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      "title": "Whitepaper: Sustainability In Healthcare",
      "body": "## Current Status:\nSustainability in healthcare is complex and necessary in a community where the population is aging, prescription costs are soaring, and chronic, psychiatric, and infectious diseases are growing. Sustainability can be defined as “a complex system of interacting approaches to the restoration, management, and optimization of human health that has an ecological base, that is environmentally, economically, and socially viable indefinitely, that functions harmoniously both with the human body and the non-human environment, and which does not result in unfair or disproportionate impacts on any significant contributory element of the healthcare system.”\n\nSustainability in healthcare will require extensive public and government targeted awareness campaigns and pilot programs to increase mindfulness. Helping to preserve the environment by properly disposing of harmful waste products and reducing the carbon footprint are key in the implementation of sustainability. Sustainability in Healthcare by Allocating Resources Effectively (SHARE) is an example of sustainability in healthcare awareness campaigns. Healthcare spending equates to 17% of GDP in the United States, and of that spending, $6.5 billion is spent annually using 800 trillion BTU of energy. The healthcare industry also consumes over 300,000 gallons of water per year and over 6,500 tons of waste per day. Waste by healthcare organizations is a significant impact on the environment.\n\n## Proposed Course of Action:\nThere are many strategies in which healthcare organizations can reduce the environmental impact: by reducing chemical use, implementing environmentally preferred purchasing, seeking alternative sustainable products, constructing green facilities, reducing energy consumption of raw materials and water, minimizing waste, engaging in recycling programs, transitioning to renewable energy sources, eliminating incineration, and improving transportation strategies. \n\nThe transition starts with C-Level suite leaders in healthcare organizations by making sustainability a priority. Internal and external sustainability can be achieved through leadership, education, and accountability in the organization and in the community they serve. Stakeholders must be educated by boosting awareness of environmentally friendly practices. If you recycle and conserve electricity at home, why would you not exhibit the same practices at work? Creating a safer and healthier environment for patients, while conserving is part of our responsibility as healthcare leaders.\n\nIn thinking of sustainability initiatives in healthcare, many changes would need to be implemented including organizing “green teams” to help educate the organization stakeholders. Conducting a waste audit to determine what comes in and out of the hospital environment can assist in spotlighting waste trends. Observing and evaluating “red bag” waste, solid waste, food waste, laboratory chemical waste, and chemotherapeutic/pathological waste is very important to waste reduction. A waste audit identifies wasteful practices and develops waste management strategies incorporating waste reduction, reuse, and recycling measures. Other ways to reduce waste and integrate sustainability in healthcare includes selecting reusable vs. disposable products through procurement processes. Purchasing less hazardous products and products with less packaging is a start to sustainable procurement practices.\n\nIncineration is a practice used in most healthcare settings but proves to be unsustainable. “Red bag” waste is being incinerated but non-medical waste is arbitrarily being placed in these receptacles which translates to inappropriate waste segregation and more money being spent to properly segregate the waste. Once the waste is incinerated, dioxins and mercury are polluting our air and water systems creating a problem with dangerous fish consumption. Plastics equal approximately 15%-30% of medical waste, which is two times more plastic waste than municipal waste. Alternatives to incineration include using an autoclave, steam sterilization or microwave and chemical disinfection before sending waste to landfills. Other strategies include using food waste for composting.\n\n## Support:\nSpecifically, at UT Southwestern Medical Center, sustainability initiatives are in place to support the UTSW mission of promoting health, and a healthy society by implementing strategic sustainability programs and to be recognized as a leader in sustainable healthcare, health education, research, and operations. UT Southwestern has implemented green committees to evaluate how the organization can support and drive the sustainability mission through more sustainable operations. Committee members represent all areas of the healthcare population at the institution to present and evaluate ideas and programs. UT Southwestern established green teams at the hospital and facilities levels to include recycling, construction, energy/water conservation, and a transportation shuttle system. \n\nThe Facilities Management Department leads the energy and water conservation initiative and tracks all utility usage, participates in demand response programs and manages all trash and recycling. In 2018, the UT Southwestern campus, excluding hospitals, generated more than 7.2 million pounds of trash and recycled almost 715,000 pounds of material. The overall recycling rate was 8.97%. These statistics proves that UT Southwestern and the healthcare industry have a long way to go toward sustainability practices. UT Southwestern engages in surplus measures for the reduction and reuse of furniture and equipment before purchasing new. Lastly, using campus shuttles and Dallas Area Rapid Transit (DART) transportation reduces the carbon footprint for UTSW employees and patients while navigating around campus.\n\n## Conclusion:\nSustainability in healthcare has made strides in the recent years and the trend will be a permanent practice in the future. It is important to reduce the carbon footprint that healthcare organizations emit into our environment while educating patients toward more green initiatives. Together, we can limit waste through sustainability practices at all levels of healthcare for a more sustainable future environment.\n\nFrom [Settle Consulting](https://www.settleconsulting.org/whitepaper-sustainability-in-healthcare)",
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