“Climatitis!” Global Warming Meets Healthcare in the Big Apple
What does climate change have to do with the hospital design and construction of Mount Sinai's newest hospital?
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What an interesting read, Anmol! I never thought I could connect hospitals to climate change and supply chain and I learned so much from your article. I want to expand further on your concerns for Mount Sinai and propose my recommendations:
1. Hospital is actually one of the major contributor to greenhouse gas emissions. According to Popular Science, the U.S. healthcare system released the equivalent of 614 million metric tons of carbon dioxide in 2013, around 10 percent of the total emissions in the United States. (https://www.popsci.com/hospital-emissions-climate-change) The scale of the impact shocked me. While I have been working in energy all my life, and partnered with hospitals in China to cure coal-mining related diseases, little did I expect the very hospitals to be a big source of the pollution. This challenged me to reconsider the sources of pollutions in other areas. For example, with current technologies, electric vehicles in China actually causes more waste in air than benefits.
2. Who are the players in the supply chain of a hospital and what are the customer promise? I agree with Anmol that hospitals do not just serve patients within the hospitals. According to the American Journal of Public Health in October, contribution to climate change by the institutions trying to protect our health will be responsible for the loss of 123,000 to 381,000 healthy life in the future. Hospitals need to expand their view of who they serve and who they owe social responsibility to. Different from traditional manufacturing companies we covered in TOM cases, supply chain issue in the case of hospitals require rethinking of the key parties in the supply chain and how to create value for them- it could be medical equipment suppliers and residents living nearby.
3. Solving supply chain issue of hospitals needs national scale of integration. Given the nature and the revenue generation model, hospitals alone cannot efficiently achieve immediate success in fighting climate change. As a research about New Zealand hospital pointed out, Sustainable Health Sector National Network NZ plays a key role in connecting and sharing resources among hospitals. (http://www.scoop.co.nz/stories/GE1711/S00098/nz-health-sectors-role-in-responding-to-climate-change.htm) It is not a supply chain issue for one hospital in New York City and cannot be solved by one hospital. Hospitals need to think out of the box to learn from industrial companies their best practices, form alliance with larger organizations and seek government support.
The clearest opportunity for new hospitals to serve as a role model of sustainability is to integrate energy efficient best practices into their operations in a way that aligns with their operating incentives. Energy saving initiatives, such as smartly managing heating and cooling systems must be attached to a clear business case in order to ensure their sustainability. Likewise initiatives to introduce alternative sources of energy, such as solar arrays and battery packs. to hospital complexes need to directly serve the ‘always-on’ operating requirements of a medical facility. Without these business linkages, the environmental implications alone will not be enough.
Anmol – One risk that natural disasters also pose for hospitals is destruction of patient information and personal records. The problem of climate change for a hospital is then magnified as they become liable for not just the patients in the hospital, but any patient whose records are on file. Digitized patient medical records on internal servers in basement could certainly be destroyed, but many hospitals still keep paper records on file, which may be a more imminent concern.
I think you raise an interesting point about hospitals having a responsibility to address their global emissions, just like any other industry. However, it may be difficult to convince hospitals to update and change environmental practices to better serve long-term goals of reducing climate change. As you suggest, hospitals may see this as an investment in their long-term viability, but many other threats may seem just as worthy. Terrorism and online hackers pose similar threats to natural disasters caused by climate change and so a hospital may not see the incentive to combat climate change when these other risks loom large. Policymakers may have to impose environmental regulations to improve greenhouse emissions from hospitals, if it is deemed critical for society.
Thank you for this interesting article and insights, Anmol. I completely agree that hospitals should include controls in their systems to address issues caused by climate change — such as storing critical machinery and samples on higher floors or having backup generators. I am slightly less convinced whether hospitals feel the moral obligation (or even should) of investing in eco-friendly machinery and practices at the expense of cost. I agree with the comment above by Maximus; unless it makes clear business sense for the hospital to engage in these green practices, I am skeptical whether they will make the large capital investment to do so. The only exception I see to this is if legislation is passed that puts a cap on greenhouse gas contributions hospitals can make, similar to those put on other fore-profit corporations. I think this is unlikely in the short term, as most people would prefer hospitals put their capital towards treating patients or investing in possibly groundbreaking medical research rather than focusing on sustainability initiatives.
This was an enjoyable read Anmol! Two of the major questions your article raised for me are: 1. the amount of greenhouse emissions actually caused by hospitals and, 2. the effectiveness of asking hospitals to make sustainability and green-technology related decisions. I found @Yin’s comment on the actual scale of pollution created by hospitals to be very illuminating. The next aspect is also alluded to by the other commentators, when they suggest that hospitals should work towards maximizing direct health returns, as they may not be placed or expected to address these challenges.
The suggestion to treat hospitals (and perhaps all public institutions) on par with for-profit organizations would allow for efficient allocation of capital towards addressing climate change. If hospitals had to make regular payments towards their pollution costs, it would incentivize management and the public towards mitigating and ultimately mitigating this risk.
A cynical question on the link between increased need for care (Eg: due to increased incidences of Asthma) and increasing emissions: At present healthcare’s business model is based on treating and alleviating patient suffering. It is not based on improving quality of life. As such, is its operating model likely to shift to accommodate greater environmental stewardship and reducing the number of patients requiring care?
This was an enjoyable read Anmol! Two of the major questions your article raised for me are: 1. the amount of greenhouse emissions actually caused by hospitals and, 2. the effectiveness of asking hospitals to make sustainability and green-technology related decisions. I found @Yin’s comment on the actual scale of pollution created by hospitals to be very illuminating. The next aspect is also alluded to by the other commentators, when they suggest that hospitals should work towards maximizing direct health returns, as they may not be placed or expected to address these challenges.
The suggestion to treat hospitals (and perhaps all public institutions) on par with for-profit organizations would allow for efficient allocation of capital towards addressing climate change. If hospitals had to make regular payments towards their pollution costs, it would incentivize management and the public towards mitigating and ultimately eliminating this risk.
A cynical question on the link between increased need for care (Eg: due to increased incidences of Asthma) and increasing emissions: At present healthcare’s business model is based on treating and alleviating patient suffering. It is not based on improving quality of life. As such, is its operating model likely to shift to accommodate greater environmental stewardship and reducing the number of patients requiring care?