1. Greening Healthcare A first step Mark Ballard Lisa Mu Sarah Khan Joanna Oda

2. What is Sustainable Healthcare? Currently many hospitals only look at patient healthcare vs. financial budget Hospitals should look at three factors: Patient Healthcare Financial Budget Minimizing Environmental Harm

3. Outline Global Warming and Hospitals Canada’s Commitment Why Teach Sustainable Healthcare What others are doing about Sustainability The Role of DPAS in Sustainability What Medical Students need to know Rough Course Details Conclusions and Questions

4. Global Warming An Inconvenient Truth Provides a good Overview Humans are the primary cause of Global Warming

5. Healthcare and Global Warming Healthcare is second only to the manufacturing industry in its generation of pollution Healthcare makes up 10% of Canada’s GDP Thus major consumer Thus major polluter

6. Hospital’s Ecological Footprint The average Canadian  7.66 hectares The average American  12.22 hectares The average Asian  1.78 hectares Vancouver City  180 X its political boundaries A Canadian Hospital  700 X its actual size

7. Hospital’s Ecological Footprint Points of Interest  Energy use contributed to 88% (the energy consumption for developed nations is 50%)  8.2 pairs of gloves per patient per day were worn  Of 220 tonnes of paper 97 tonnes were recycled  Companies were unwilling to provide information on product composition  Food was not calculated  Building maintenance was not calculated

8. Pollution’s Impact Pollution and ecotoxicity Resource depletion Climate and atmospheric change Reduced ecosystem health

9. Healthcare’s pollution Clean general waste Recyclables Biomedical waste Gaseous, Chemical and liquid waste Radioactive waste Pharmaceutical waste Miscellaneous waste

10. Canada’s Commitment Kyoto Accord  Carbon dioxide emissions 5% below 1990 Levels  Huge Public Support  Political and economic objectives not competitive with US

11. Canada’s Commitment Asia Pacific Partnership on Clean Development and Climate  An agreement signed by US and Canada to promote the collaboration between countries in the development of clean energies  “a deal on climate change that doesn’t limit pollution is the same as a peace plan that allows guns to be fired” –Worldwide Fund for Nature

12. What has been done in other places United States  New Hospitals Built to LEEDS standards Leadership in energy and environmental sustainability development Ontario  Waste Disposal Improvements  Air Cleaning  First LEED hospital

13. What has been done in other places British Columbia  Interior Health Authority 3 LEED Hospitals  Recognized by the Government  Research on adverse effects done by Healthcare  Capital Services wrote up rules on new hospital design

14. What are the policies of selected Health Authorities Vancouver Coastal Health  No response, no Publications Vancouver Island Health Authority  Forwarded e-mail to another department Northern Health Authority  Purchases bulk quantities BC College of Physicians and Surgeons  No Response, no publications

15. Why Teach Sustainability Primum non nocere- First do no harm Healthcare pledges to not hurt people Healthcare generates pollution Pollution hurts people Hospitals should reduce pollution  In fact healthcare should take a role of leadership in this area

16. What the student’s want to learn What can I do? Work-Life Balance  Too much personal spending Excessive Paper Too much Recycling  And not enough reusing and reducing Lack of foresight in building design

17. Where does DPAS fit? DPAS

18. Considerations Students in Hospital can consider actions they are making New Family Physicians can make considerations in the location of their family practice offices

19. Current Decision Tree Number of Patients Cost of Rent

20. New Decision Tree Number of Patients Cost of RentEnvironmentally Friendly

21. The Decision Making Model Many Patients vs. Few Patients High Rent vs. Low Rent Green Decision vs. Wasteful Decision

22. What can be done practically In Addition to a theoretical thinking model practical ideas for inspiration can be brought up  Staff Training Programs  Proper disposal procedures  Influence on administrative decision making

23. Summary DPAS can provide:  Knowledge of the ethical duty of healthcare to the environment  A theoretical model to help students make environmentally sound decision in the hospital and at home  Inspiration on practical solutions that students can take to make things a little greener

24. Potential Instructors Dr. Warren Bell Dr. Bob Wollard Dr. Trevor Hancock  Very knowledgeable in this field  Provided many of the sources for this presentation

25. Conclusions Sustainable healthcare is recognized, but, not acted upon. DPAS is in an optimal position to be a leader in this area Important for the future of our planet, of our patients and of our families.

26. Student Initiatives PEAS Approaching University of Ottawa Medical Faculty Approaching Selected Hospitals in Victoria Vancouver Coastal Health

27. Acknowledgements Dr. John Anderson Physicians For Global Survival Dr. Trevor Hancock