Mary Dunn

More than 20 years ago, the IOM report To Err is Human prompted the industry to realize that our healthcare system causes approximately 98,000 deaths each year due to medical errors. I am part of a generation of professionals who have learned to adopt systems thinking; measure, monitor and improve; and ultimately improve the quality of care.

Today, we face a series of different challenges. Healthcare is in the midst of a global pandemic, and this is a reckoning of systemic racism, let alone a huge resignation. However, we are also facing a climate crisis. Are these things related? Is there anything we can do? The answer is undoubtedly yes. I am writing to advocate the inclusion of climate change in the list of strategic and ethical requirements for healthcare leaders everywhere.

why is that?

• Even today, the health care industry’s emissions of climate change are causing deaths. In 2018, greenhouse gas emissions from the healthcare industry alone led to 388,000 disability adjusted life years lost.
• The impact of climate change on health is inseparable from the problem of systemic racism. E.g, Redlined community (Racist housing policies that lead to systemic underinvestment) are warmer than unexperienced communities, and higher temperatures can kill lives.
• climate change Make the conditions for the spread of certain infectious diseases more favorable Diseases include epidemics, but also diseases that have a major impact on health, such as Lyme disease and water-borne diseases.

As the world changes, it is time for healthcare leaders to develop a new set of strategic priorities to meet the health system’s readiness and adaptability needs in this situation.

So in this situation, what can you do to influence the change?

First, accelerate the understanding of the intersection of health and climate. The information is there, so take some time to consume it. Harmless health care It is the leading non-profit organization focusing on this subject in the United States, and has many abundant resources available for use.I learned a lot from publications like The Lancet Countdown to climate change and health Questions and books Environmental medicine with What we can save.

Reading is important, but don’t let it be your only action. Here are some steps to be taken.

See how climate fits into your organization’s strategic plan and embed measures that link your organization’s success to its climate change efforts. Your organization can demonstrate its efforts to impact climate change in two main ways.

One set of actions is to reduce emissions. This may seem like a switch to renewable energy, a review of your organization’s investment portfolio, and most importantly, healthcare efforts to reduce emissions from the supply chain.

Another set of actions is related to adaptation. In short, since climate change has already occurred, this is about developing a strategy to help your community-but you define the community (local, regional, national)-to deal more effectively with the impacts of climate change that exist today , And it will get worse in the future.

It is almost impossible to maintain the progress of the plan without a way to measure progress, so this means that it is very important to incorporate climate-related measures into the organization’s strategic plan. In terms of mitigation, this may seem like an effort to become a net-zero institution (Caesar In the U.S. and National Health Service Is the leader of this journey). In terms of adaptation, perhaps your organization has picked some metrics relevant to your community from the recent Lancet Climate Change and Health Report and tracked its efforts and progress.

Help people establish connections between climate and existing strategic projects and skills.

In many cases, climate change is far from and irrelevant to the pressing issue at hand. At the same time when major problems arise, people may worry that we will not be able to get rid of such major events as the Covid-19 response. I am not advocating that we abandon these immediate priorities, but I do think we need to add a climate-conscious lens. Establish links to show that through the hard work we are already doing, we can have a greater impact from a climate perspective. E.g:

• Are you discussing the social determinants of health? Link these conversations with the climate-Climate change is a social determinant of health.
• Are you working hard to improve your supply chain? As many organizations consider the effectiveness of their supply chains after the pandemic, it is time to add a sustainability perspective. As the world becomes more emissions-focused, so will healthcare. Healthcare organizations have huge purchasing power that can be used to achieve positive goals. It is easy to think that sustainable development may always be more expensive. But there is a lot of waste in the healthcare field, so efforts to reduce emissions can not only reduce emissions, but also reduce costs.
• Are you discussing value-based payments? There is readily available information about heat waves and air quality, and these environmental conditions have a real impact on human health.review CDC’s assessment of the regional impact of climate change on health. Is there a way to systematically add some indicators related to heat, air quality or other related factors to your care management plan, and adopt a set of related interventions to better help your community adapt?

Find your community.

I don’t consider myself an expert on climate change, and I guess you may not either.

But as healthcare professionals, we have a lot to discuss climate issues, just as we have a lot to learn from people working in other fields. What I do know is that no one can solve this challenge and it is important to find the community.

Here are some ideas:

• Involve your supply chain and finance teams. Often behind the scenes, these teams will play a key role in helping your organization move forward.
• Utilize existing infrastructure. CDC has invested in climate and health through its capabilities in multiple states. Support plan. Take a look at what may be in your community that you can learn from and build.
• Contact your partner in public health or healthcare services. The healthcare delivery system and public health can play complementary roles. Weaving resources and initiatives will help the community go further.
• Provide seed funding for community organizations. Like many healthcare jobs, community organizations play a key role. These may not be new relationships, but relationships that have been established through other initiatives. Community-based organizations essentially operate on small budgets. Consider how to channel resources into these organizations to ensure that they become partners and adjust your efforts around topics such as VBP, climate, and other work. Find a way for them to take the lead in reaching the communities they serve.
• Based on your community data resources (HIE, etc.). Many community-based data projects are reimagining their future. Can these organizations become community resources, providing data sets or services that cannot be provided by a single organization, involving topics such as climate change?

Take the small change test as the forerunner.

When faced with the amazing assessments of medical errors made by the Institute of Medicine, we lead with beliefs, quizzes on change, and systematic thinking.This topic is gaining momentum, and institutions like the National Academy of Sciences and HHS Show their intention to actHowever, market forces are not yet in place to put climate change on the agenda of every medical institution. This is where your voice, beliefs and actions matter. Chances are that you can do some small things today to help your organization achieve change and build momentum. A small change test can make a big difference.

Marie Dunn is a public health professional and health director who has worked in the intersection of analysis, population health and climate for a long time.