Abstract
As understanding grows of the scale of health care's environmental impacts, so too does interest in measuring and reporting on sustainability as a facet of health care system performance. This article examines important lessons from health care's long experience with performance and quality measurement and reporting that can be applied to the creation of health care sustainability metrics. Although some large health systems such as Kaiser Permanente have invested heavily in environmental stewardship, in the US the focus of health care sustainability measurement and reporting has typically been on corporate social responsibility and climate risk disclosure. The ability of health care organizations to generate data on and control environmental impacts can be limited by legacy infrastructure and complex supply chains. However, just as in other domains of performance, health care sustainability measurement and reporting must proceed from a clear conceptual framework and statement of purpose. Measurement must reflect strategic goals, instead of letting goals become dictated by ease of measurement. Health system leaders now need to set clear and compelling sustainability goals, invest in internationally comparable metrics by which to measure their success, and embed them in their core business.
Highlights
The health sector’s contribution to damaging and degrading the natural environment has become increasingly clear in recent years
Some large health systems such as Kaiser Permanente have invested heavily in environmental stewardship, in the US the focus of health care sustainability measurement and reporting has typically been on corporate social responsibility and climate risk disclosure
Just as in other domains of performance, health care sustainability measurement and reporting must proceed from a clear conceptual framework and statement of purpose
Summary
Evolution And Approaches “performance” measurement and reporting in health care may cover various aspects of health services (for example, patient access, costs and efficiency, and so on), in recent decades there has been an explosion in the use and reporting of measures of clinical and service quality.[8]. Tension exists between the use of performance measures for external assessment and for internal quality improvement purposes[8] and between the approaches most suited to each of the four pathways of change.[11] Performance and quality information is a public good that will not evolve spontaneously without active stewardship and guidance by governments and that requires careful investment and attention.[10] System-level performance measurement requires a clear conceptual framework that covers all major domains of the health system and aligns with its objectives, integrates with its information technology systems and data collection infrastructure, captures highpriority but hard-to-measure areas, and is designed for international comparability.[10]
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