Framing the Need for Sustainability
Health care leaders approach questions related to sustainability and climate change from a wide range of perspectives, but the issues—energy conservation, clean air and water, less dependence on fossil fuels, and the like—are too important to lose sight of in the maelstrom of political debate and rhetoric. We all want cleaner air and water and less dependence on fossil fuels; we all want to spur innovation that will create long-term jobs; we all want to generate less waste; and we all want to pay less for energy, water, and waste by getting more from renewable sources. And if the scientists are right and global warming is occurring, health care organizations will be doing our part by reducing the amount of energy our facilities consume from fossil fuels.
But a realistic approach must consider that—given their different locations and circumstances—each health care organization faces different kinds of pressures. Projects, including sustainability projects, must align with the ever-changing strategic imperatives of the organization. In short, projects need to make both financial and strategic sense.
Every year, the American College of Healthcare Executives surveys its members to determine their priorities. The 2009 survey revealed the following:
- Financial challenges
- Health care reform implications
- Care for the uninsured
- Patient safety and quality
- Government mandates
- Physician-hospital relations
- Patient satisfaction
- Personnel shortages
- Capacity
- Technology
- Governance
- Disaster preparedness
- Issues about not-for-profit status
So, designing sustainability projects that not only reduce waste or save water but also help solve one of these challenges will be much more likely to win support and, in fact, to support the organization.
What Is Sustainability Anyway?
To win support and maintain their success, sustainability projects must have staying power—that is, they must be "sustainable." Today, the term "sustainability" is used in many different ways. In fact, it's a little overwhelming: Google returns 31 million results for the word sustainability and 951 million results for green in the sense of environmental issues.
The Roadmap uses "sustainability" to suggest that programs must make financial sense and must align with the strategic imperatives of the health care organization. The well-known triple-bottom-line analysis (illustrated in the accompanying diagram) is used on many Internet sites to suggest that sustainability is the nexus of imperatives that are good for people, good for the planet, and good for profits.
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 cans back, not because the restaurant owner didn't care about energy, but because it was more important to create the atmosphere his clients demanded and drive revenue than to reduce energy costs. Schendler's point is that "it's one thing to watch a PowerPoint presentation on corporate sustainability, and another thing entirely to make it real." In other words, he points out, in the world of sustainability, there is a "dirty secret: sustainable business is often hard to pull off. The unforeseen can crush the promise of incredible payback. Until we have conferences about the mistakes we made and the pitfalls we've encountered, not just about the brilliant successes we've had-our learning curve will remain flat."
Health care leaders are not easily persuaded that sustainability is easy, cheap, or fun, or that it is the solution to many of their problems. However, the issue is too important to ignore. The first step in developing an organization's strategic direction is often the most difficult. Decisions about which program will provide the biggest bang for the buck, the largest cost savings, or the biggest environmental improvement are complex and complicated. The Roadmap tools will enable health care leaders to tackle these decisions with confidence.
The Roadmap seeks to distill the mass of information on sustainability into a few credible, simple-to-understand resources targeted to your needs. Whenever possible, target-setting and implementation tools are tied to an educational resource that provides more detailed information about the prescribed action.
Our Focus
The environmental health of a hospital building is like that of an organism: it requires air (or energy) as it inhales and exhales; it drinks and emits water; and it takes in materials and excretes waste. The Sustainability Roadmap addresses each of these components individually; taken collectively, they mean a more sustainable and healthy building.
Our Assumptions
- Our members have a range of political viewpoints. Not all AHA/ASHE/AHE/ASHRMM members are intent on saving the world from global warming. While we support the science on this issue, we think it is beside the point; we don't want to focus on the business-as-usual forces that may divide us. If we instead focus on the issues we have in common, we can accomplish everything we need to do.
- Our members have different motivators. Drivers may include a combination of financial incentives, the need for environmental or compliance improvement, and community health, communications, and public affairs. Each may require a different approach but calls for easy access to tools, ideas, and resources that can help get the work done.
- Our members have a range of expertise on this issue. Some are tackling the issue of sustainability for the first time, and others have studied the issues and have some expertise. Some have a wealth of in-house resources and corporate support for greening the organization, while others have little or no support.
Our Goals
- Encourage collaboration. It's important to share our stories and lessons learned so that resources are used wisely and goals are met efficiently.
- Encourage involvement. Sustainability in health care is a journey. The issue may not be a driving force in the industry, but our stakeholders increasingly expect us to be engaged. Moreover, it's the right thing for us to be doing.
- Encourage vigorous, credible activity to show results. If we work together as an industry and show significant improvements in getting things done, we can better control our destiny and prevent further industry regulation.
- Elevate the importance of our members in their health care organization. Leadership and expertise in sustainability will elevate you, your department, and your projects and will help your organization succeed.
- Make sense of the myriad of information available.
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 members have overcome barriers. An examination of obstacles and challenges and how they have been overcome provides an opportunity to share lessons learned, thereby maximizing limited resources and helping us meet our goals.
- Provide the tools that were used. Too often, members develop an RFP, a calculation tool, or some other item that either someone else has already created or that someone else could benefit from in the future. A primary goal of the case studies is to provide free, downloadable copies of materials that members have found useful.
- Measure outcomes and results. When possible, tools to help with cost-benefit analysis, benchmarking, and data collection will be provided