Sustainability in healthcare: efficiency, effectiveness, -economics and the environment

Sustainable Healthcare to Provide Quality Care in the Surgical Industry in the United Kingdom

The surgical industry makes a major contribution to sustainable healthcare. This article aims to critically evaluate sustainable healthcare to provide quality surgical care in the United Kingdom. For this study, a systematic review was conducted using peer-reviewed studies and articles from the United Kingdom related to surgical and anesthetic fields that were published within the last five years. The journal articles were selected based on their relevance to the sustainability and performance of the healthcare system, including risks, and subsequently screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 model screening approach. The findings of the relevant journal articles were then critically evaluated for each theme. A total of 79 studies were retrieved, and 15 of the retrieved studies met the inclusion criteria. Of those, 10 articles evaluated existing sustainability practices, only seven articles discussed significant determinants of quality healthcare, and only 86.67% of the articles highlighted the implications of sustainability. The key predictors of high-quality medical care are effective resource management, the acquisition of a moral surgical team, the provision of professional services, integration, short hospital stays, and low mortality and morbidity rates. Conserving water, optimizing treatment routes and transportation, and creating cultural change were found to be the pillars of high-quality, sustainable healthcare. The concept of sustainability varied between these studies, and limitations on sustainability as a result of reduced mortality, morbidity, and business services were observed. Anesthetic gas emissions from operating rooms continue to have the most detrimental effect on the sustainability of the surgical industry. A significant gap was noted between the available data and their implications.

How is the Societal Perspective Defined in Health Technology Assessment? Guidelines from Around the Globe

Some researchers have argued that the aim of an economic evaluation should be to offer guidance on resource allocation based on public interest from a societal perspective. The application of a societal perspective in health technology assessment (HTA), while common in many published studies, is not mandated in most countries, and there is limited discussion on what the societal perspective should encompass. This study aimed to systematically compare and contrast the HTA guidelines in different countries. HTA methods guidelines were identified through international HTA networks, such as the Professional Society for Health Economics and Outcomes Research (ISPOR) and Guide to Economic Analysis Research (GEAR). The respective HTA agencies were grouped into two categories: well-established and newly developed, based on the establishment date. Data extracted from the guidelines summarised the methodological details in the reference cases, including specifics on the societal perspective. The database search yielded 46 guidelines, and 65% explicitly considered the societal perspective. The maturity of these agencies is reflected in their attitudes towards the societal perspective; the societal perspective is defined in 73% of the guidelines of well-established agencies and only 56% of those of newly developed agencies. The guidelines from multipayer healthcare systems are more likely to consider the societal perspective. Although most guidelines from the well-established agencies recommend the inclusion of a societal perspective, the types of costs and consequences that should be included and the recommended approaches to valuing them are variable. The direct costs to family and carers were included in 73% of the societal perspective definitions, while non-health outcomes were considered in only 40%. Most HTA guidelines lack clear guidance on what to include under specific perspectives. Considering the recent advancements in economic evaluation methods, it is timely to rethink the role of the societal perspective in HTA guidelines and adopt a more comprehensive perspective to include all costs and consequences of healthcare services.

Exploring, Diversifying and Debating Sustainable Health (Care) Approaches

Today’s sustainability challenges have major implications for human health and health care. At the same time, the way health care is organized and conducted has major sustainability implications. Sustainable health and sustainable health care approaches in research, which engage with health and sustainability as intertwined phenomena, feature increasingly prominently in various literatures, i.e. (i) literature based on the premise of ‘(un)healthy environments result in (un)healthy people’ (e.g., planetary health); (ii) literature on the implications of ecological change for the sustainability of healthcare systems; and (iii) literature on healthcare systems’ sustainability in view of a range of socio-economic factors. However, an integrative elaboration of the manifold relationships between health and sustainability challenges in these literatures is currently lacking. This review paper therefore maps how these three literatures represent intertwinements between health and sustainability challenges, as well as their suggestions to address these challenges. In addition, we explore which themes and questions are pertinent, meaning they have remained largely unaddressed. By performing a qualitative mapping review, we find that calls for structural attention to inequality, to in-and exclusion, and to stakeholder needs and perspectives cut across these three literatures. Furthermore, we identify three cross-cutting key questions that require future research attention. First, how do divergent ideas on what is and divergent ideas on how can that be known give rise to different health- and sustainability visions and pathways? Second, what do abstract problem statements and solutions presented in agenda-setting work look like in practice in specific and diverse empirical contexts across the globe? And third, how are diverse health and sustainability dynamics historically and spatially interconnected? Moreover, we observe that some voices have so far remained largely silent in scientific debates on health and sustainability intertwinements, namely non-expert voices such as patients and citizens, voices from a variety of social scientific and humanities disciplines, voices from relevant domains beyond (environmental) health, and voices from the global South (from non-experts, social scientific and humanities researchers and domains beyond health). We conclude that a focus on inclusive and equitable engagement with intertwined health- and sustainability challenges is imperative. This requires moving away from developing universal knowledge to address generic problems, to foregrounding plurality in terms of problem statements, knowledge, solutions, and the values embedded therein.

Strategies during digital transformation to make progress in achievement of sustainable development by 2030

PURPOSE

The purpose of this study is to explore strategies during transformation to obtain sustainable development and to identify the human-based factors contributing to the transformation.

DESIGN/METHODOLOGY/APPROACH

This qualitative study explored the strategies that health-care leaders need to adopt during transformation to achieve the Sustainable Development of the United Nations' agenda by 2030. The study was conducted in early 2020 among ten health-care leaders in the USA. The research design was an exploratory qualitative approach that used a semi-structured, open-ended questionnaire asked of ten US health-care leaders who had experience in leading health-care transformation in their organizations. The study findings identified that health-care leaders can facilitate the achievement of Sustainable Development by establishing strategies in knowledge improvement, innovation development, motivation increment, global strategy and local strategy alignment, leadership support and partnership development.

FINDINGS

Six major themes emerged from the data linked to the central research question: "What are the strategies during digital transformation to make progress in the achievement of Sustainable Development by 2030?" The compressed collection of themes for the study included the following six major themes: knowledge development; innovation development; motivation; global strategy establishment; leadership; collaboration enhancement; and two minor themes, namely, mindset change and vision creation.

RESEARCH LIMITATIONS/IMPLICATIONS

Due to the few numbers of participants selected for this study (N = 10) may not be generalizable to other settings. The implication of this study is to identify the significant factors contributing to making progress in sustainable development in health-care organizations. The health-care leaders can learn what significant strategies can be helpful to establish future-based organizations toward achieving sustainability.

PRACTICAL IMPLICATIONS

The results of this study provided actionable strategies to empower the employees and increase managerial innovation in health-care organizations.

SOCIAL IMPLICATIONS

Promoting partnership of health-care organizations with social and global activities such as sustainable development goals that are contributing in 5Ps: People, Prosperity, Peace, Partnership and Planet.

ORIGINALITY/VALUE

The main reason for the study was that health-care leaders worldwide could have a novel study that delineates the digital transformation strategies needed for creating impactful outcomes toward achieving sustainable development. Moreover, this unique study provided a useful outlook for health-care leaders to establish future-based health-care organizations while learning the dynamic of digital transformation is the key for health-care organizations to adapt their strategies for a sustainable future.