Linking Sustainability Investments to Organizational Priorities

The past two editions of Value.Delivered have addressed ongoing initiatives to reduce the negative environmental impacts of healthcare operations and more recent efforts to mitigate the cost implications of tariffs. One might think that tariffs, which are expected to increase supply costs by 15 percent, combined with the pending rise in uninsured patients as the result of recent federal legislation, would decrease interest in sustainability initiatives. But the fact is many programs that are good for the environment, and in turn human health, can also ease financial constraints. For example, healthcare systems across the country have documented millions of dollars by switching to less carbon intensive anesthesia gasses, increasing the purchase of reprocessed medical devices, reducing food and plastic waste, and moving to alternative energy sources. See specific examples in the Value.Delivered column in the July issue of Healthcare Purchasing News.

Demonstrating the return on investment (ROI) of environmental initiatives is increasingly important, according to healthcare leaders attending the first ever American Hospital Association (AHA) Sustainability Summit in July. Still, even a positive ROI is not always enough to get approval, with speakers emphasizing the need to demonstrate additional benefits, such as patient satisfaction or employee engagement. 

A key takeaway from the Summit was the need for an enterprise-wide view of the costs and benefits of sustainability initiatives, which can be supported by simulation tools and the involvement of a team of cross-functional leaders.  

At the Summit, participants were introduced to the Carbon Emissions Learning Lab (CELL) , one of several simulation tools offered by the Geneva Sustainability Centre to help health systems reduce the negative impact of climate change on human health and the risks to operations as a result of climate-related natural disasters, such as wildfires and flooding. 

In the CELL simulation, teams of multi-functional healthcare system leaders consider a range of actions they could take over the course of multiple years to reduce their organization’s overall carbon emissions while supporting safe, effective, and resilient operations. Beyond deciding how much they want to invest in employee sustainability training each year, the participants can only choose a total of three initiatives per year from four categories: leadership and governance, clinical practice, operations, and supply chain. As a result, they need to consider which projects are more foundational and should be implemented first or which are necessary to mitigate downstream risks. As participants submit their decisions for a given year, the program provides them with results, not only on carbon emissions reduction but also on how their decisions impacted budgets, employee engagement, organizational reputation, and operational continuity. 

Many of the Summit presenters also described the value of creating cross-functional sustainability teams to support broader thinking when making decisions.  They specifically referenced leadership involvement from clinical areas, supply chain, facilities, food and nutrition, and environmental services (infection prevention) among others. The benefits include:

• By viewing sustainability initiatives from different vantage points, organizations can identify multiple benefits that otherwise might be missed if only evaluated through a single functional lens. 
• A systems approach can also identify where costs will be incurred and where the benefits, including cost savings, will be realized. With this broader, enterprise -wide view, cost savings can be used to offset the expenditures.
• By securing the support of the leaders of various functional areas, it is easier to gain the involvement and ideas of front-line workers who often see opportunities for improvement before anyone else. 
• When front line employees make suggestions and/or successfully implement projects, they can be commended for their involvement, securing important recognition for critical yet often unheralded employees. 

Like healthcare delivery, making decisions about what actions best support sustainability is a complicated topic, with multiple aspects to consider. What works best for one hospital, just like for one patient, will vary. The key is taking a system level perspective and garnering the broad expertise needed to recognize all the implications of various sustainability initiatives.