Willi Haas, Ulli Weisz IFF Institute of Social Ecology Vienna, Klagenfurt University

td-conference, 2010, Geneva – Willi Haas, Ulli Weisz, 1

hospitals & sdhealth & sd environ. efficiency productoutcome quality

A significant sustainability question: Increase number of health treatments or increase public health?

Willi Haas, Ulli WeiszIFF Institute of Social Ecology Vienna, Klagenfurt University

td-conference, September 2010, Geneva, Switzerland



• manifold relations between health and sustainable development

• public health is an objective of sustainable development

• public health is a means to achieve sustainable development

health & sdhealth & sd



• health care systems in developed countries contribute significantly to climate change

• climate change threatens public health




Anteil der Krankenhäuser am österreichischen CO2-Ausstoss inkl. Vorleistungen

Source: own calculations using an extended IO-table for Austria based on NAMEA 2000 and national accounts 2000

HOSPITALS

Share of hospitals on Austrian CO2 emissions 2000 (direct and indirect)

17.043

13.724

22.77017.326

0

5.000

10.000

15.000

20.000

25.000

1997 1998 1999 2000 2001 2002 2003 2004

OECD/NA-concept SHA

Source: OECD, Statistik Austria

9,6% of GDP

7,5% of GDP

National costs for health care system




• While the health care systems core business is to cure, it threatens public health

• Green hospital initiatives can not address this issue sufficently




3. Specific actions and examples of change in the health-care setting

3.1 Energy efficiency3.2 Green building design3.3 Alternative energy generation3.4 Transportation3.5 Food3.6 Waste3.7 Water


2009



Energy consumptionin kg oil equivalents per person and year

Average life expectancy and average energy consumption per capita of more than 100 countries for 2003Quelle: Wilkinson Paul, R Smith Kirk, Joffe Michael, Haines Andrew (2007): A global perspective on energy, health effects and injustices. Series Energy and Health 1. The Lancet: 5-18

Life

exp

ecta

ncy

in y

ears

76

In developing countries the more energy consumption the higher the life expectancy

In developed countries energy consumption and life expectancy are independent from each other

environ. efficiency



• Global problems require a fundamental change how our societies operate, if we want to avoid unfavourable development of living conditions

• Health systems in developed countries need to change as well

• In addition to energy efficiency of single units e.g. hospitals health systems need to be efficient as a whole – relation of output public health situation to environmental pressure

environ. efficiency



• There is very little information available on the health systems environmental efficiency. However, it seems to be that there are many possible path ways – e.g. prevention

• What you don‘t observe you do not react upon

• What then hospitals can do?

environ. efficiency

• Instead of focussing on maximising number of treatments the most efficient improvements of the public health situation are required



• Analysing hospitals reveals serious sustainability problems

• Aging society

• More and more is possible

hospitals & sd

• More complex illness patterns• Shift from acute to chronic • Medical science/technical progress

• Financial constraints• Health jobs count already as most burdened



• Sustainable solutions have two basic requirements if they want to be successful:

• They need to be scientifically plausbile to be appropriate to reduce global sustainability problems

hospitals & sd

• They need to be attractive and feasible for the ones who have to take action

• Solutions require a co-production from actors form practice and science



• Collaboration over years with hospitals and with health promotion researcher

• In varying and complex settings between scientists and actors from hospital association, hospital management, nursing and medical staff

• Key were networking meetings

outcome quality



• Outcome quality: To observe and minimize side and long term effects of the core business

• With other words to become more sensitive on issues of problem shifting

outcome quality



Environments of the Hospital

Hospital

Economical Sustainability

Ecological Sustainability

SocialSustainability

Grafik-Design: Angy Rattay

A multi-criteria approach for a “Sustainable & HP hospital”(developed and tested in the “Sustainable Hospital Project”, Vienna 2007-10)

Health Promotion

Diagnostic Treatment

outcome quality



Environments of the Hospital

Hospital

Economical Sustainability

Ecological Sustainability

SocialSustainability

Grafik-Design: Angy Rattay

By a multi-criteria approach defining a “Sustainable” & Health Promoting hospital(developed and tested in the “Sustainable Hospital Project”, Vienna 2007-10)

Health Promotion

Diagnostic Treatment

These criteria have to be implemented in the hospital by … Explicit policies, targets, action planes,

indicators, … Defined responsibilities (roles, units) Integration in management system (QM,

Balanced Scorecard, … and/or special environmental MS such as EMAS, ISO 14000)

Monitored operational change in core & support processes


hospitals & sdhealth & sd environ. efficiency productoutcome quality product

http://www.das-nachhaltige-krankenhaus.at/



Thank you for your attention!

Contact:[email protected]@uni-klu.ac.at

f i n

Willi Haas, Ulli Weisz IFF Institute of Social Ecology Vienna, Klagenfurt University

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