Tenet Health: Fighting the Climate Change Fever

Tenet Health is actively adapating to and mitigating the impacts of climate change at the forefront of the healthcare industry.

Tenet Health, as one of the largest integrated healthcare management companies in America operating 77 hospitals and 500 outpatient centers, has a responsibility to lead the healthcare services industry toward sustainable solutions as global warming causes drastic climate change over the next 10 years. [1] As temperatures, carbon emissions, and incidence of catastrophic weather events rise, the population’s health issues rise in tandem. [2] COPD issues are projected to rise as a result of air quality degradation. [2] Heat related strokes and deaths will increase as temperatures trend upward. [3] Stronger and more frequent storms, hurricanes, and droughts will drive hospital admissions higher and strain capacity, all while increasing injuries and deaths. [2]

Tenet has the opportunity to adapt their supply chain not only to efficiently address these health concerns, but also so as to help mitigate the company’s contribution to global warming. By transitioning their nearly 600 facilities to energy efficient, environmentally conscious operations, Tenet can both increase positive health outcomes in the community as well as realizing a share of the resulting savings. In a recent study, Duke University and the NASA Goddard Institute for Space Studies estimated that “cutting GHG emissions (and thus pollution from fossil-fuel burning) could prevent 295,000 premature deaths in the U.S. by 2030. Near-term annual health benefits are estimated to be $250 billion per year.” [4]

Tenet has created a Sustainability Advisory Council at the corporate level, and “Green Teams” at each individual hospital to create awareness and enact initiatives around the Healthier Hospitals Initiative metrics. [5] Tenet has put in place goals for the following programs:

Short term goals (next 2 years):

  • Engaged Leadership (5)
    • Educate and raise awareness in each facility and hospital leadership team around sustainability initiatives and gameplan.
  • Healthier Food (6)
    • Reduce meat purchased by 10% per year OR achieve ultimate goal of an average 1.5 oz per meal served.
  • Leaner Energy (7)
    • Reduce greenhouse gases by decreasing weather-adjusted energy intensity from metered energy use by three percent from baseline.
  • Less Waste (8)
    • Reduce Regulated Medical Waste to either less than 10 percent of total waste or less than 8 tons per operating room per year.
  • Safer Chemicals (9)
    • Green Cleaning: Inventory cleaning products and purchase 90% Green Seal or UL ECOLOGO certified cleaning products
  • Smarter Purchasing (10)
    • Surgical kit review: Review and reformulate (where appropriate) at least 80 percent of total O.R. kit types.

Medium term goals (3-10 years):

  • Engaged Leadership (5)
    • Commit to success on all 5 metrics listed below.
  • Healthier Food (6)
    • Increase by 5% per year or achieve ultimate goal of 20% of meat and poultry purchases raised without the routine use of antibiotics. Increase the percentage of local food purchases by 5 percent annually OR achieve ultimate goal of 20 percent of total.
  • Leaner Energy (7)
    • Reduce greenhouse gases by decreasing weather-adjusted energy intensity from metered energy use by ten percent from baseline.
  • Less Waste (8)
    • Short term goal plus: Achieve a 15 percent recycling rate compared to total waste.
  • Safer Chemicals (9)
    • Short term goal plus: DEHP and PVC Reduction: Eliminate DEHP and PVC from at least two product categories.
  • Smarter Purchasing (10)
    • Short term goal plus: Single use device reprocessing- collect and purchase 20 percent reprocessed non-invasive devices compared to total. Greener Electronics: Specify, purchase, and report expenditures on greener electronics with a goal of 80 percent registered with EPEAT.

Tenet is on the right trajectory with these initiatives ramping up over the next 10 years. Every initiative that the company has enacted will return threefold: in retarding the overall advance of climate change by switching to greener purchasing and operating activities, in actively contributing to the health of current patients and staff by serving sustainable food and controlling chemical waste, and in expanding Tenet’s capacity to treat and serve future patients by ensuring the efficiency of the corporation.

Tenet can now begin to focus on how the enterprise can best serve the projected rising health victims of climate change: Tenet should continue to expand and diversify its points of service, by buying and building more low-cost access points like urgent care centers and short stay hospitals. The company should invest in flexible capacity beds to prepare for volume surges related to storms and heat waves. Finally, Tenet should ensure that it employs a diverse and comprehensive staff of physicians and other healthcare providers, so as to be ready for any sudden rise in negative health outcomes as a result of climate change.

Questions remain regarding how large integrated healthcare companies like Tenet can endure the current pricing pressure in the industry which demand leaner operations, successfully enact their sustainability objectives, and stay ready to ramp services to meet increasing demand in the face of climate change.

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[1] http://www.hbs.edu/environment/climate-change/climate-change-101/Pages/climate-change-selected-indicators.aspx

[2] Intergovernmental Panel on Climate Change (IPCC), Climate Change 2014: Impacts, Adaptation, and Vulnerability – Summary for Policymakers (2014)

[3] Risky Business Project, Risky Business: The Economic Risks of Climate Change in the United States (2014)

[4] Risky Business Project, From Risk to Return: Investing in a Clean Energy Economy (2015)

[5] “Tenet Healthcare Corporation | Green Team Development.” Healthier Hospitals Initiative, www.healthierhospitals.org/get-inspired/success-stories/tenet-healthcare-corporation-green-team-development.

[6] “Engaged Leadership.” Engaged Leadership | Healthier Hospitals Initiative, http://healthierhospitals.org/hhi-challenges/engaged-leadership.

[7] “Healthier Food.” Healthier Food | Healthier Hospitals Initiative,  http://healthierhospitals.org/hhi-challenges/healthier-food

[8] “Leaner Energy.” Leaner Energy | Healthier Hospitals Initiative, http://healthierhospitals.org/hhi-challenges/leaner-energy

[9] “Less Waste.” Less Waste | Healthier Hospitals Initiative, http://healthierhospitals.org/hhi-challenges/less-waste

[10] “Safer Chemicals.” Safer Chemicals | Healthier Hospitals Initiative, http://healthierhospitals.org/hhi-challenges/safer-chemicals

[11] “Smarter Purchasing.” Smarter Purchasing | Healthier Hospitals Initiative, http://healthierhospitals.org/hhi-challenges/smarter-purchasing


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Student comments on Tenet Health: Fighting the Climate Change Fever

  1. One area that I find particularly interesting in Leigh’s discussion of Tenet Health is how health care models need to evolve in order to combat changes to healthcare needs posed by climate change. While this is clearly an appropriate path forward, I wonder how Tenet can be incentivized to make these difficult, expensive, and likely risky changes. We have seen time and again that the healthcare system in the US has not adapted to the realities of climate change today, let alone 10+ years from now [1]. Are hospital systems even the right players to be providing care in a more dynamic environment, and if so, what concrete steps can we take now to ensure that they are incentivized to adjust their practices?

    1. Gary Cohen, “What does Climate Change Have to Do With Health Care?”, Forbes, accessed November 2017, https://www.forbes.com/sites/skollworldforum/2013/04/07/what-does-climate-change-have-to-do-with-health-care/#11a6f9287915

  2. I agree with your assessment of Tenet Health needing to focus more on how it can prepare for the types of diseases and healthcare issues arising from climate change in the long run. In addition to your point around improving its ability to handle large volume of patients arising from drastic climate events, I wonder if there is a way to predict the types of health issues that will be more common in general (e.g. insufficient amounts of certain types of vitamins in our body resulting from lack of food products that can supply these vitamins) and begin developing infrastructure / treatments to prepare for a bigger general shift in healthcare needs.

  3. Great read Leigh – thanks for sharing. As you highlighted in your piece, there is not only a social responsibility dimension to this issue but also a major business responsability. To build up on your point regarding more frequent natural catastrophies, I could see Tenet leveraging their first mover advantage and operational expertise to propose their services to communities/organizations less well-equipped to deal with such emergencies. I find that their is a deal pool of companies operating in hostile/remote locations who may be interested in these services going forward. I see both a software (medical expertise) and hardware (modular emergency hospitals developed specifically for natural disasters) opportunity for them and needless to say that they could offer potential clients one of the two or both services. One issue that may arise from this shift in their business model is the strain that it could put on human resources currently focused on providing more conventional services.

    1. *major business opportunity.

  4. This was fascinating! Your post prompted two ideas. I’d be interested in the total possible impact of the entire US healthcare industry trying to reduce meat consumption. It makes sense that a healthcare company might be the right type of institution to implement such a change, given their focus health. One of the challenges with this plan is figuring out which supply chain changes would produce the most climate impact. It’s hard to optimize when you lack reliable data. This process would be made much easier if you either had an effective regulatory mechanism to internalize the negative externality of climate change. Failing that, I could imagine a system where every item sold includes information on the estimated climate impact of its production, allowing all consumers to make easier choices about how to reduce the environmental impact of their purchases.

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