Sustainability Mini Grants Have Everyday Impacts

March 2, 2023 - By John Knox

“We worry a great deal about climate change and its effects on human, community, and economic health and wellbeing,” says Lisa Shieh, MD, PhD.

Fellow hospitalist David Svec, MD, MBA, shares her concern, which is why they have launched a new Sustainability Seed Grant program in partnership with Kari Nadeau, MD, PhD, former director of the Sean N. Parker Center for Allergy and Asthma Research.

Ten clinicians in the School of Medicine are doing their part to address climate change by leading practical projects under the program.

Current projects are focused on areas like waste reduction in the operating room, better use of water by patients with cancer, and improving sustainability in the hospital food system.

Claire Baniel, MD, a resident in the Department of Radiation Oncology, is performing a project on “Radiation Oncology Waste Audits: An Opportunity to Increase Environmental Stewardship in Healthcare.” With her project she hopes to reduce health care associated waste and inspire other health care providers to take similar action.

“The intersection of climate health, public health, and the health care system presents a tremendous opportunity to improve patient health and systemically uplift vulnerable patient populations,” Baniel says. “Care team-led environmental stewardship encourages grassroots involvement at the patient level, and, when paired with hospital sustainability experts, unites disciplines representative of multiple areas of expertise to build a resilient and sustainable health care system that is greater than the sum of its parts.”

General surgery resident Jaclyn Wu, MD, is conducting a project with Thomas Weiser, MD, and Paige Fox, MD, PhD, associate professors of surgery. That project is “Reducing the carbon footprint of the operating room through waste reduction.”

Wu points out that the operating rooms at Stanford Health Care produce an average of 6,000 pounds of waste a day, or what the average American produces over 3.3 years.

“As surgeons caring for a population that continues to be unequally affected by climate change, our goal is to reduce the environmental impact of our operations so that the care we are providing now promotes a healthier planet in the future,” Wu says.

The 2022 Sustainability Seed Grant recipients all have used their funds for innovative projects covering a wide array of topics in sustainability research.

Above is shown the projects funded with the 2022 Sustainability Seed Grants and their principal investigators. 

Cost Savings Reinvestment Program pays forward

Shieh, clinical professor of hospital medicine, and Svec, associate professor of hospital medicine, started the program last year using funds earned from the Stanford Health Care Cost Savings Reinvestment Program (CSRP) along with underwriting from the Sean N. Parker Center for Allergy and Asthma Research.

“David and I wanted to use these funds to do something that could make a lasting impact. We both have a real concern for climate change, so we wanted to take the monies we received from the CSRP program and reinvest it into sustainability. Kari Nadeau is a leader in climate health. We partnered with her to combine our resources and create this seed grant program to drive sustainability here at the hospital,” Shieh explains.

“Health care contributes to a substantial portion of emissions and environmental impact. Our hope was not only to accelerate the work but also to advance the research in this necessary field of study,” adds Svec.

Dr. Lisa Shieh working with medical residents

He and Shieh agree on giving grants to programs that have real practical potential.

“We are not funding basic research; we are funding improvement. While there are some quantitative studies, like, for example, ‘how do we do carbon accounting?’, they are aimed at understanding our system better so we can find opportunities for improvements,” Shieh observes.

Shieh and Svec envision the sustainability grants not only helping locally, but also much more broadly through presentations and publishing.

“Most residents and even faculty who are clinically based have very little access to grant money because they don’t really have time to write a grant proposal. So this is a way to reach the clinically active teams and get them to think and act about this important matter,” Shieh says.

“We also want to share the investigators’ work with the world and influence the care in other regions. The grants can span all parts of the health care system—inpatient, OR, outpatient, etc.—and we are giving all our grant winners resources to help them achieve that. We want them to present their work. We will be inviting the investigators to present their work at the annual symposium that the Stanford Health Care Sustainability Program Office kicked off last year. We want our grant recipients to publish their work, and the money from these seed grants will allow them to do that by paying for conference attendance, publication fees, and similar expenses,” Shieh adds.

In addition to reducing waste and conserving resources, it’s really so we can live together on this planet sustainably. If we use up what we have, then we will be left with nothing.

Emphasis on collaboration and diversity

The program’s call for proposals “strongly encourage(s) proposals that emphasize interdisciplinary collaborations and that incorporate diversity,” and Shieh and Svec seek applicants from across Stanford Health Care and the entire university. In that spirit the program works with Stanford Health Care, the Sustainability Program Office, and other divisions in the Department of Medicine.

Shieh and Svec invite other interested departments to invest funds so the Sustainability Seed Grant program will last in perpetuity.

They found a great deal of diversity among the grant proposals that were submitted, with applications from students, residents, and faculty. Applicants represented many departments, from basic science to population health.

In addition, the seven judges who review the proposals comprise a diverse committee, with representation from the Department of Medicine, Stanford Health Care, and the Doerr School of Sustainability. Among criteria used to select grant recipients are improved sustainability metrics, improved value for patients, and ability to publish and share with others.  

On the general subject of sustainability itself, Shieh defines it as a societal goal that relates to the ability of people to coexist on earth over a long time.

“It really is about how we can conserve our resources for the future and about climate change. In addition to reducing waste and conserving resources, it’s really so we can live together on this planet sustainably. If we use up what we have, then we will be left with nothing,” she says.

The Sustainability Seed Grant program is part of a growing movement in medicine to be proactive about climate change. Don Berwick, president emeritus of the Institute of Healthcare Improvement, warns that “climate change is the largest threat to human health on the planet, according to the World Health Organization, and health care has its part in reducing greenhouse gas emissions”.

“We know there are many people worried about climate change,” Shieh says. “This program is our way for us to come together as a community to be proactive about it.”

Turning Climate Despair Into Action

Read the Department of Medicine’s featured story on Dr. Britt Way, her book Generation Dread, and confronting climate change’s toll on mental health in our 2022 Annual Report.

I found that I could accept things for being as turbulent as they are and move towards them with a disposition of joy.