45 – Healthcare Providers and Services, and Healthcare Technology

globalreporting.org

45 – Healthcare Providers and Services, and Healthcare Technology

This table shows a list of topics identified as relevant by different stakeholder groups. They can be considered as stakeholders’ suggestions or requests

for topics to be monitored or disclosed by organizations.

Additional information about the project can be found at https://www.globalreporting.org/reporting/sector-guidance/Topics-

Research/Pages/default.aspx

45 Healthcare Providers and Services, and Healthcare Technology

21 Topics

Providers of patient health care services. Includes dialysis centers, lab testing services, and pharmacy management services. Also includes

companies providing business support services to health care providers, such as clerical support services, collection agency services, staffing

services and outsourced sales & marketing services. Owners and operators of health care facilities, including hospitals, nursing homes,

rehabilitation centers and animal hospitals. Owners and operators of Health Maintenance Organizations (HMOs) and other managed plans.

Companies providing information technology services primarily to health care providers. Includes companies providing application, systems

and/or data processing software, internet-based tools, and IT consulting services to doctors, hospitals or businesses operating primarily in the

health care sector. Distributors and wholesalers of health care products not included elsewhere.

Sustainability

Category

Environmental

Topic

Toxic chemicals

and materials

Topic

Specification

(if available)

Hazardous

chemical and

toxin use

Explanation Reference(s) 1 Constituency

Health care facilities around the world are reducing their

use of hazardous chemicals and products. For example:

More than 6,000 health care facilities in the U.S. are

eliminating mercury-containing medical devices in favor

of safer non-mercury alternatives

Hospitals from Stockholm, to Prague, and throughout the

U.S. are phasing out phthalate-containing PVC medical

devices and switching to safer plastics

232, 496 Business

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 1 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

Many hospitals are reducing pesticides by using

integrated pest management techniques

Many hospitals are choosing safer, less toxic building

materials for new construction and renovation projects.

Green chemistry is the design of products and processes

that reduce or eliminate the use and generation of

hazardous substances. Green chemistry seeks to reduce

and prevent pollution at its source.

High-priority chemicals and materials include:

Mercury

PVC (vinyl plastic) and phthalates

Brominated flame retardants

Glutaraldehyde and ethylene oxide

Pesticides

Volatile organic compounds in building materials

Hazardous ingredients in cleaning products.

Green chemistry is the design of products and processes

that reduce or eliminate the use and generation of

hazardous substances. Green chemistry seeks to reduce

and prevent pollution at its source.

The ubiquitous exposure to toxic chemicals in everyday

life has increasingly become a health concern.

Unfortunately, many products used in health care

contribute to hazardous exposures — including cleaners

and disinfectants, phthalates in medical devices, flame

retardants in furniture, formaldehyde in furniture and

solvents in labs.

Emerging scientific research is raising the level of

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 2 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

concern about the health impacts of chronic chemical

exposures. We now know that: Even small doses of

chemicals can cause disease — interfering with sexual

development, disrupting hormones and causing cancer at

very low levels. Children and developing babies are most

vulnerable. Hundreds of synthetic chemicals are found in

human breast milk and in the cord blood of babies in the

womb. Chemicals can act like drugs in our body,

disrupting systems at low levels of exposure, and

potentially causing harm in combination.

Chemical Related Diseases: As chemical use has grown in

industrialized societies, so have chemical-related

diseases, including cancer, asthma, birth defects,

developmental disabilities, autism, endometriosis and

infertility. Mounting scientific evidence links the

incidence of these diseases in part to environmental

toxicants. Health care institutions have a particular

ethical responsibility to use products containing

chemicals that pose less risk to human health — and due

to their massive buying power, the health care system

can play a key role in shifting the economy toward green

chemistry.

A growing number of hospitals are taking a "better safe

than sorry" approach to chemicals — eliminating

suspected hazards and switching to safer alternatives.

Benefits of this approach to the bottom line can include

reduced disposal costs, reduced liability and improved

health for employees.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 3 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

Toxins with an especially heavy impact in the health care

sector may be found in:

489 Business

Cleaners and disinfectants

Dioxin-containing byproducts

Electronic equipment

Flame retardants

Fragrance chemicals

Mercury-containing medical devices and wastes

Pesticides

Phthalates and DEHP

PVC

Health care institutions, like institutions outside the

health care sector, regularly use a surprising number of

highly toxic materials. These toxins affect patients,

hospital staff, and hospital visitors.

Plastics use and

management

Many of these toxins are defined and regulated by

federal, state and local laws. Others are used daily but

hardly regulated at all. They include carcinogens,

materials that damage the skin and organs, and materials

that corrode, irritate, or release other toxins in the

course of normal use, storage, transportation or disposal.

Plastic, a valuable material, can generate significant

positive, or negative, impacts on economy, environment

and society. Plastic should be treated as a resource and

managed judiciously.

A disclosure on management approach for plastics,

353, 367 Civil Society

Organization

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 4 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

including governance, strategy, risks, opportunities,

considering: opportunities for product redesign,

increasing recycled content, implementing reclaim

and/or reuse which could attract economies, brand

loyalty, investment, employee goodwill, and; risks to the

business, stakeholder health, environment and society

(including reputational/social license to operate,

regulatory, investor, insurer, and liability risks) for

plastics that are directly harmful to stakeholders, or

indirectly through plastics being wasted/littered.

Performance indicators regarding the types and volumes

of plastics being used, collected and/or distributed

downstream; the portion that is made of post-consumerrecycled,

bio-based, biodegradable, compostable, and/or

oxobiodegradable material; the ratio of expected lifespan

of plastic products/packaging in contrast to the

duration of their intended use; these volumes broken

down by end of life disposition.

Most of this disclosure can be captured through the

existing GRI framework (e.g. GRI G3 EC9, EN1, EN2,

EN22), but commentary is needed to ensure disclosers

appreciate the materiality of plastic; other questions can

be added to the framework. Refer to the Plastic

Disclosure Project ( www.plasticdisclosure.org ) for more

details on the suggested questions. PDP will align its

questions to GRI G4 to assist disclosers.

Plastic are in high use in these "activity groups", and can

have significant positive, or negative, impacts on the

economy, environment and society: Economics: There

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 5 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

are significant cost savings available to organisations that

treat plastic as a resource (e.g. through redesign, use of

recycled content, reclaiming, etc.) and risks of increased

direct costs (regulation, liability, cost of capital,

insurance) to organisations that do not lead in this area

as well as indirect economic costs to impacted industries

(e.g. food production, tourism). Environment: Plastics

that are wasted or littered become extremely harmful to

the environment, which will have a material effect on

biodiversity and the global food chain, both nearby and

far outside the local area of operations. Society: Some

plastics are harmful to stakeholders during manufacture,

use and/or disposal (e.g. due to phthalates, BPA), impact

the wellbeing of society (e.g. effect of litter on

community spirit and their interest in sustainability).

While a valuable invention, which benefits society in

many ways, the negative impacts associated with

society's growing use of plastic are not fully recognised.

Roughly 85% of plastic used in products and packaging is

not recycled, and most plastic produced in the last 60

years still remains in the environment today. Discarded

plastics persist in the environment for dozens or

hundreds of years, accumulating across the globe, often

out of sight of the producers and users. The direct

physical impacts of plastic are significant to the

organisation in increased costs or missed opportunities,

and related economies (e.g. over $1.2bn in annual

damages to ocean-related industries in Asia-Pacific), the

environment through harming habitats and species, and

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 6 of 26


Sustainability

Category

Topic

Healthcare

waste

management

Topic

Specification

(if available)

Healthcare,

medical

research

facilities and

laboratories

Explanation Reference(s) 1 Constituency

to stakeholders health when exposed to the chemical

ingredients; and are magnified if fragmentation of the

plastic occurs, making it available for ingestion to

additional species, who adsorb the chemical ingredients

and/or the toxins carried on the plastic. These negative

impacts could be avoided and turned into positive

impacts, if plastic was treated as a resource to be

managed judiciously (e.g. the US economy lost $8.3bn

worth of plastic packaging in 2010) - "It is not good

business practice to throw away valuable resources".

Medical waste is all waste materials generated at health

care facilities, such as hospitals, clinics, physician's

offices, dental practices, blood banks, and veterinary

hospitals/clinics, as well as medical research facilities and

laboratories.

102, 242 Business

The Medical Waste tracking Act of 1988 defines medical

waste as "any solid waste that is generated in the

diagnosis, treatment, or immunization of human beings

or animals, in research pertaining thereto, or in the

production or testing of biologicals." This definition

includes, but is not limited to:

blood-soaked bandages

culture dishes and other glassware

discarded surgical gloves

discarded surgical instruments

discarded needles used to give shots or draw blood

(e.g., medical sharps)

cultures, stocks, swabs used to inoculate cultures

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 7 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

removed body organs (e.g., tonsils, appendices, limbs)

discarded lancets

Hospitals generate millions of tons of waste each year. In

the past, many hospitals simply dumped all waste

streams together, from reception-area trash to

operating-room waste, and burned them in incinerators

and this is still common practice in many developing

countries.

Infectious waste

Yet medical waste incineration is a leading source of

dioxin, mercury, lead and other dangerous pollutants

that threaten human health and the environment.

Despite these dangers, many governments, public health

agencies, international organizations and transnational

corporations continue to promote incineration

technologies as waste management "solutions."

Infectious waste is waste that is suspected to contain

pathogens (disease-causing bacteria, viruses, parasites,

or fungi) in sufficient concentration or quantity to cause

disease in susceptible hosts. The subcategories of

infectious waste are (a) waste contaminated with blood

or other body fluids; (b) microbiological cultures and

stocks of infectious agents from laboratory work; and (c)

waste from infected patients in isolation wards. Waste

contaminated with blood or other body fluids include:

free-flowing blood, blood components, and other body

fluids (semen, vaginal secretions, cerebrospinal fluid,

synovial fluid, pleural fluid, pericardial fluid, peritoneal

527 Civil Society

Organization

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 8 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

fluid, amniotic fluid, saliva and other body fluids visibly

contaminated with blood); dressings, bandages, swabs,

gloves, masks, gowns, drapes, and other material

contaminated with blood or other body fluids; and waste

that has been in contact with the blood of patients

undergoing hemodialysis (e.g. dialysis equipment such as

tubing and filters, disposable towels, gowns, aprons,

gloves, and laboratory coats).

With regards to infectious healthcare waste, there are

four approaches to healthcare waste treatment. A

decentralized approach is one where the technology is

installed on-site at the healthcare facility. By treating the

waste as close as possible to the point of generation, this

approach has the advantage of eliminating the transport

of hazardous healthcare waste.

Another approach is centralized treatment at an off-site

facility designed to handle the waste from hospitals,

clinics, medical laboratories, doctors‘ offices, and other

health facilities in a large urban center, province, or

region. This approach requires the transport of infectious

waste from many sources to the central treatment

facility and is only possible if there is a good

infrastructure for collection, transport and temporary

storage. Its major benefit is cost reduction as it takes

advantage of the economies of scale.

A third approach is cluster treatment wherein a hospital

serves as a hub for treating waste from surrounding

nearby hospitals, clinics, and other facilities. Cluster

treatment is an option for small municipalities, parts of a

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 9 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

province, or districts that may be too far from a central

treatment facility but have an adequate infrastructure

for collection and transport of infectious waste within

their area.

A fourth approach is mobile treatment. In this approach,

the treatment technology is mounted on a mobile

platform, such as a specially designed mobile container

or a flatbed truck, and is brought to hospitals and other

health facilities within a service territory. The mobile

treatment system treats and converts infectious waste

into regular waste as the mobile unit is parked on the

hospital grounds. After treatment, the system is driven

to the next healthcare facility.

Pharmaceutical

products and

items for

handling them

Improper treatment and disposal of healthcare waste

pose serious hazards of disease transmission due to

exposures to infectious agents among waste pickers,

waste workers, health workers, patients, and the

community in general.

For a healthcare facility, several practical options exist

for small quantities of pharmaceutical waste: return of

expired pharmaceuticals to the donor or manufacturer;

encapsulation and burial in a sanitary landfill; chemical

decomposition in accordance with the manufacturer‘s

recommendations if chemical expertise and materials are

available; and dilution in large amounts of water and

sewer discharge into a sewer for moderate quantities of

relatively mild liquid or semi-liquid pharmaceuticals, such

as solutions containing vitamins, cough syrups,

intravenous solutions and eye drops.

527 Civil Society

Organization

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 10 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

Pharmaceutical waste includes expired, unused, spilled,

and contaminated pharmaceutical products, drugs,

vaccines, and sera that are no longer needed. The

classification also includes discarded items used in the

handling of pharmaceuticals, such as bottles, boxes,

gloves, masks, vials, and tubing contaminated with

pharmaceutical residues.

Improper treatment and disposal of pharmaceutical

healthcare waste pose risks, because for example waste

scavengers might collect the expired, unused, spilled,

and contaminated pharmaceutical products, drugs,

vaccines, and sera that are no longer needed, and take or

sell them.

The huge quantities of medicines ending up in waste or

in aquatic systems are a major environmental health

issue. The increasing documentation of low-dose health

effects makes pharmaceuticals a priority area from an

environmental health perspective. Hundreds of different

active pharmaceutical compounds are being discovered

in waterways all over the world. Concern is increasing

about the harm these might be doing to human health

and the environment.

44, 240 Business

Although levels are usually too low to result in acute

effects such as organ damage, there are two cases where

drugs have had drastic effects: where the antiinflammatory

diclofenac has virtually wiped out the

vulture population of Asia, while man-made estradiol has

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 11 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

caused fish to start changing sex.

Although the levels of other drugs don't cause acute

reactions, there is little or no information about the nonacute

effects which low doses might have on wildlife and

humans.

There are suggestions in research that contaminated

water affects fish in subtle ways, such as changing

breeding behaviour. This may cause declines in

populations, or even be an indicator of other problems.

Ordinary risk assessment is of limited value in

determining the environmental hazard posed by low

levels of pharmaceutical compounds, as it only looks at

acute effects, struggles to assess the potential effects of

mixtures of compounds, and has no way to anticipate

freak reactions.

What we do know is that pharmaceutical compounds are

biologically active and they are detectable in our

waterways. We can be sure that it would be better if

they were not there. Therefore, we need to take steps to

deal with the problem.

While patients should be allowed access to the best

available pharmaceutical treatment, other things being

equal, we should consider the medicine's PBT

(persistence, bioaccumulation and toxicity) when

developing, manufacturing, prescribing, purchasing,

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 12 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Technology for

waste

sterilization

and/or

destruction

Explanation Reference(s) 1 Constituency

donating and disposing of medicines. Our collective aim

should be to protect people and the environment from

contamination of hazardous chemicals that wouldn't

otherwise be there.

A wide range of alternative technologies are now

commercially available. Steam sterilization in autoclaves

is the most common alternative treatment method.

Since autoclaves have been used in the treatment of

infectious waste for many decades, their operation is

well established. Several types of steam sterilizers or

autoclaves are available: gravity-fed, pre-vacuum and

pulse or multivacuum cycle autoclaves. Unlike

incinerators, autoclaves heat the waste to temperatures

high enough to disinfect but not hot enough to burn and

create air pollutants such as dioxins and furans. A posttreatment

shredder or grinder could be used if the waste

is to be rendered unrecognizable and if reduction of

waste volume is desired. Microwave treatment is

another type of alternative technology. For years, the

most common microwave device has been a medium- to

large-scale, semi-continuous system using an internal

shredder, rotating internal screw, and industrial

magnetrons to generate microwave energy. There are

also commercial dry heat treatment technologies. Moist

heat has been shown to be more effective than dry heat

in achieving disinfection, so dry heat systems generally

require longer exposure times and higher temperatures

to meet minimum disinfection levels.

123, 241 Business

Medical waste incineration is a leading source of dioxin

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 13 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

pollution, one of the most potent carcinogens known to

science. Fortunately, there are viable alternatives to

incineration that are safer, cleaner, do not produce

dioxin, and are just as effective at disinfecting medical

waste. These technologies can be used on all types of

medical waste, including pathological and chemotherapy

waste.

Given that alternatives to incineration are available, a

complete phase-out of medical waste incineration is

possible and appropriate. This will require changes in

state laws, persuasion of hospital systems that non-burn

approaches are both effective and environmentally

preferable, public education, and better segregation and

reduction of waste by hospitals. Pathological and

chemotherapeutic wastes can be treated using alkaline

hydrolysis technology which combines steam sterilization

with tissue digestion using sodium or potassium

hydroxide.

Investment and commitment in the management of

health care waste (a by-product of healthcare that

includes sharps, non-sharps, blood, body parts,

chemicals, pharmaceuticals, medical devices and

radioactive materials).

445 Mediating

Institution

Poor management of health care waste potentially

exposes health care workers, waste handlers, patients

and the community at large to infection, toxic effects and

injuries, and risks polluting the environment.

Healthcare waste is a by-product of healthcare that

includes sharps, non-sharps, blood, body parts,

593 Mediating

Institution

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 14 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

chemicals, pharmaceuticals, medical devices and

radioactive materials

Social Migrant workers Recruitment

and

employment

Poor management of healthcare waste exposes

healthcare workers, waste handlers and the community

to infections, toxic effects and injuries

Recruitment and employment of migrant workers

Number of migrant workers employed

Countries of origin

Gender of workers

Positions within company

Length of contracts

Recruitment channels

Any fees for recruitment

Passport retention

Migrant workers both internal and external are a

significant and growing feature of all company activities.

There are over 200 million migrants in the world. They

are found within nearly all business sectors and across all

regions. Many migrant workers, particularly those

working in unskilled jobs are subject to discrimination

and are vulnerable to exploitation and abuse.

For many migrants exploitation begins during

recruitment. Exorbitant fees and other charges, often at

usurious rates of interest can leave many migrant

workers effectively bonded labour whatever the

subsequent conditions of employment.

253 Mediating

Institution

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 15 of 26


Sustainability

Category

Topic

Privacy of

medical records

and genetic data

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

Company due diligence and reporting should therefore

extend into the supply chain for labour.

The storage and uses made of health records and the

results of genetic tests raise questions in relation to the

right to privacy.

66 Mediating

Institution

Access to quality

medical

treatments

Care quality

Racial and

ethnic

disparities

Staff training,

staffing ratios

per patient and

turnover rates

This case raises questions about the right to privacy of

the people from whom the samples were taken. There

has, for example, been concern that samples of this kind

could be used in paternity suits or to assess health

insurance risks. AT the other hand, Retention of the

samples has significant potential public health benefits,

such as retrospective diagnosis from the stored blood

spot, even after the individual is deceased, to help

provide counselling to the family. Approved research can

provide information that is of public health interest or

information that can provide a better understanding on

how diseases develop, identifying potential opportunities

for intervention.

Measures taken to eliminate racial and ethnic disparities

in providing treatments.

Minorities can be treated in a disadvantageous way in

health care as in all other areas in life

Adequate and properly trained staff are critical to

healthcare, oil and gas and financial services.

Healthcare providers, including hospitals, nursing homes

and home health care need to report on staffing ratios

per patient and their turn-over rates. This information

494 Business

245, 362 Labor

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 16 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

directly indicates the quality of care provided.

with the Volker rule (US Dodd-Frank) are critical to

solvency.

Clinical trials

Disease spread

control

Food quality

Consent

processes

Health care

facilities

Catering

services

Extensive academic research and judicial decisions as

well as federal and state legislation make these material

indicators for sustainability. See, for example, "Hospital

Nurse Staffing and Patient Mortality, Nurse Burnout, and

Job Dissatisfaction," JAMA. 2002; 288(16):1987-1993.

doi:10.1001/jama.288.16.1987;

Article 7 states that “no one shall be subjected without

his free consent to medical and scientific

experimentation”. Several companies and research

bodies have faced media and legal scrutiny over consent

processes used in clinical trials, irrespective of their

medical success or failure

Acute respiratory diseases during health care may

constitute a public health emergency of international

concern as defined in the International Health

Regulations

Healthcare providers should take into account the

following topics when designing the menu for their

patients:

* Antibiotics

*Chemicals in the food system

Genetically engineered foods

*greening serviceware

*hospital food environments

*climate change (by buying local products for example)

66 Mediating

Institution

583, 586 Civil Society

Organization

357 Business

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 17 of 26


Sustainability

Category

Topic

Health service

effectiveness

Topic

Specification

(if available)

Cost

effectiveness of

key health

interventions

Explanation Reference(s) 1 Constituency

Health care facilities across the continent are

recognizing that the food system — how our food is

produced and distributed — is misaligned with dietary

guidelines, and is largely reliant on methods of

production and distribution that harm public and

environmental health.

The food system is inherently a deeply complex and

interwoven concept that must be considered from an

integrative, ecological perspective in order to develop

solutions that nourish our health and that of the planet.

Healthy Food in Health Care has selected a broadreaching

scope of topics of concern that form the basis

for our work. These issues, like antibiotic resistance, for

example, cut to the core of a hospital’s operations.

Others, like climate change and genetically engineered

foods, are matters of serious public health concern that

we believe the health care community has a capacity and

power to influence.

Some systems devote resources to expensive

interventions with small effects on population health,

while at the same time low cost interventions with

potentially greater benefits are not fully implemented.

The impact of interventions on population health is vital.

But it is also important to determine the role of different

interventions in contributing to other socially desirable

goals, such as reducing health inequalities, and being

responsive to the legitimate expectations of the

population

584 Mediating

Institution

The impact of interventions on population health is vital.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 18 of 26


Sustainability

Category

Topic

Medicines

management

Topic

Specification

(if available)

Patient safety

and

environmental

impacts

Explanation Reference(s) 1 Constituency

But it is also important to determine the role of different

interventions in contributing to other socially desirable

goals, such as reducing health inequalities, and being

responsive to the legitimate expectations of the

population

Rational use of medicines requires that "patients receive

medications appropriate to their clinical needs, in doses

that meet their own individual requirements, for an

adequate period of time, and at the lowest cost to them

and their community

590 Mediating

Institution

Corruption

Access to and

quality of

treatments

Irrational use of medicines is a major problem

worldwide. WHO estimates that more than half of all

medicines are prescribed, dispensed or sold

inappropriately, and that half of all patients fail to take

them correctly. The overuse, underuse or misuse of

medicines results in wastage of scarce resources and

widespread health hazards

Measures taken to avoid corruption in the following

processes: provision of services by medical personnel,

human resources management, drug selection and use,

procurement of drugs and medical equipment,

distribution and storage of drugs, regulatory systems,

and budgeting and pricing

505, 555 Business

Because of the complexity of health care systems and

services, and the significant amount of money involved,

the risk of corruption is high, that can result in the

inequality of access to and quality of treatments.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 19 of 26


Sustainability

Category

Other

Topic

Corporate

governance

Topic

Specification

(if available)

Healthcare

systems and

services

Gender

participation on

governance

bodies

Explanation Reference(s) 1 Constituency

Corruption in hospitals, informal payments for health

care, in pharmaceutical sector and HIV/AIDS

Fighting corruption in the health sector is a complex

challenge. At one end of the scale are doctors and nurses

who charge small informal payments to patients to

supplement inadequate incomes. At the other end, and

far more pernicious, are the corrupt suppliers who offer

bribes, and the health ministers and hospital

administrators who accept bribes, or siphon millions of

dollars from health budgets, skewing health policy and

depleting funds that should be spent building hospitals,

buying medicines or employing staff.

GOVERNANCE / EUROPE: boardroom lady boom: is it

possible without quotas?

On 22 June, the CapitalCom agency published its 2011

survey into the boardroom gender mix of CAC 40

companies, with fairly encouraging results: the

proportion of women on the board has doubled in recent

years, from 10.5% in 2009 to 20.8% in 2011.

34, 506 Civil Society

Organization

389 Financial

Markets &

Information

Users

In January, the French parliament adopted legislation

imposing quotas for the proportion of women on the

board of major companies. Under the measures, the

development of female board membership is mandatory

and gradual: 20% for listed groups, public companies of

an administrative, industrial and commercial nature by

January 2014, rising to 40% by January 2017. The law

also stipulates that companies with no women present

on their board must appoint at least one within six

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 20 of 26


Sustainability

Category

Topic

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

months of it being on the statute books (voted on 13

January 2011). In France, some 2,000 companies are

affected (the 650 largest listed firms and companies with

more than 500 employees and those generating sales in

excess of €50bn). In terms of sanctions for

noncompliance, appointments that run counter to the

parity principles are to be declared null and void and

attendance fees are to be temporarily suspended.

At the European level and at the instigation of the Vicepresident

of the European Commission, Viviane Reding,

the European parliament will decide in March 2012 on

whether to adopt common legislation on this matter (a

mandatory proportion of women in decision-making

positions of 30% in 2015 and 40% in 2020). This will

depend on the level of improvement seen based on the

selfregulation of European companies, in accordance

with the equality initiative adopted by the European

Commission in December 2010 and the European

parliament resolution of 17 January 2008 calling for the

Commission and member states to promote a balance

between women and men on company boards,

particularly where member states are shareholders.

Europe as a whole illustrates the degree of hesitation

between a soft-law approach and conventional

legislation (quotas in this instance), but it is clear from

the experience at national level that the second method

tends to get much better results.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 21 of 26


Sustainability

Category

Topic

Political

accountability

Topic

Specification

(if available)

Explanation Reference(s) 1 Constituency

There are various measures of political accountability

that can be measured (contributions, disclosure, board

oversight).

Note that this topic is applicable to more than the three

industries noted. Essentially the political accountability

practices of any company that is owned by public

stockholders. Political contributions, the amount of

disclosure and board oversight are among the data items

that would be helpful in a sustainability report.

394, 616 Financial

Markets &

Information

Users

In making investment decisions (especially for investors

interested in socially responsible investing) is would be

helpful to understand how a given company is exposed

to political risk (i.e. are they backing the winning

candidate, are they subject to potential retribution, why

do they find it necessary to make political contributions,

etc.).

I have found the information I reference to be helpful in

constructing investment portfolios that take into account

this attribute of sustainability. Since it is not currently an

established parameter in the socially responsible

investment industry (www.ussif.org), adoption by the

Global Reporting Initiative would go a long way in

moving the topic of political accountability forward.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 22 of 26


Sustainability

Category

Topic

Public health

service

effectiveness

Topic

Specification

(if available)

Laboratory

readiness -

Outbreaks of

novel, emerging

and dangerous

pathogens

Explanation Reference(s) 1 Constituency

Laboratories readiness and response for rapid detection

and containment of outbreaks of emerging and

dangerous pathogens

Outbreaks of emerging and dangerous pathogens are a

great risk for public health

591 Mediating

Institution

1

All references can be found at https://www.globalreporting.org/reporting/sector-guidance/Topics-Research/Pages/default.aspx

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 23 of 26


References

All references can be found at https://www.globalreporting.org/reporting/sector-guidance/Topics-Research/Pages/default.aspx

34

Baghdadi-Sabeti, G. & Serhan, F., 2010. WHO Good Governance for Medicines Programme: An Innovative Approach to Prevent Corruption in the

Pharmaceutical Sector, Geneva: World Health Organization (WHO).

44 Becker, J., 2010. Minding the Gap: Research Priorities to Address Pharmaceuticals in the Environment, Arlington: Health Care Without Harm.

66

Castan Centre for Human Rights Law; International Business Leaders Forum; Office of the United Nations High Commissioner for Human Rights,

2008. Human Rights Translated, A Business Reference Guide, New York: United Nations Global Compact.

102 Davis, S. C., 2002. 10 Ways to reduce regulated medical wastes (RMW), Arlington: Healthcare without Harm.

123

232

240

Emmanuel, J. & Stringer, R., 2007. For Proper Disposal: A global inventory of alternative medical waste treatment technologies, Arlington:

Health Care without harm.

Greiner, T., Rossi, M., Thorpe, B. & Kerr, B., 2006. Healthy Business Strategies for Transforming the Toxic Chemical Economy, Spring Brook:

Clean Production Action.

Health Care Without Harm Europe, 2007. Preventing damage to the environment from pharmaceuticals: a primer, Prague: Health Care Without

Harm Europe.

241 Health Care Without Harm, 2001. Non-Incineration Medical Waste Treatment Facilities, Washington, D.C.: Health Care Without Harm.

242

Health Care Without Harm, 2001. Waste Minimization, Segregation and Recycling in Hospitals. [Online]

Available at: http://www.noharm.org/lib/downloads/waste/Waste_Min_Seg_Recyc_in_Hosp.pdf,

[Accessed 19 March 2013].

245 Heineman, B. J., 2011. We May Never Know Leaders' Responsibility in Gulf Disaster, Boston: Harvard Business Review.

253 Institute for Human Rights and Business (IHRB), 'The Dhaka Principles for Migration with Dignity', Dhaka, 2011.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 24 of 26


353

Kershaw, P., Katsuhiko, S., Lee, S., Samseth, J., Woodring, D., & Smith, J., 2011. Plastic Debris in the Ocean. In United Nations Environment

Programme (UNEP), UNEP Year Book 2011 (pp. 20-33). Nairobi: United Nations Early Warning and Assessment.

357 Kulick, M., Nathanson, A. & Sirois, E., 2011. Menu of Change: Healthy food in health care, Arlington: Health Care Without Harm.

362

Aiken, L.H., Clarke, S.P., Sloane, D.M., Sochalski, J., Silber, J.H., 20025. Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job

Dissatisfaction. Journal of the American Medical Association, 288(16), pp. 1987-1993.

367 MacKerron, C., 2011. Unfinished Business: The Case for Extended Producer Responsibility for Post-Consumer Packaging, Oakland: As You Sow.

389° Natixis, 2011. Strategy Note Equity Research - Strategy/SRI: Monthly review June 2011, Paris: Natixis.

394 Nowak, T., 2012. Low Fee Socially Responsible Investing. 1st ed. Grayslake: Quantum Financial Planning LLC.

445

489

494

496

Prüss, A., Giroult, E. & Rushbrook, P., 1999. Safe Management of Wastes from Health-care Activities, Geneva: World Health Organization

(WHO).

Sutherland, L., Easthope, T., Sattler, B., Welker-Hood, K., Wilburn, S., 2008. Guide to Choosing Safer Products and Chemicals, Arlington: Health

Care Without Harm.

The American Hospital Association (AHA), 2012. Eliminating Racial and Ethnic Disparities. [Online]

Available at: http://www.aha.org/advocacy-issues/disparities/index.shtml

[Accessed 29 March 2013].

The Centers for Occupational and Environmental Health, University of California, 2008. Green Chemistry: Cornerstone to a Sustainable

California, San Francisco: The Centers for Occupational and Environmental Health, University of California.

505 Transparency International, 2006. Global Corruption Report 2006, London: Transparency International.

506 Transparency International, 2006. Global Corruption Report 2006: Corruption and Health, London: Pluto Press.

527

United Nations Environment Programme (UNEP), 2012. Compendium of Technologies for Treatment/Destruction of Healthcare Waste, Nairobi:

United Nations Environment Programme (UNEP).

555 Vian, T. & Nordberg, C., 2008. Corruption in the Health Sector, Bergen: U4 - Chr. Michelsen Institute.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 25 of 26


583 World Health Organization (WHO), 2002. Prevention of Hospital-acquired Infections, Geneva: World Health Organization (WHO).

584 World Health Organization (WHO), 2003. WHO Guide to cost-effectiveness analysis, Geneva: World Health Organization (WHO).

586

590

World Health Organization (WHO), 2007. Infection Prevention and Control of Epidemic- and Pandemic-prone Acute Respiratory Diseases in

Health Care, Geneva: World Health Organization (WHO).

World Health Organization (WHO), 2012. Pursuit of Responsible Use of Medicines: Sharing and Learning from Country Experiences, Geneva:

World Health Organization (WHO).

591 World Health Organization (WHO), 2012. Rapid Risk Assessment of Acute Public Health Events, Geneva: World Health Organization (WHO).

593

616

World Health Organization (WHO), Department for Public Health and Environment Assessing and Managing Environmental Risks to Health,

'WHO Core Principles for Achieving Safe and Sustainable Management of Health-care Waste', 2007.

Zicklin Center for Business Ethics at the Wharton School of the University of Pennsylvania, 2012. CPA-Zicklin Index of Corporate Political

Accountability and Disclosure, Washington, D.C.: Center for Political Accountability.

° Resource available on request and/or for a fee.

Sustainability Topics for Sectors: What do stakeholders want to know?

HEALTHCARE PROVIDERS AND SERVICES, AND HEALTHCARE TECHNOLOGY

May 2013

Page 26 of 26

More magazines by this user
Similar magazines