Driving Change in Healthcare - Embracing Sustainability for Better Health

​​​Healthcare sustainability is often viewed through the lens of environmental impact, yet it encompasses broader considerations for the healthcare sector and public health. Integrating sustainability into healthcare practice reduces our carbon footprint and supports value-driven care, improving patient outcomes and workforce engagement.

The Hidden Cost of Healthcare's Environmental Footprint

The healthcare sector is an extremely resource-intensive industry, contributing to significant waste production, and water and energy consumption. The industry is estimated to account for 4.4% of global net GHG emissions, making it the fifth-largest emitter if it were a country. Climate change, greenhouse gas (GHG) emissions, and air pollution have been shown to have local health impacts. For example, the incidence of dengue cases has been increasing since 1990¹. Air pollutants and GHG emissions have also been linked to increased emergency hospital admissions for respiratory and cardiovascular diseases². These trends place additional pressure on the healthcare system, which is already facing high service demands due to the rising burden of disease associated with an ageing population.

The healthcare sector faces a dual challenge: managing service demands while addressing its role in contributing to the climate crisis. At the peak of the COVID-19 crisis, the waste generated by the medical sector was estimated to have increased by 65%³. In addition, the substantial waste produced from care delivery—stemming from single-use medical supplies, plastic packaging, and unused or expired medications—can be morally distressing for healthcare workers who recognise its contribution to environmental contamination.

There are co-benefits in actions that reduce carbon emissions and, at the same time, improve health. For example, promoting active travel and low-carbon diets also improves health outcomes. Ultimately, the greenest approach to healthcare is eliminating the need for medication entirely. In this regard, the ongoing population health efforts through Healthier SG, as well as initiatives to address health inequity are critical. In addition, for those with medical conditions, adhering to their doctor's advice not only maintains better health but also supports healthcare sustainability. For example, Diabetes, if well-managed, has been estimated to result in a 15-20% reduction in carbon emission compared to poorly managed cases due to a reduced need for more resource-intensive care such as hospital admission⁴.

TTSH's ESG Strategy: A Whole-of-Hospital Commitment

In view of the above considerations, we have formally embarked on healthcare sustainability at Tan Tock Seng Hospital (TTSH), driven by a structure comprising an ESG Council and two dedicated workgroups focused on waste management and integrating sustainability into our care practices respectively. Leadership is crucial, and environmental sustainability is now a strategic goal in our corporate strategy. To engage the hospital community and communicate our sustainability goals to stakeholders, we developed an ESG statement of intent. In this regard, we aim to:

• Reduce our carbon footprint, conserve natural resources and promote environmental sustainability.
• Foster a culture of compassion and inclusivity and provide equitable and accessible healthcare services.
• Uphold the highest standards of ethical governance, transparency, and accountability.

To equip leaders and staff with relevant knowledge and skills to undertake sustainability initiatives, the Centre for Healthcare Innovation, under the ambit of the National Healthcare Group, has introduced relevant training courses. We have also ringfenced established funding to support piloting green initiatives and care models. Furthermore, we have also set up a volunteer interest group, EcoCare, to foster and encourage a ground-up approach.

Small Changes, Big Impact: Green Projects in Action

These efforts have yielded significant results over the past year. For example, cataract surgery is the most frequently performed procedure at TTSH, with nearly 8,000 cases yearly. A review of the cataract procedure by a multidisciplinary team comprising administrators, operations managers, nurses, doctors, Infection Control and Kaizen experts has resulted in a potential reduction of over 700 kg in single-use consumables and the recycling of more than 2,000 kg of waste each year, saving at least $2,000 and decreasing the carbon footprint by over 2,000 kg of CO2e — equivalent to the carbon dioxide absorbed by 93 trees annually⁵.

Furthermore, a recycling pilot involving several departments, including Nursing, Pharmacy, Linen, Food & Beverage services and Materials Management department, has successfully diverted over five tons of paper and plastic waste from incineration and landfill. This pilot has since been scaled to more hospital departments and locations.

Additionally, a ground-up initiative called Food Rescue was piloted with good outcomes. Initially proposed by hospital staff, this initiative aims to minimise food waste from catered hospital events. Since its implementation, the group has attracted 141 members from various departments and has successfully reduced food waste from 20 events.

Staying True to Our Mission: First, Do No Harm

The healthcare sector must proactively address its environmental impact to uphold its mission of 'first, do no harm'. In this regard, TTSH has developed a structured, whole-of-hospital approach for a holistic and comprehensive response, from management to the ground-up level.

With a whole-of-hospital approach, and as everyone does their part, we can lead the way in making sustainability a key priority for the healthcare industry moving forward.