Healthcare sustainability: how one nurse is enacting change (and how you can, too!)

In 2009, we posted an interview with Erika Kimball, RN, BSN, entitled “How one nurse is transforming her hospital into a ‘Green Zone.’” The popular piece (republished this year) tracked Kimball’s efforts to create as much sustainability as possible at her California hospital.

Now, five years later, she’s filling us in on her progress and what the future of sustainable healthcare holds:

Scrubs: What new initiatives have you been working on since you last talked to Scrubs?

Kimball: I am still working part-time as a nurse and doing sustainability work with hospitals and healthcare. My main sustainability project over the last two years has been implementing the clinical recycling program at a major teaching hospital in the San Francisco Bay Area. We also conducted a comprehensive pilot study that shares best practices for clinical recycling. I am also currently working on a few additional projects, including developing green business standards for outpatient clinics and practices.

Scrubs: How can nurses across the country help further (or start!) sustainability programs at their own hospitals?

Kimball: Get involved, educate yourself on current sustainability initiatives and make your voice heard. Nurses are holistic health advocates, and we see firsthand the link between environmental health and patient health. We must speak up for environmentally sound healthcare practices. Join your hospital green team. If there is no green team, join one of the many quality or excellence committees, and champion sustainability as part of the group’s work. Nonprofits including Healthcare Without Harm and the Healthier Hospitals Initiative provide free online guides for projects you can undertake through your hospital’s sustainability or quality groups.

Scrubs: How hard has it been to enact change?

Kimball: Change is difficult. Hospitals have many competing priorities, and sustainability is largely still ranked as a “should-do” in a field of “must-dos.” I began my sustainability journey by launching programs in the hospital: starting a supply collection program and then founding my hospital’s green team. Every hospital is different, but I don’t know that every hospital needs a green team. I think that sustainability should be viewed as a platform upon which quality, safety, efficiency and patient experience are improved.

As a consultant, I’m brought in by organizations that are already onboard with sustainability. The key to success is smart program design, as you have to make it easy to do the right thing. Education and outreach are also key factors for implementing and maintaining positive change. Think about initiatives such as hand washing or safe patient transfers. Just like these initiatives, sustainability takes ongoing education, outreach and attention.

Scrubs: What do you see as the biggest hurdle in “greening” healthcare?

Kimball: I think one of the biggest hurdles is being cleared. A lot of healthcare resource use takes place in the hospital setting. The push for “greening” healthcare largely began in the hospital, and as we noted above, change can be challenging in the hospital. Industry partners are now taking a much bigger role in facilitating sustainability. Supply and device manufacturers, major equipment makers and pharmaceutical companies are all improving their environmental performance and partnering with clinics and hospitals to help them do the same.

The voice of the customer drives change in industry, and healthcare is a massive industry. I think the biggest opportunity for creating positive change as clinicians is to demand sustainability from our industry partners, just as we demand safety and quality.

Scrubs: What do you think the next big step needs to be?

Kimball: I think the next big step is recognizing sustainability as a tool to improve outcomes, versus an item on the to-do list. Whether you’re a device manufacturer ensuring safe working practices in factories, a doctor incentivizing alternative transportation among office staff, a pharmacy providing a take-back program for unused medications or a nurse educating patients on use of nontoxic cleaners at home—sustainable practices benefit health. The healthcare industry as a whole benefits from taking a more active role in the sustainability movement.

Nurses, what do you think of Erika’s points? How is your hospital progressing in terms of sustainability, and what are you most hoping to see happen soon? Tell us your thoughts in the comments below!