Greening the healthcare sector Think Tank

14 October 2014
Mater Hospital, Brisbane 

A discussion by the health sector about accelerating progress towards sustainable healthcare and hospital practices

You can now download the full report 

Background

The third annual Think Tank provided the opportunity for the health care sector to discuss case studies of change, national and international opportunities for collaboration, and contribute to a discussion to accelerate progress towards sustainable healthcare and hospital practices.

The Think Tank was hosted by the Australian Healthcare and Hospitals Association and Climate and Health Alliance in partnership with the international coalition of health care organisations, the Global Green and Healthy Hospitals network. The meeting was held on 14 October 2014 at the Mater Health Services in Brisbane. The 30 participants were from 25 organisations including hospitals, health care services and peak bodies, state government health departments, professional associations, universities and advocacy groups.

Think tank results

• Enabled presentation and discussion of key issues including engagement of management and staff; waste and utility management; data management and reporting
• Highlighted successful case studies and opportunities for national and international collaboration
• Enabled knowledge sharing and networking amongst participants
• Identified and prioritised a set of challenges for consideration by AHHA and CAHA
• Raised awareness of greening health care issues and meeting outputs amongst broader health care stakeholders through social media.

Common factors that can support success

1. Behavioural change will begin with a change in thinking – move from a medical to social model of health
2. Imperative to have executive support which is then also reflected in strategy and planning
3. Imperative to have multiple ways to engage staff but this needs to be backed by support for them to act
4. Network to share innovation, success, research, learning: someone, somewhere is tackling your problem
5.  ‘Waste’ is an effective starting point enabling tangible gains that can leverage support
6. Lack of a definition of ‘sustainable healthcare’ for use by the sector
7. A perceived disconnect between sustainability and healthcare resulting in low priority for sustainability
8. Gaining support within health care organisations and across the sector
9. Obtaining long term, external funding for sustainability activities

Top challenges identified by participants

1. Lack of a definition of ‘sustainable healthcare’ for use by the sector
2. A perceived disconnect between sustainability and healthcare resulting in low priority for sustainability
3. Gaining support within health care organisations and across the sector
4. Obtaining long term, external funding for sustainability activities

Presentations

1. Engaging staff to achieve institution-wide sustainability goals
2. Sustainable futures for rural healthcare
3. Global Green & Healthy Hospitals Connect: A platform for global collaboration to accelerate low carbon transformation in healthcare
4. Advances in water and waste management
5. What is the Australasian Healthcare Infrastructure Alliance doing to promote environmental sustainability?
6. Snapshot of Victoria’s environmental data management system

It is with great sadness that CAHA received news of Professor Emeritus A.J. (Tony) McMichael’s death last week from complications associated with influenza.

It is no understatement to say the climate and health world globally is reeling from the loss of a giant among men, a visionary intellectual, public health champion and extraordinary human being.

His colleague and friend Professor Colin Butler has penned the following blog, which is being updated with tributes: click to read the blog

Melissa Sweet from Croakey has written the following blog, which is also being updated: click here to read

The British Medical Journal, The Lancet, Environmental Health Perspectives are all planning obituaries.

CAHA Convenor Fiona Armstrong writes:
“Like many others, I was inspired to work in climate and health from reading Tony’s research. I consider myself extraordinarily fortunate to have had the benefit of his wise counsel since CAHA was established in 2010. He was a quiet champion of CAHA’s work, an inspiration and guide.”

Watch this video of Tony’s speech at the launch of the CAHA/The Climate Institute report, Our Uncashed Dividend, in 2012 here

Fiona wrote the following post about the festschrift, held in his honour at ANU, in 2012: click here

A profile here, published some time ago, captures some of the achievements of this extraordinary man.

By Chris Hill, Director of Environmental Sustainability, Mater

Published 5 May 2014 on Sustainability At Work

The priority of our team at Mater Health Services will always be the delivery of exceptional care to patients. That raises the question “Why focus on sustainability?”

I for one believe the two are not mutually exclusive, and in fact often ask why you would not focus on this area, which can return financial savings that can be reinvested into patient care. These savings also translate to broader benefits – from an environmental perspective through decreased consumption, and also the often hard-to-measure behavioural change.

The journey for me at Mater has evolved significantly over the past few years as our Sustainability at Materprogram gained momentum within our group of almost 7600 staff.

Our program commenced in 2008, initially driven by legislative requirements for the Clean Energy Act and associated Smart Energy Savings Program from a state-wide perspective, and the Federal National Greenhouse and Energy Reporting Act 2007.

What was predominantly implemented to ensure adherence to these policies has grown into a key area of focus for Mater and seamlessly integrated into “normal business practice”.

To support the implementation of various campaigns and tactics associated with the program, a multidisciplinary committee, comprising executive directors and senior directors from across Mater, was established. This process really began from scratch, with no existing platform to refer to regarding how to successfully implement our ideas across our health care environment for the best possible outcome.

Recognition of the environment in our strategic plan was crucial for the implementation of our program in the key areas of focus – energy, water, waste, facilities design, procurement, transport and stakeholder engagement – from which 126 initiatives were identified.

The implementation of initiatives began with those that provided tangible results, so that staff could “see” the changes and therefore more easily align to the program. Examples included dual printing (with more than 6 million pages saved to date), the installation of 24 water tanks across our South Brisbane campus, increase to bike parking (90 spaces, each with a locker) and a commitment to recycling across numerous areas.

A comprehensive communication and engagement plan was developed in-house with Mater Marketing to develop an easily identifiable design to be consistently used for all communication related to the program. The plan also articulates aims and objectives, key messages, stakeholders and communication tools.

A behavioural study undertaken with Griffith University and The University of Queensland, supported by results from an all staff engagement survey, indicated waste was a priority of staff in terms of tangible environmental sustainability.

This was translated into practice, with changes such as supporting co-mingled recycling in non-clinical office areas and changes to clinical waste disposal processes. There are now 11 recycling streams in place across areas of the campus and during the last two years, this has increased recycling by more than 115 tonnes per year and has reduced clinical waste by more than 80 tonnes. This program is planned for expansion across the entire organisation.

Other programs targeting behavioural change involved direct engagement with staff. A “turn it off” campaign was delivered in conjunction with the universities to encourage staff to turn off lights and appliances when not in use. Mater-branded “keep cups” were also made available within cafes. This cost-neutral campaign has resulted in sales of almost 3000 cups since 2011.

We have also linked to external campaigns, with great success. During MobileMuster in March 2013, more than 40 kilograms of mobile phones and accessories were donated by staff, supporting the positioning of permanent collection points. National Ride to Work Day also attracted more than 50 participants who were treated to a free end-of-ride breakfast.

During a Friday File Fling in November 2013 to support National Recycling Week, more than five tonnes of material was collected by Mater’s waste team for recycling (or shredding, for confidential material).

Staff education is also now incorporated into a variety of programs coordinated by Mater Education Centre. Mater’s behavioural standards handbook and new staff orientation sessions reinforce Mater’s commitment to environmental sustainability by setting out expectations for responsible stewardship from the commencement of employment.

While staff support of the program is essential to its success, the ability to demonstrate organisational savings – both financial and environmental – is not only required for the program’s future, but also aids in it becoming a component of “business as usual”, rather than an additional program drawing from other priorities.

Energy initiatives such as installing energy efficient lighting into Mater car parks has reduced energy use by more than 30 per cent, with a less-than-two-year payback. As part of our commitment to the Smart Energy Savings Plan, a $1.9 million chiller replacement program was delivered. It has decreased energy use, and air conditioning scheduling continues to be monitored to ensure its use during core periods.

The implementation of a campus-wide temperature policy to regulate summer and winter temperature levels is also expected to contribute to a reduction in energy use. Electricity contract negotiations in partnership with an external energy broker have delivered substantial financial savings for the 2013-14 financial year and current renegotiation to a “flexible” wholesale price is expected to deliver further savings from January 2015. We are also investigating the appointment of an external contractor to develop an energy management plan for Mater that will recommend and cost payback periods for a number of initiatives, to allow for inclusion in our capital budget process.

Mater has delivered many other initiatives which have contributed to Sustainability at Mater. These include fleet and fuel reduction, reduction in the use of plastic water bottles for patients, miscellaneous lighting upgrades, carbon footprint measurement, volatile organic compound-free paint and green waste shredding.

All initiatives, big or small, support Mater’s goals within the area of environmental sustainability.

To summarise, in my opinion, the success for environmental sustainability across an organisation must include the following components:

• You must have top management support for this to be successful.
• Multiple contributions from all areas do make a difference.
• Embed these changes into “business as usual” and there are more dollars available for patient care.
• Environmental sustainability integration is transferrable across all industries.

Chris Hill is Mater’s director of environmental sustainability.  He can be contacted via [email protected].

This was first published in Catholic Health Australia’s Autumn 2014 issue of Health Matters.

By Dr Liz Hanna, Australian National University

Posted by the Fifth Estate on 16 May 2014

The first federal budget from the Abbott government very clearly demonstrated its ideology to the Australian public, which it kept carefully under wraps prior to the election, along with repeated promises of “no surprises” and “no cuts”, while they lauded the merits of “trust”.

So Australia now has a government under false pretenses.

Sly manoeuvring includes cuts of $50 billion to hospitals, forcing cash-strapped states to push for a rise in GST, which many analysts agree is needed to sustain required levels of services, and was recommended in the Commission of Audit.

Another sleight of hand is the systemic demise of preventive health care towards funding high-tech research, much of which will benefit big pharma. Such a fiscally irresponsible move reflects again the distorted ideology of giving preferential treatment to profits over the health of the public.

Investments in prevention give benefits in the order of 3:1 to 40:1, that, is every dollar spent on preventing diseases saves between 3 to 40 dollars in health spending in treating that disease at a later date (on today’s prices). The benefits to the individual, their family and society of avoided illness far exceeds these figures. So it is not only heartless, but bad economic policy to curtail prevention research and programs.

Preventative health starts with the environment

On all continents, the greatest population health gains have been achieved via providing urban communities clean and healthy environments, and by people following a healthy lifestyle. This means clean air, clean food and clean water.

Environmental degradation hampers health, and lifestyle diseases continue to contribute heavily to Australia’s burden of disease. Yet the Abbott Government’s first budget wilfully sets to destroy recent advances.

Their bad policies will:

worsen air pollution and reduce physical inactivity by promoting roads over rail
exacerbate climate change, giving us hotter summers, and more disastrous fires, droughts and damaging storms, by scrapping renewable energy incentives and promoting fossil fuel industries
shovel more people into a state of poverty and hopelessness, which inevitably results in poorer health, made worse by restricting access to expensive health care

Australia must address climate change

Australia would be better served by a budget that addressed Australia’s high vulnerability to climate change. Rather than supporting Australia to prepare for more frequent and more intense heat waves, deeper droughts, more catastrophic fires and storms, and steering Australia to reverse its own contribution to these, this budget does the reverse.

Adaptation funding, already diminished, will be wound back and ceased. The budget proposes to abolish the Australian Renewable Energy Agency, established to boost the rollout of affordable renewable energy, to scrap of $10 billion Clean Energy Finance Corporation, and remove the carbon price. Funding for public transport is scuppered to build more roads, whereas subsidies to polluters continue, and new incentives are planned for mining.

An ideological opposition to health?

This government is apparently ideologically opposed to the health of Australians. The boost to medical research is a con job, thrown in as a sweetener, hoping Australia will swallow the nasty pill of the demise of Medicare. Can we trust this – or future – governments not to incrementally erode the universality of Medicare? Past performance would suggest not. For decades, the Liberal Coalition has made repeated efforts to dismantle Medicare at every opportunity.

Australia’s health system took decades to build, and we have an excellent mix that attends the needs of the poor, funded proportionally by income tax, and provides for private health care.

We deliver better health outcomes than the more expensive American model, yet this government pushes us away from a health system regarded by many as “the envy of the world”, and towards that poor performing system. As the population expands, the health system, including health promotion and protection, needs investment, not slashing.

Amalgamation of major agencies such as the National Preventative Task Force and the Australian Institute of Health and Welfare with groups whose focus is health efficiencies is a retrograde step.

Australia considers itself an advanced society. Advanced societies investigate their vulnerabilities, address their shortfalls, track their progress, confront the residual challenges and monitor performance by publishing trend data. The AIHW gives us this.

We took pride in our government’s transparency and commitment to good health, and were proud of our achievements. Hiding trends by blinkering our health and welfare statistics looks very shifty, Mr Hockey.

Anti-Australian bias

The ideology revealed here in this budget reveals an anti-Australian people, pro-business bias. The only future being protected in this budget is fossil fuel and big miners.

By savaging the most needy in society, this government clearly ignores the evidence that the supposed “trickle-down effect” does not work – it only widens the gap between the haves and have-nots. It will expand Australia’s underclass.

The government has demonstrated a total disregard of the wealth of evidence about nation building. Social science clearly shows that deprivation of opportunities to contribute to society sets people up for a lifetime of social exclusion. Similarly, public health evidence shows this sets people up for a life of poor health. Those individuals loose out, and society looses out, by shifting their potential productive contribution to one of ultimate dependence. Furthermore, their plight negatively impacts upon their family, and drags them down as well. The ripple effect is very powerful within those inner rings. A few pennies saved multiplies enormously in the costs, financial and human. So these budget moves are dangerously flawed in the human toll and economic argument.

A budget designed to build a strong future for Australia would invest in its people, in their health and education, and promote a healthy world in which current and future generations can productively contribute.

Instead, the budget destines us all to a world of worsening disasters, greater inequities and the social consequences that inevitably arise.

This budget not only broke our trust, but subjects Australia to a trajectory of increasing hardship and ill-health. The ramifications of their systematic destruction of civil society will be felt for generations to come.

Dr Liz Hanna is a fellow at the National Centre for Epidemiology and Population Health at ANU, and president of the Climate and Health Alliance.