Overview Effective environmental stewardship requires passionate and committed leadership to minimize the impact of daily decisions on the environment. Given that reducing the carbon footprint of the healthcare sector is a shared responsibility, hospitals have a significant role to play. In this regard, M.P. Shah Hospital has developed its Green365 Strategy, which seeks to reduce the hospital's environmental impact and contribute to achieve sustainability.

Background

The environment is a crucial aspect of human life and must be protected through the conscious adoption of sustainable practices.

With climate change threatening to destabilize health systems in unprecedented ways, healthcare facilities have a pivotal role to play in reducing the sector's carbon footprint, building resilience against extreme weather events, shifting disease burdens, educating staff and the public, and promoting policies that protect public health from climate change. Leadership is critical in driving the adoption of climate and sustainability approaches in business strategies and plans.

M. P. Shah Hospital strives to improve its environmental performance in daily business operations and demonstrate leadership in environmental sustainability and the global fight against climate change. To this end, the hospital has developed its Green365 strategy, which seeks to reduce the hospital's environmental impact and ensure environmental sustainability. Green365 means that the hospital’s community wants to remain green 365 days a year, ensuring that environmental sustainability is an integral part of the patient-centred journey.

Solution proposed

M.P. Shah Hospital's Board approved and rolled out the Green365 Strategy, which is now an integral part of the hospital's "Sustainable Growth" pillar.

This pillar outlines relevant initiatives for the next five years and is one of the five pillars of the hospital's overall strategy.

The sustainable growth pillar comprises several initiatives and actions that are distributed across five areas: water, food, transport, green infrastructure, and top leadership. Through these efforts, M.P. Shah Hospital is committed to reducing its environmental impact and ensuring that sustainability is an integral part of the hospital's operations.

Water

Initiatives aimed at water management and conservation include harvesting-grey waters to water the gardens, installing sensor tap in public washrooms, dual flush toilets, and "reverse osmosis" drinking water dispensers, to reduce the need for bottled water, thereby minimizing plastic waste and conserving resources.

Food

The hospital implemented measurement of waste to reduce food waste.

Transport

To reduce emissions from transportation, initiatives include encouraging carpooling among the workforce during inter-clinic visits and outreach visits, as well as promoting carpooling for staff transport.

Green infrastructure

The hospital has implemented green landscaping, with the first activity being the planting of trees. The hospital also encourages biophilic designs that incorporate natural elements into the built environment to improve patient outcomes.

In addition, M.P. Shah Hospital has implemented negative and positive pressure rooms for patients' isolation and positive pressure rooms in the Central Sterile Supply Department to maintain air quality. It has also installed HVAC systems throughout the facility to maintain the right temperature and humidity. Mechanical ventilation systems have been installed in the Accident and Emergency and Intensive Care Units to ensure adequate air flow. The hospital complies with statutory regulations set by the National Environmental Management Authority, which is a government agency in Kenya that is responsible for overseeing and regulating environmental management in the country. Other engineering controls, such as vents and extractor fans, have been installed in toilets, with regular painting and air curtains. Infection prevention and control measures have been taken, such as converting wooden under-sink cabinetry to stainless steel and installing vacuum plants to handle suction bottles in the units.

Top leadership

The hospital has launched a green policy and programme and conducted an environmental impact assessment. Green champions and green committees have been established to promote sustainability and environmental consciousness throughout the organization.

Orientation and induction programmes have been implemented to encourage green behaviour among staff, while a diversity, inclusivity and equity policy ensures that the hospital's sustainability efforts are inclusive and equitable.

M.P. Shah Hospital has also signed the United Nations Global Compact. The hospital has integrated Green365 into its 2021-2025 strategy under the operational excellence pillar and has included Green key performance indicators into its balance score cards.

The senior leadership team at M.P. Shah Hospital comprises women, reflecting the hospital's commitment to full and effective participation and equal opportunities for leadership at all levels, including women in its senior management team. The hospital has a sexual harassment policy in place to ensure a safe and respectful workplace for all. Wellness and prevention packages are offered to promote a healthy lifestyle and prevent illness.

The Dinshaw Byramjee Clinic, a clinic to reach out to the bottom-of-the-pyramid continues to support universal health coverage by providing affordable and accessible medical services.

The hospital recognizes the importance of mental health and has a dedicated employee support group to address mental health concerns. It has also set up an infectious disease department to manage infectious diseases and prevent their spread.

In addition, the hospital has a nursing school and continuous medical education forums to ensure that its staff has the necessary skills and knowledge to provide high-quality care.

The challenges

Adopting environmentally sustainable health systems is a daunting task for hospitals in developing countries. But if each hospital does its parts, this can reduce the carbon footprint at a country level and eventually at a global level.

The healthcare industry needs to do a lot more to contribute towards implementation of green strategies for a sustainable healthcare future and usually the barriers centre around having enough funding and resources.

Sustainability in healthcare is a new field, thus little information is available.
High cost of published interventions requires innovation and creativity.
Budgetary constraints that slow the transformation of old buildings to green buildings.
Change management among staff and patients to encourage green behaviour such as e-waste recycling, reduced consumption of red meat, etc.
Inflation has increased the cost of utilities and supply chain despite managing consumption. Thus, eroding the financial benefits of the green initiatives.

Expected impact and vision of the project

This project aims to mitigate negative economic, social, and environmental impacts while building resilience to unforeseen stressors in the future, including potential pandemics. It will assist healthcare staff review the facility’s environmental performance in terms of green buildings, green human resource management and gender diversity. It will also develop a culture of resource optimization and utilization through training and education programs to develop collaborations with stakeholders and use the framework for competitive advantage.

Integrating sustainability into the operational strategy of healthcare facilities will position it to meet changing regulations promptly, hence, lowering reputational and legal risks.

Measurable impacts

Green supply chain – Zero reduction of stock outs of critical medicine
Green HR – Improved employee engagement through green human resource management. Pooled wellness programmes: monthly prayers, fortnightly Zumba sessions, monthly birthday celebrations.
Green leadership – Employee engagement surveys, culture of safety surveys, leadership rounds, peer mentorship of leaders; measuring individual sustainability behaviour through performance management.
Energy conservation – Reduction of energy consumption from the main grid, increased solar utilization.
Water conservation – Reduced water conservation by water harvesting, zero purchase of bottled water, installation of reverse osmosis plants, recycling grey water.
Green buildings – Improved air quality, lighting, and temperature.

Co-benefits

Implementing sustainable healthcare practices provides a range of health co-benefits. Green landscaping can improve the mental health and wellbeing of patients, staff, and visitors. Proper disposal of electronic waste and textiles can reduce the risk of hazardous chemicals exposure and pollution, which can lead to better overall health outcomes. Improved infection prevention control standards can reduce the spread of diseases and infections within healthcare facilities, improving patient outcomes and reducing healthcare costs.

Sustainability case studies