HEALTH SERVICES 5. To recognise how rising demand for healthcare is putting strain on both point of...
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HEALTH SERVICES
5. To recognise how rising demand for healthcare is putting strain on both point of care services and the global ecosystemDefine the concept of sustainability
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Source: The Economist
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150 years 100 years 50 years NOW
First Oil Well
4142 cars, 10 miles concrete road in US
240,000,000 PCs
650,000,000 cars
4,800,000,000 passenger flights/year
First commercial jet ticket
First home PCDomestic light bulb
We’re releasing 350 million years of
buried CO2 VERY quickly…
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Energy Information Administration, 2009
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Need, demand, and supply
• What do these figures tell us about current and future need, demand, and supply?
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Social
Environ-mental Economic
Development that “meets the needs of the present without compromising the ability of future generations to meet their own needs.”
Brundtland Commission
Sustainable development
Climate change/ carbon reduction?
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HEALTH SERVICES
6. To discuss concepts of equity and equality in a global contextTo understand how climate change will exacerbate global inequality
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Global inequality
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What are our responsibilities?
• Should everyone be entitled to the same set of health resources?
• Should everyone be entitled to a ‘minimum set’ of health resources?
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The world map reflecting production related to climate change.
Who produces the greenhouse gases?
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Who bears the burden?
The world map reflecting mortality related to climate change. “Climate Change presents the biggest threat to health in the 21st Century” The Lancet (373;9697 pp 1659-1734, May 16-22 2009).
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What are our responsibilities?
• Should everyone be entitled to the same set of health resources?
• Should everyone be entitled to a ‘minimum set’ of health resources?
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HEALTH SERVICES
7. To understand environmental indicators and how they may be applied in healthcare management
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1 tonne per day
112g CO2/km
Average UK person: 8 tonnes per year
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Social
EnvironmentalEconomic
The ideal evaluation?
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HEALTH SERVICES
8. To discuss how carbon as well as capital could be seen as a scarce resource to be allocatedTo understand that doctors working in the NHS share their institution’s legal duty to reduce greenhouse gas emissions 80% by 2050 (Climate Change Act 2008)
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Carbon Reduction Targets
• How might efforts to reduce carbon:– Reduce health inequalities– Exacerbate health inequalities
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1.Prevention of disease, health promotion
2.Greater engagement of patients in managing their own care
3.Lean care systems: minimising low value activities (including travel)
4.Preferential use of effective & proven technologies with the lowest carbon footprint
Principles of sustainable clinical practice
Mortimer-F. The Sustainable Physician Clinical Medicine 2010, Vol 10, No 2: 110–11
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Sustainability & Quality of Care
Patient safetyEfficiency
Clinical effectivenessEquity of access
TimelinessPatient experience
Sustainability ?
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Your turn: identify an opportunity to improve sustainability in your medical school or in a clinical setting and the channels
by which change can be brought about.
• What unsustainable practices can you think of:
• a) On a general medical ward? • b) In an operating theatre?