustainable procurement and will further advance that implementation in the coming year. We have invested a lot of time and effort in building design and construction standards that are sustainable.
Where we’ve had a lot of impact so far is in:
- Employee engagement. Whether with clinicians or support staff, we have seen a lot of enthusiasm for supporting sustainability issues. As part of our latest employee engagement survey, we had two questions about sustainability and the results were resounding proof that if you have employees engaged with sustainability, you also have extremely high engagement overall. We’ve also seen a lot of success in encouraging our employees to stop commuting to work in single-occupancy vehicles.
- Energy infrastructure. We recently did a project where we upgraded our HVAC controls from pneumatic to digital, and we were able to save over $300,000 a year. The project cost $700,000 and we were able to get a utilities rebate for more than $400,000. Working on big opportunities with our utility and facilities partners was a really big win.
Dial: First, decide how to define sustainability for your organization. Secondly, think about how you can integrate that definition into institutional-wide goals and align it with your strategic plan pillars. Then you create administrative engagement structures — it could be through leadership councils or engagement structures for you employees. For example, we have more than 1,000 employees engaged on our Green Team.
Collaborate internally and externally to gain insights and expertise
Indiveri: Scope 3 offers the greatest opportunity for improvements. It is essential that suppliers, providers and GPOs align, collaborate, share transparent data and commit to this work for the next two, five and even 10 years.
Dunne: The collaborations with Vizient, NGOs, suppliers and other providers is essential to drive strategies toward decarbonization. There are so many competing priorities, but you have to make sure you are working with suppliers and prioritizing those relationships. At MSK, we’re always looking to have those two-way conversations to help us meet our organizational priorities.
You can really break down silos through common aims like decarbonization, sustainability and supply resiliency. One way to do that is to reach out to providers who are common GPO members. We all have similar needs and constraints, and the goals that Vizient is pursuing through its core tenets, such as supplier diversity and environmental sustainability, allows providers to show that these are not individual priorities — they are organizational and industry priorities.
Dial: Leverage external partnerships — you don’t have to reinvent the wheel. Work with your GPO and participate in external councils like Health Care Without Harm. When you bring all these unique stakeholders together, they all have diverse perspectives and expertise in specific areas. Creating a platform where they can share that expertise creates a much more holistic approach so you can address challenges and create solutions in areas ranging from healthcare operations to supply chain to even clinical practice.
Duffina: Ideally, we all would establish one metric to know if an organization is sustainable — but one metric for such a huge endeavor is unlikely. So, each of those pockets of coalitions is important to help advance the conversation. We need to work together, and we need to be as transparent as we can.
Measure the work
Dial: At the end of the day, the success of sustainability efforts relies on transparency, accountability and measurement. It’s all about the data: Set your goals, measure them and publicize your results.
Dunne: If you’re driving energy efficiency, reducing your resource consumption within the supply chain, mitigating the global warming potential of your anesthetic gases or reducing fuel use within transportation efficiencies, all of these efforts can be quantified and shown to reduce the climate impacts within healthcare and our organizations.
Stay focused on the goals that lie ahead
Duffina: There are international goals around getting to carbon neutrality by 2050, which is a really important date for everyone to keep in mind. All of these coalitions need to drive to that — we all need to have that one common goal in mind as we set up our programs to make headway in this space.
Dial: We have to focus on reducing our carbon footprint; creating more water-efficient practices; upgrading infrastructure; reducing waste; ensuring proper disposal and ecofriendly pharmaceuticals; and embracing sustainable goods, procurement and transportation. All of these are challenging but necessary.
Indiveri: A couple of the major focuses now and moving forward are climate action and decarbonization. The media and headlines are helping to highlight these efforts. Providers are getting their arms around data and suppliers are willing to advance this work. Sustainability and decarbonization require collaboration and commitment across the entire healthcare ecosystem.
Dunne: We’re going to hold ourselves accountable, and we’re going to do it together. That’s how we’re going to achieve these lofty expectations. Frameworks and goals are great — but the North Star is action and progress.