Environmental Sustainability and Healthcare's Triple Aim

I attended the 25th annual Institute for Healthcare Improvement Forum last week in Orlando, Florida.   A key session for me came on Wednesday when Dr. Don Berwick, founder of IHI and former administrator of the Center for Medicare and Medicaid Services, convened a session titled Environmental Sustainability and the Triple Aim: A Call to Action.

The IHI has proposed the Triple Aim as the focus for healthcare improvement in the 21st Century:  improved population health, improved individual experience of care and lower per capita costs--across the globe.

The premise of the Forum session is that environmental sustainability not only relates to the Triple Aim but actually redefines it.    Dr. Berwick touched on the impact of climate change, toxic chemicals and unhealthy food on population health and cost of care.  The logical argument comes down to this:  environmental sustainability is a necessary condition for achievement of the Triple Aim.

Dr Berwick then turned the session over to a panel of speakers:   Dr. Jeff Thompson, CEO of Gundersen Health System; Blair Sadler, IHI Senior Fellow; Seema Wadhwa, director of the Healthier Hospitals Initiative (HHI) and Director of Sustainability, Inova Health System; and Robin Gunther, Principal, Perkins + Willmer and Senior Advisor, Health Care Without Harm.

Dr. Thompson described Gundersen Health's leadership in renewable energy--his system will offset all of its energy use with renewable systems owned by Gundersen Health by the end of 2014. Jeff also discussed the progress they have made in managing waste and promoting healthy food in the communities Gundersen serves.  Here's a link to the Gundersen summary of environmental stewardship.

For healthcare organizations ready to reduce negative environmental impact and promote healthier communities, Seema outlined the six HHI challenges in engaged leadership, healthier food, leaner energy, kess waste, safer chemicals and smarter purchasing.   HHI has a range of free resources to support effective changes to reduce environmental impact and reduce dollar costs on the HHI website.

Robin Gunther sketched the future of designing the built environment, outlining how buildings, landscapes and communities promote healing and health--far beyond initial steps of recycling and energy conservation.

Both Dr. Berwick and Blair Sadler connected quality improvement to environmental sustainability--perspectives and tools from quality improvement can catalyze work to align our health systems with the rest of Nature.

The session subtitle, A Call to Action, makes sense to me.

Working with Blair, Seema, and Jeff Rich, Executive Director of Sustainability at Gundersen Health's GL Envision division, I've identified one specific action.   To test our belief that perspectives and tools from quality improvement can catalyze sustainability work in healthcare, we're taking a specific step in the first quarter of 2014.   We will invite QI specialists to a three session webinar, free of charge, to learn about energy terms and energy data relevant to hospitals and other big healthcare buildings.  We'll work through the example of modeling energy use described in our recent two-part blog post.   We'll encourage the QI specialists to say hello to their facilities and sustainability managers and offer specific technical support to document improvement in energy use.   The 60-minute sessions will be 27 February, 13 March and 27 March.   We'll post more information on our website and on the HHI website early in January 2014.

Model for Improvement and Hill Climbing

Is Our Building Using Less Energy this Year?-Part 2