1. Climate Change Uncertainties: Opportunities for Business Innovation? The Business Perspective: UPMC Allison Robinson, PhD, MS Director, Environmental Initiatives University of Pittsburgh Medical Center March 27, 2008

2. Acknowledgments UPMC thanks the Heinz Endowments for providing initial funding of our Environmental Initiatives Program. Through organizational collaborations, we are achieving mutual goals for the benefit of communities served.

3. Agenda About UPMC Awareness Actions Anticipated Outcomes

4. About UPMC The region’s largest employer, with 48,000 employees –UPMC is the number one employer in Allegheny County with 45,000 employees Nearly $7 billion in revenue

5. About UPMC 20 hospitals 400 outpatient sites and doctors’ offices, retirement and long-term care facilities In a typical day, –more than 2,600 patients are cared for as in- patients –more than 8,000 people are treated through outpatient clinics and facilities

6. About UPMC An insurance plan with more than 1 million members About 5,000 physicians are affiliated with UPMC –including nearly 2,500 employed physicians Commercial and international ventures –International presence with facilities located in Ireland and Sicily

7. About UPMC Recent environmental awards and recognition: –Magee-Women’s Hospital of UPMC: April, 2006: Hospitals for a Health Environment (H2E) Awards – –“Making Medicine Mercury Free” –“Partner Recognition” October 11, 2007: U.S. Environmental Protection Agency, Office of Children’s Health Protection –“2007 Children’s Environmental Health Excellence Award”

8. About UPMC Recent environmental awards and recognition: –UPMC Children’s Hospital of Pittsburgh: October 11, 2007: U.S. Environmental Protection Agency, Office of Children’s Health Protection –“2007 Children’s Environmental Health Excellence Award” –UPMC Presbyterian-Shadyside Hospitals: UPMC Shadyside/Hillman Cancer Center - 2006 Partner Recognition Award, 2007 Making Medicine Mercury Free UPMC Presbyterian – 2007 Partner Recognition Award, 2007 Making Medicine Mercury Free

9. Awareness of Climate Change: Perceptions Business’ sense of responsibility –Corporate Social Responsibility Goals: Minimize harm Maximize benefits Be accountable and responsible to key stakeholders Support strong financial results –http://www.bcccc.net/index.cfm?fuseaction=Page.viewPage&pageId=567&nodeI D=1&parentID=473 [accessed 3/20/08]http://www.bcccc.net/index.cfm?fuseaction=Page.viewPage&pageId=567&nodeI D=1&parentID=473

10. Awareness of Climate Change: Perceptions UPMC’s sense of responsibility: –Minimize harm Nature of healthcare business Organizational and program mission –Maximize benefits Nature of healthcare business Organizational and program mission Promote health prevention –Climate change has potential adverse health effects

11. Awareness of Climate Change: Perceptions Business of healthcare –Sustained health  survival –Approached to business: Intervention (major) Prevention (minor) –Need to balance approaches Some prevention practices should result in reduced environmental impacts

12. Awareness of Climate Change: Perceptions UPMC’s Sense of Responsibility: –UPMC’s Mission: To provide outstanding patient care to shape tomorrow's health system through clinical innovation, biomedical and health services research, and education. –UPMC’s Environmental Program Mission: To implement systemic change through education, internal and external collaboration on policy development and policy implementation To achieve the expected result of sustained health service quality, environmental risk reduction, and improved resource conservation

13. Awareness of Climate Change: Perceptions UPMC’ sense of responsibility –Be accountable and responsible… Provide affordable healthcare services Voluntarily practice, comply, and maintain leading operational and service quality standards –Joint Commission –Sarbanes Oxley Participate competitively in industry – …to key stakeholders

14. Awareness of Climate Change: Perceptions UPMC’ sense of responsibility –Be accountable and responsible to key stakeholders: Patients Regulatory agencies Communities Professional and Industry groups Contractors and Vendors

15. Awareness of Climate Change: Perceptions UPMC’ sense of responsibility –Support strong financial results Nearly $7 billion in revenue Through Strategic Business Initiative, promote regional business development in support of healthcare service delivery

16. Awareness of Climate Change: Realities Green Products and Services Healthcare Industry –USGBC’s pending LEED for Healthcare Green Guide for Healthcare –Global Health and Safety Initiative Practice Green Health –DOE’s EnergySmart Hospitals Program

17. Actions with respect to Climate Change UPMC Environmental Initiatives Program –Systemic initiatives Reduction of environmental impacts Existing resources and services –Systemic policy development Behavioral change Culture change –Approaches reflect multifaceted perspectives Internal operations –Clinical and non-clinical External interests

18. Actions with respect to Climate Change UPMC Environmental Initiatives Program –Gap Analysis (Business Opportunity?) Industry UPMC –Problem Definition Industry relevance Scope and Scale -UPMC -Healthcare

19. Actions with respect to Climate Change : Example Initiatives Environmentally Preferred Purchasing –Availability and accessibility of products –Hospital grade vs consumer grade Characteristics –Durability vs biodegradable –Infection control Energy Management –Healthcare’s demand in national comparison –DOE’s EnergySmart Hospitals program

20. Anticipated Outcomes of Actions Actual: –Research, research, research Anticipated: –Realistic: Better service for patients Better healthcare –Ideal: Reduced need for intervention services