Professor of Operations Management
Senior Researcher, Healthcare
The central theme of the 9th Vlerick Healthcare Conference, which took place on 27 October 2022, was sustainability in the healthcare sector. The latest insights from the academic and professional world were shared in a lively, interactive setting with plenary lectures and thematic sessions. Professor Brecht Cardoen (Vlerick Healthcare Management Centre), researcher Esther Van Haute and Julie Leblanc (Vlerick Alumni Healthcare Club) look back on the event.
The transition to sustainability has begun and the interest in this theme is becoming clearly evident in the health sector. With the growing climate and energy crisis and the increasing pressure on all countries, companies and organisations to change their working methods, this sector will also need to accelerate. According to Dr Michael Wagemans (Partner and Head of Sustainability & ESG at KPMG Belgium), you can summarise the meaning of the word ‘sustainability’ as long-term value creation, but this meaning also depends on the relative emphasis on the various aspects of the social, economic and environmental dimensions of sustainability. This involves the responsibility borne by organisations for their impact on society, with a focus on reducing the negative impact (e.g. greenhouse gas emissions) and promoting the positive impact (e.g. increasing access to healthcare for vulnerable target groups). With initiatives such as the Covenant of Mayors 2030 and the shift to renewable energy, we have also started down this sustainability path in the healthcare sector but are facing many challenges along the way.
Worldwide, healthcare organisations make a significant impact on the environment. For example, healthcare is responsible for the fifth largest contribution to greenhouse gas emissions worldwide, 5.5% of total greenhouse gas emissions in our country can be attributed to the healthcare sector and about 8.4 kg of waste per person is produced per operation in a Flemish hospital1. The numerous initiatives of healthcare organisations to reduce their environmental footprint are therefore not going unnoticed. Attention to themes such as diversity and the accessibility of affordable care is also increasing. However, a sustainability plan is indispensable with a view to coordinating these diverse initiatives and anchoring sustainability in an organisation. But how can you get started?
There are four important steps towards greater sustainability, starting with thorough reflection and defining the social impact that an organisation wishes to have. This is about defining your purpose, with a view to creating a lasting impact. This objective will form the basis of your sustainability plan. Dr Michael Wagemans notes that not every organisation has the same ambition, and that you can differentiate between a compliance, strategic or transformational approach. Depending on this choice, a different implementation plan will be carried out with a different need for willingness to change.
When you draw up a sustainability plan, you will soon notice that sustainability has numerous dimensions with many more important challenges to overcome. These include waste disposal, diversity, data protection, greenhouse gas emissions, etc. In order to create sustainable value and not get swamped by endless unstructured projects that fizzle out over time, it is crucial to set priorities for the goals that you want to achieve as an organisation. Professor Kerstin Fehre points out the importance of a ‘materiality matrix’, an instrument that links the importance of actions for stakeholders with the performance of the organisation or company. When considering these sustainability issues and setting priorities, it is important to involve all the stakeholders in this dialogue and thus to achieve a broadly supported sustainability plan. The United Nations Sustainable Development Goals can be an important source of inspiration here.
There is often no shortage of committed messages after these reflection exercises, but how do you actually apply sustainability in practice? Sustainability needs a strategy. It's all about translating your sustainability objectives into actions. During the conference, Keira Driansky (Country President Belgium & Luxembourg - AstraZeneca) and Thomas Canon (Sustainability Program Director - IBA) shared their insights into which initiatives are being taken within their company to convert their strategy into actions. Both speakers immediately made it clear that it is not enough to add sustainability as an additional item on the strategic agenda, but that it should form part of every current strategic agenda item in order to anchor sustainability in the organisation both now and in the long term. It also became clear that striving for the right balance may be the biggest challenge: the balance between stakeholders (patients and planet), but also the balance between purpose and profit. Stefaan Claeys (Facility Director of the Imelda Hospital in Bonheiden) also demonstrated that organisations which operate sustainably need to integrate their sustainability goals into all decision-making processes, and therefore also into the investment process. We need to be vigilant, as we can sometimes find threats to our sustainability goals tucked away among promising innovations. For example, the sky-high energy consumption of hardware and the storage of image material that must be retained for many years can have a significant impact on our sustainability goals, both ecologically and financially. Take the 7-Tesla MRI, for example, whose high image quality also has a high cost. Achieving a balance between the long-term advantages and disadvantages is therefore essential.
Finally, it remains important to monitor your sustainability objectives and the implementation of your sustainability strategy by defining KPIs in the area of ESG. ESG (Environment, Social and Governance) refers to a framework that emerged from the financial world with a view to evaluating the environmental, social and governance aspects of a company, in order to help investors assess the long-term viability of a company's actions2. Currently, this framework is also being used by many leaders to make their sustainability plans controllable and measurable.
If we look beyond sustainability at the organisational level, we can still see many challenges ahead. During this conference, the focus lay not only on creating a sustainable organisation, but also on creating a sustainable healthcare system in which all stakeholders are involved and work together in an integrated manner. Because of our humanitarian responsibility as a sector, we must ask ourselves how we can work together to shift to sustainable care so we can keep people healthy without making our planet sick. Dr Eveline DeCoster, dermatologist and advisor to Zakia Khattabi – Federal Minister for Climate, Environment, Sustainable Development and Green Deal – has already given us a few tips.
From the European Union, the transition to sustainable healthcare is accompanied by the provision of a European reference framework, the European Green Deal. This EU Green Deal forms a roadmap – encompassing environmental, economic and social aspects of sustainability – to accelerate the move towards a clean and circular economy in Europe, promote resource efficiency, reduce pollution and reverse the loss of biodiversity.
However, sustainability is also being considered at a global level. Following COP26 (Conference of Parties) in November last year, at which Belgium also made the promise to develop sustainable health systems in order to be climate-neutral by 2050, a commitment known as the Alliance for Transformative Action on Climate and Health (ATACH) was drawn up at the international level. Within this alliance, the ambitions are to be realised by using the collective power of the WHO member states and other stakeholders to advance this agenda in terms of pace and scale and to promote the coherence between climate change and health in national, regional and global plans.
The feedback from ATACH is also integrated into the Belgian National Environment and Health Action Plan (NEHAP3). The National Environment and Health Action Plan provides a global, coherent action framework in the areas of environment and health at all institutional levels in Belgium. NEHAP3 aims to offer a toolbox for practical, coordinated actions and promotes synergies at all levels: between players, sectors, topics and policies.
In Belgium, we will also have to say goodbye to linear economies and move towards circular economies in which waste is kept to a minimum. As part of the Belgian National Recovery and Resilience Plan (NRRP), the federal government wishes to support innovative projects that contribute to the implementation of activities and/or applied research in four specific sectors, including healthcare. In conjunction with Pierre-Yves Dermagne, Minister Zakia Khattabi has therefore made an initial call for projects, namely Belgium Builds Back Circular.
At our conference, we were already able to witness a number of projects that tie in perfectly with this transition towards circular economies. According to Arianna Gamba, Programme Manager for Circular Healthcare at Health Care Without Harm Europe, hospitals are heavily dependent on plastic goods in their daily activities and this increases their environmental footprint. On the other hand, we are seeing a shift towards the greater use of disposables and biobased products. Although some disposables and biobased products are recyclable, Gamba argues that recycling is not the final solution for tackling the sector’s waste problem. The mission of Health Care Without Harm is to encourage the use of more sustainable products through their waste hierarchy. By means of the hierarchy, they emphasise the need to reuse, reconsider and redesign the products that hospitals are currently using. Building on these arguments, we heard from Joost van der Sijp, surgeon, oncologist, co-founder and director of GreenCycl, that the enormous amount of waste produced during an operation continues to increase. He stressed the impact of the single-use model, which on the one hand protects the safety of patients and offers various advantages, but on the other contributes to the enormous amount of waste produced by the sector. He demonstrated a circular flow in which they use materials/waste from the hospitals and redesign it into high-quality products which can then be reused within the hospital. The process generated by GreenCycl demonstrates the circular economy that we must strive to achieve in a sector that is struggling with its impact on the climate.
Despite the huge amount of attention paid to environmental sustainability, you cannot overlook social sustainability. This is about the interests of healthcare workers, of patients, but also of other people who are affected by the healthcare we provide. We must therefore constantly ask ourselves whether the healthcare we offer is ethically and socially sustainable. Equality and accessibility to healthcare continue to be a major challenge in Belgium, a challenge that we will have to tackle in the years ahead.
1 Based on presentations by Arianna Gamba, Eveline DeCoster and Joost van der Sijp, respectively.
2 Who cares wins: connecting financial markets to a changing world, 2004, World Bank Group