Unexpected Partnerships: Climate Change, Healthcare, and Partners Healthcare Hospitals

On October 23, 2016, Massachusetts General Hospital (MGH), a national leader and #1 Hospital ranked by U.S. News & World Report,[1] was recently profiled in the Boston Globe for its plan to explore building a new ‘green’ pediatric hospital– structural innovations, energy efficiency, indoor greenhouse and all.[2] This comes after a series of ‘green’ initiatives rolled out by its parent umbrella organization, Partners Healthcare, across its hospital sites. While this may seem en vogue across industries, these ‘green’ choices have been deliberate. This post explores why environmental friendliness has important health implications, and how Partners has been a leader in the charge.

Healthcare’s Footprint

According to the World Health Organization (WHO), “between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths worldwide per year, from malnutrition, malaria, diarrhea, and heat stress.” These translate to “direct damage costs to health (i.e. excluding costs in health-determining sectors such as agriculture and water and sanitation)…estimated…between US$ 2-4 billion per year by 2030.” As these predictions show, climate change will have an important impact on health.[3]  

But, almost more importantly, these numbers speak to a capacity issue and need for hospitals to be more resilient in the face of climate change — something that was seriously reinforced when health care facilities were flooded by Hurricanes Katrina and Sandy, leading to untimely closures that turned patients away.[4]

As healthcare delivery systems prepare for the future increased demand, they must also consider how they simultaneously contribute to climate change. While the healthcare sector represents approximately 18% of the US GDP,[4] hospitals have historically also spent $5.3 billion on energy every year, and use twice as much energy per square foot as traditional office space.[11] As large contributors to the economy, the healthcare sector must find a solution to these staggering negative contributions to global climate change.

As an initial step, hospital networks have created shared agreements on reducing environmental impact, like the 2020 Health Care Climate Challenge through Health Care Without Harm (HCWH). These agreements focus on three pillars towards successfully becoming more green: mitigation, resilience, and leadership.[6]

  • Mitigation involves reducing healthcare’s own carbon footprint.
  • Resilience is adapting to extreme weather and epidemiologic shifts in disease.
  • Leadership involves using the unique position of the hospital within communities to promote and protect public health by educating the staff and broader citizens about climate change’s effects on health and safety.

Partners’ Current Strategy

Partners Healthcare, the largest healthcare network in Massachusetts, has taken an active role towards mitigating its own carbon footprint through partnerships with the Boston local government, with Healthcare Without Harm (and the 2020 Health Care Climate Challenge), and as founding member of the Healthier Hospitals Initiative, a coalition of eleven of the country’s most progressive and innovative health systems.[8] Through these partnerships, Partners’ has published a strategy that focuses on:[12]

  • Engaging leadership on environmental health and sustainability
  • Leaner energy use
  • Reducing waste and increasing recycling
  • Using safer chemical
  • Purchasing environmentally preferable products
  • Serving healthier foods and beverages
  • Recent Successes

Anecdotally, Partners has made specific operational changes towards improvement, including:[8]

  • Adopting a single-stream waste management program
  • Initiating lines of healthy food choices
  • Capturing and reprocessing chemicals used in its clinical lab facilities
  • Replacing bottled water with filtered tap water dispensers
  • Building a replacement hospital that is designed to operate on 42% less power than the current energy code standard

As an aggregate, Boston hospitals, including Partners Healthcare, have also made significant gains toward specific targets, resulting in cost savings conservatively estimated at $11.9 million:[7]

  1. From 2011-2013, Boston hospitals cut energy use by 6% compared to business as usual.
  2. Boston Mayor Marty Walsh challenged hospital facilities to achieve green house gas reductions greater than 25% by 2020 — MGH reached 35% reduction in 2014.
  3. Boston hospitals have, or are developing, significant Combined Heat and Power plants (CHP), which are approximately 25% more efficient than utility sources, can deliver 18% green house gas reductions, and reduce pollutant emissions that impact public health and welfare. This has been especially important with recent grid failures during extreme weather conditions.

Ways Going Forward

While Partners is achieving initial gains, it should continue to focus more granularly on the areas outlined in its strategy. Like its peers, Partners could purchase a larger share of renewable energy to reduce emitted greenhouse gases while also building more energy-efficient facilities to increase total patient capacity.[13] These ultimately can save dollars that could be spent on actual healthcare delivery to patients in need.

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  1. BostonGlobe.com. 2016. Mass. General explores possible new “green” pediatric hospital – The Boston Globe. [ONLINE] Available at: https://www.bostonglobe.com/metro/2016/10/23/mass-general-explores-possible-new-green-pediatric-hospital/ssXvD6Ts6JBf0XF05gdnGM/story.html. [Accessed 04 November 2016].
  2. Massachusetts General Hospital. 2016. #1 in the Nation – Massachusetts General Hospital, Boston, MA. [ONLINE] Available at: http://www.massgeneral.org/News/newsarticle.aspx?id=5409. [Accessed 04 November 2016].
  3. World Health Organization. 2016. WHO | Climate change and health. [ONLINE] Available at: http://www.who.int/mediacentre/factsheets/fs266/en/. [Accessed 04 November 2016].
  4. Forbes Welcome. 2016. Forbes Welcome. [ONLINE] Available at: http://www.forbes.com/sites/skollworldforum/2013/04/07/what-does-climate-change-have-to-do-with-health-care/#74ac7b303e69. [Accessed 04 November 2016].
  5. Chung JW, DO Meltzer. (2007). Estimate of the Carbon Footprint of the US Health Care Sector. JAMA. 2009;302(18):1967-1972
  6. 2020 Health Care Climate Challenge | Health Care Without Harm. 2016. 2020 Health Care Climate Challenge | Health Care Without Harm. [ONLINE] Available at: https://noharm-global.org/issues/global/2020-health-care-climate-challenge. [Accessed 04 November 2016].
  7. Boston Green Ribbon Commission. 2016. Health Care Working Group – Boston Green Ribbon Commission. [ONLINE] Available at: http://www.greenribboncommission.org/work/health-care-working-group/. [Accessed 04 November 2016].
  8. Sustainability | Innovation and Leadership | Partners HealthCare . 2016. Sustainability | Innovation and Leadership | Partners HealthCare . [ONLINE] Available at: http://www.partners.org/innovation-and-leadership/sustainability/. [Accessed 04 November 2016].
  9. Triple Pundit: People, Planet, Profit. 2016. How Hospitals Are Addressing Climate Change. [ONLINE] Available at: http://www.triplepundit.com/2014/10/hospitals-stepping-challenge-climate-change/. [Accessed 04 November 2016].
  10. Sustainability for Healthcare Management | Practice Greenhealth. 2016. Sustainability for Healthcare Management | Practice Greenhealth. [ONLINE] Available at: https://practicegreenhealth.org/tools-resources/sustainability-health-care-book. [Accessed 04 November 2016].
  11. Triple Pundit: People, Planet, Profit. 2016. How Hospitals Are Addressing Climate Change. [ONLINE] Available at: http://www.triplepundit.com/2014/10/hospitals-stepping-challenge-climate-change/. [Accessed 04 November 2016].
  12. Healthier Hopsitals: Participating Hospital. [ONLINE] Available at: http://www.healthierhospitals.org/about-hhi/participating-hospitals/. [Accessed 04 November 2016].
  13. Kaiser Permanente Share. 2016. Kaiser Permanente Makes Major Wind and Solar Energy Purchases – Kaiser Permanente Share. [ONLINE] Available at: https://share.kaiserpermanente.org/article/kaiser-permanente-makes-major-wind-and-solar-energy-purchases/. [Accessed 04 November 2016].


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Student comments on Unexpected Partnerships: Climate Change, Healthcare, and Partners Healthcare Hospitals

  1. A major concern with climate change is the potential for an increase in the incidence and severity of major storm events such as hurricanes and tornadoes. As a medical community the response to these events is often variable and depends on the local healthcare systems resources and ability to mobilize those resources. You mentioned that the local hospital communities in Katrina and Sandy were unable to provide the care needed for potential patients during the storm. If we are facing a world in which these storms are occurring more frequently, we cannot accept the outcomes in Sandy and Katrina. In response to this need, the healthcare community has founded seventeen disaster medicine fellowships to train emergency medicine residents in disaster medicine. MGH and the Harvard Emergency Medicine Residency program offers this fellowship. The fellowships consist of a one-year curriculum which aims to educate the fellows on how to produce an action plan for extreme scenarios such as a severe storm and how to work with a network of hospitals to put the plan into action. Action plans would consist of organizing the resources of the Center for Disease Control, Department Health and Human Services, Mediflight services, and local hospitals to make a coordinated response to disaster. With programs such as these producing experts in disaster health, the hope is that we can as a healthcare community continue to offer care to every patient during the severe weather events.

  2. Super interesting! I had never before thought of the health implications and taxes on our healthcare system resulting from climate change. It is great to see that MGH has 1) recognized its impact on climate change and adjusted its resource usage and 2) has been proactive in thinking about how it can better prepare for environmental changes.

    What I really took away from this is that it takes a lot of stakeholders to encourage energy saving measures. It concerns me because MGH is so large and it seems that it took the entire Partners network and mayor of Boston to put energy saving initiatives in process which makes me think this will be a challenge for smaller hospitals to be encouraged to adopt similar initiatives. I wonder if there is a way Partners could systematize their efforts and encourage smaller hospital networks to adopt these positive environmental actions.

    The first point about growing the healthcare system as a result of climate change is fascinating and I would love to learn more about how globally the healthcare system is preparing itself for an increased need for space and care. In one of the first cases we learned about a Heart Hospital that had a series of traveling doctor units that would essentially provide “pop-up” hospitals / care centers. I wonder if this solution could be applied in other areas of the world in the short term to deal with any health problems resulting from major weather crisis.

  3. Very interesting read on the accountability standards healthcare delivery firms are beginning to adhere to in light of the climate change threat. I am glad that you shed color on some of the proactive steps that Partners Healthcare is taking to promote energy efficiency and sustainability.
    1) I am curious to know if you believe hospitals are taking sufficient measures to better equip their emergency response systems, facilities and resources during extreme weather conditions. The need to set up backup water and electricity infrastructure and to ensure existing hospital facilities are retrofitted to withstand adverse weather conditions has become increasingly critical especially after witnessing the aftermath from hurricane Rita and Katrina.
    2) It would also be interesting to see if Partners’ effort in spearheading the Healthier Hospitals Initiative can translate into other initiatives such as entering into meaningful partnerships with insurance companies who have significant skin in the game when it comes to climate change. Some insurance companies such as Allianz have developed risk models to improve the predictability of floods and hurricanes which can prove valuable to the healthcare delivery sector.
    Thanks again for sharing!

  4. I had never thought about the effect of climate change on healthcare before, so I really appreciated it. The framework of mitigation, resilience, and leadership you gave was really interesting for me to think about, especially resilience because it wasn’t something that I thought would be pertinent to developed economies.
    I think it’s easy to see “saving lives right now” as the more immediate goal than the goal of “combating effect of climate change”. So I wonder if leadership is even more important in healthcare to make the changes you recommended, for goal-alignment purposes.

  5. Fantastic post! It’s quite interesting that the healthy food option is a new initiative to address the climate change issue (one would think healthy food would have been a norm in order to help patients stay healthy).

    Humor aside, given the enormous healthcare spending and the lack of lack of integration of the healthcare systems in place, it is of vital importance for hospitals to prepare for the effects of climate change. I think an opportunity to further decrease carbon emissions would be the hospital related transportation. Healthcare facilities rely heavily on transportation (from obtaining supplies, to moving patients, workers etc.). Including high-fuel efficiency or alternative fuel fleet in their plans would contribute to a further significant decrease in greenhouse gas emissions.

    On the food related note, MassHospital could further source local and seasonal food, reducing meat protein intake and minimizing food waste.

  6. To related this to my post, it is surprising that MGH has no EV charging station on any of its campuses or parking garages. I also haven’t noticed any solar panel. In the research buildings, the infrastructures are often very old and the hospital is not spending enough to upgrade things like lighting. Most are still using those long fluorescent light, which breaks often and are less energy efficient.

    I totally agree as one of the largest employer in the area, Partners Healthcare should prepare itself for climate change, and more importantly be a leader on this front.

    Partners Healthcare provide discounted T-pass to its employees, which is great but compared to other institutions such as MIT, the discount is relatively small. It also encourages commute by biking, but I believe it could do more than what they already offer. Their sorting and recycling could also be improved.

  7. This is a really interesting topic – perhaps healthcare is not the first thing that comes to mind when we think of climate change, but I completely agree that climate change will have a huge impact on healthcare. Mass General Hospital is a highly respected leader in research and treatment of many disease areas. I’m glad that its being proactive about making changes to be greener in light of climate change. I think this will set an example for other hospitals and hospital networks to do the same.

    In the areas that will be most impacted by malnutrition, malaria, diarrhea, and heat stress, how have hospitals been preparing to handle the increase in number of patients due to climate change? There may be possibilities for hospitals networks such as Partners to work in collaboration with hospital networks in developing countries to increase hospital beds, overall, capacity, and physician availability.

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