Framing the Need for Sustainability

Reducing energy use, waste, and costs; getting ahead of the regulatory curve; enhancing the environment for patient care; improving an organization’s standing in the community: These goals and others drive health care leaders to consider sustainability initiatives. And although these goals may be perceived from a wide range of perspectives, sustainability offers a strategic framework that unifies everyone around the aim to optimize benefits in three realms: the environmental, the economic, and the social—also known as the triple bottom line.

Because pressures and motivations vary from one health care organization to another depending on location and circumstance, each organization must find its own reasons for undertaking a sustainability initiative and then establish the business case for doing so. While “it’s the right thing to do” may be enough to get organizations started on a journey to sustainability, at some point, health care leaders will have to explain to their stakeholders why it is worth the time, expense, and effort. For sustainability initiatives to be sustainable themselves, health care leaders must have clear business reasons for pursuing them.

What Is Sustainability Anyway?

Sustainability is a broad topic. In fact, in recent years, the amount of literature regarding sustainability has exploded, becoming somewhat overwhelming: Google returns 31 million results for the word “sustainability” and 951 million results for “green” in the context of environmental issues. Although few of us have the time or inclination to wade through that information, most everyone is willing to take concrete, deliberate steps toward sustainability, especially if someone explains, in clear and understandable language, what sustainability is and what we can do to achieve it. To make sustainability less confounding, the Roadmap seeks to distill the mass of information on sustainability into credible, simple-to-understand resources targeted to the needs of the health care industry.

Let’s start with the word “sustainability.” In simple terms, it refers to the ability of a system to keep doing what it’s doing over time. A system that is unsustainable collapses, by definition. A growing number of scientists and researchers are contributing to the explosion of literature on sustainability with information about global trends—climate change, deteriorating natural resources, increasing waste, political instability—and establishing the case that “business as usual” in our interconnected global world is unsustainable. Health care leaders recognize the sizable impact their facilities and practices have on the health and safety of those they serve and on the greater world, and accordingly they understand the importance of making decisions that simultaneously improve their bottom line, the environment, and the community. The nexus of these three imperatives of sustainability—that actions must be good for profit, planet, and people—is what triple bottom line analysis is all about. It is represented in the following diagram:

Sustainability is the nexus of imperatives that are good for people, good for the planet, and good for profits.

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Our Philosophy

In his book Getting Green Done (2009), facility engineer Auden Schendler describes a project in which he replaced the incandescent lights in a restaurant with compact fluorescents. Almost immediately, he was forced to put the lighting cans back, not because the restaurant owner didn't care about saving energy, but because the restaurant clients felt the compact fluorescents had a negative effect on ambience. It was obviously more important for the owner to create an atmosphere that appealed to clients and kept them coming back than it was to reduce energy costs. Schendler concludes, "It's one thing to watch a PowerPoint presentation on corporate sustainability, and another thing entirely to make it real." His example makes the point that in the world of sustainability, the unforeseen can crush the promise of incredible payback. Schendler believes that, in reality, sustainable business is often hard to pull off.

The philosophy behind the Roadmap is that we can make sustainability easier to achieve by sharing information not only about our successes, but also about the pitfalls we’ve encountered and the mistakes we’ve made. We believe the challenges we face in the world today are too complex, pressing, and interdependent for any one person or organization to effectively take on alone. But the challenges must not be denied or ignored. The Roadmap is designed to help everyone approach the challenges before us with confidence.

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Our Focus

Achieving sustainability requires us to see things from a systems perspective; in other words, that our world is made up of countless systems linked together in cause and effect relationships, and that these systems affect one another. A health care facility is a system, and therefore health care leaders must understand its key elements and linkages in order to make decisions that lead to a more sustainable and healthy building. Like a living organism, a building requires energy and water, it inhales and exhales, it takes in materials, and it produces waste. The Roadmap addresses energy and water use, waste, and supply chain topics and what you can do in those areas to begin your journey to sustainability. A new search feature allows users to find what they need either by these categories or by department or improvement type.

Finally, the Roadmap is designed to be a “sharing community.” A DISQUS feature is available on most pages that encourages users of the site to participate in several ways: (1) by rating a tool’s usefulness; (2) by contributing tools, resources, comments on codes and regulatory issues, etc.; or (3) by contributing information for a case study. There is a tremendous amount of information in the marketplace, and it will take a community to help us prioritize the most relevant information. Thank you in advance for your contributions.

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Our Assumptions

ASHE, AHE, and AHRMM believe the following to be true about our members. They have:

  • A range of political viewpoints. We respect that. In fact, our collective action does not require all AHA/ASHE/AHE/AHRMM members to be intent on saving the world from global warming. But what we do share is the challenge of responding to an increasingly complex and pressing set of needs in our facilities and operations. If we, as a collective group of health care organizations, can focus on solutions together, we can make significantly more progress than if we act alone.
  • Different motivators. Drivers for sustainability initiatives may include a combination of financial incentives, environmental or compliance regulations, community pressures, communication strategies, public affairs opportunities, and more. The Roadmap offers easy access to tools that can help your organization identify its own drivers and resources for designing and implementing a plan to get your initiative off and running.
  • A range of expertise on this issue. Some health care organizations may be addressing sustainability for the first time, while others may have studied the issues over time and developed some expertise. Some organizations may have a wealth of in-house resources and corporate support for “greening” their facility and operations, while others may have little or no support at all.

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Our Goals

  • To encourage collaboration. It's important to share our stories and the lessons we learn so we can wisely use our resources and efficiently meet our goals. You will notice throughout the website, Roadmap users are invited to share their own resources and experiences.
  • To encourage involvement. As health care professionals, we understand the responsibility we have to protect the safety and health of both those we serve and the environment. By encouraging our industry’s strong commitment to sustainability, we will be modeling for others how they can do it, too.
  • To encourage vigorous, credible activity that shows results. If we work together as an industry and show significant improvements in achieving the goals of saving money, improving environmental performance in measurable ways, and improving community health and patient and staff satisfaction, then we at least can get ahead of the curve of future regulations, if not eliminate the need for them altogether.
  • To elevate the visibility of our members and differentiate our organizations. Leadership and expertise in sustainability will elevate your visibility and that of your projects and department as well. Most importantly, sustainability, at least until it becomes more mainstream, can be a way for a health care organization to stand out positively among its competitors and within the greater community.
  • To make meaning of the information available. We aim to present the most helpful and practical tools in the marketplace in one location. Where gaps exist, we will continue to develop resources to fill them. To help keep the Roadmap current, we have provided a way for the health care community to share their experiences and information with others.

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Our Plans for the Future

These tools will be continually refined and improved, based on member needs and feedback. In addition, a series of case studies on each aspect of sustainability is planned. The case studies will:

  • Focus on how health care organizations have overcome barriers. An examination of obstacles and challenges, including how they may be overcome, provides the opportunity for sharing lessons learned. This helps everyone maximize resources and achieve goals.
  • Share tools used in the field. Too often, our individual members develop an RFP, a calculation tool, or some other item that either already exists or that someone else could benefit from in the future. We want to offer materials and resources that are easily accessible and free of charge to others in the health care field members.
  • Measure outcomes and results. When possible, tools to help with cost-benefit analysis, benchmarking, and data collection will be provided.

To write a case study, contact us. Look for the DISQUS section on key pages to contribute your comments, tools, and policies.

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