ANPD believes no matter your role in the practice of NPD, you belong in our community. That’s why our Specialty Spotlight series is highlighting members furthering NPD goals in unique and invaluable ways. Today, the spotlight is on the nursing partner for innovation and improvement, a unique role held by Dr. Emily R. Sermersheim.

Harms to the environment disproportionately impact communities of color and those most vulnerable. Some communities experience exaggerated impacts of climate change or “climate inequity” due to preexisting inequalities (e.g., socioeconomic disparity and systematic environmental injustices) (Environmental Protection Agency [EPA], 2023). Thus, communities that already struggle socioeconomically are often most impacted by climate change (EPA, 2023).

The Impact of Climate Inequity

Heat islands are one specific example of this phenomenon, and are defined as “urbanized areas that experience higher temperatures than outlying areas” (EPA, 2023). Urban areas with fewer elements of a natural landscape (e.g., trees, green space, bodies of water) experience hotter temperatures because buildings, roads, and other concrete structures absorb and re-emit the sun’s heat (EPA, 2023). These increased temperatures play a significant role in the quality of life of individuals in those communities. There is greater demand for cooling, which increases the need for air conditioning, leading to additional cost and energy utilization. Alarming statistics show that heat-related morbidity and mortality rise in areas impacted by the heat island phenomenon (Santamouris, 2020). 

In addition to climate change disproportionately affecting communities of color, “environmental racism,” the term used to describe the unequal impact of environmental hazards on vulnerable populations, is a serious concern for many communities in urban areas (Greenaction, n.d.). Environmental racism occurs when institutional rules, regulations, or government/corporate decisions expose people of color to higher rates of polluting industries and/or toxic waste (Greenaction, n.d.).

Healthcare Institutions Can Help

Hospitals, as anchor institutions and significant property owners in their communities, are uniquely positioned to address these social and environmental inequities (Schwarz, 2017). Healthcare systems have the rare opportunity to engage in activities to aid the health of the community by leveraging their resources through local hiring practices, purchasing locally, and engaging in community partnerships (Koh et al., 2020). By tackling the challenge of social and environmental factors in an integrated manner, hospitals can accomplish greater efficiencies, which may be passed along to the communities they serve (Practice Greenhealth, n.d.b).

There are many challenges to this integration of work, however, including the logistics of strategically aligning to optimize efficiencies — to put it simply, to break down silos in healthcare and work together.  Siloed work limits the ability to problem-solve and innovate, as innovation ideally stems from collaboration (Practice Greenhealth, n.d.b). Without a collaborative platform, leaders are often unaware of each other’s work, leading to the siloed effect, redundancy, and less optimization of efforts. At a time when organizations need to maximize investments, there is a great risk of under-powering impacts.

Innovation is needed on all fronts to accomplish this seemingly monumental task of addressing environmental concerns through an equity lens in an integrated manner.

Enter the Nursing Partner for Innovation and Improvement

Rush University Medical Center, as part of the larger Rush University System for Health (RUSH), enlisted the unique skillset of a newly created role to engage in this work: the nursing partner for innovation and improvement (NPII), a nursing professional development specialist who has the responsibility to cross interprofessional aisles with the goal of optimizing organizational and system performance.

Key responsibilities of the NPII include:

• Driving key metrics such as performance improvement initiatives, safety, compliance, regulatory issues, patient satisfaction, and employee engagement across nursing and interprofessional teams;
• Managing complex organizational change initiatives; and
• Establishing practices, templates, policies, tools, and/or partnerships to standardize processes and expand innovative capabilities on a system-wide level.

The NPII develops skills in nursing staff, assistive personnel, peers, and nursing leadership through mentorship, consultation, resource sharing, and delivery of professional development activities or programs. This role facilitates advances in practice through active participation in professional organizations and the dissemination of innovation and improvement initiatives.   

Bringing Departments Together for Change

As RUSH’s NPII, I serve as a change agent and innovation leader. I partnered with the environmental sustainability manager to engage in a pilot program led by the Advisory Services of Practice Greenhealth, an organization focused on supporting over 1,000 healthcare organizations in environmental stewardship and sustainability (Practice Greenhealth, n.d.a).

This pilot program, held from July through September of 2022, was designed to align social and environmental determinants of health activities to achieve system efficiency and sustainability. It aimed to join efforts between departments, engaging stakeholders in social and environmental sustainability endeavors to maximize impact and ensure a collaborative and aligned platform for current and future work.

In addition to the sustainability manager, we assembled a core team to participate in the pilot program, including representatives from various departments — Communications, Diversity/Equity/Inclusion, Human Resources, the University arm, Anchor Mission and Community Development Departments, and Enterprise Risk Management. Additionally, the core team enlisted support from an executive-level champion to help guide the work. Along with experts from Practice Greenhealth, this core team focused on strategies to align sustainability with social and environmental determinants of health, connecting to an overarching commitment of environmental stewardship and serving as a pillar in the community, in alignment with RUSH’s mission, vision, and values. The pilot program deliverable was a detailed roadmap designed to help our team drive the work post-pilot. 

The Path Forward

After the conclusion of the pilot, the core team continued to meet to further refine strategies for aligning opportunities. The team, branded as The RUSH Commitment (TRC), drafted a vision statement and formed a monthly collective to discuss current initiatives with social and environmental sustainability overlap. 

During our April meeting, our team reviewed a project with an environmental sustainability and anchor mission intersection called the Impact Purchasing Commitment. As part of this commitment, RUSH is focusing on four metrics for improvement: renewable electricity, furniture/furnishings, chemical reduction, and sustainable food. We also discussed a medical device reprocessing and reuse project designed to divert pulse oximeter probes from the landfill. We successfully diverted over 10,000 pounds of probes last year. Future projects for discussion include addressing environmental racism, carbon emission reduction, and many others. During these monthly meetings, our TRC team spotlights four of our individual departments, discussing current initiatives, successes, challenges, and areas of possible TRC overlap.  Importantly, the collective will use our time together to outline potential funding and volunteer opportunities in this sphere, bring any upcoming events to light, and maintain an open discussion platform where ideas can be shared as a sort of “think tank.”

An essential part of the TRC function will be telling the story. Our team will determine which projects to feature, and draft narratives or host information sessions with the goal of informing the work. We hope that these stories provide inspiration to our internal and external stakeholders — staff, students, patients, and community partners included — and instill a sense of pride in our RUSH community. We are investing and innovating today so that our community and our planet thrive for generations to come. 

Could Your Organization Leverage an NPII?

This Earth Month, remember that Advocacy, Collaboration, Resource Stewardship, and Environmental Health are all Standards of Professional Performance for nursing professional development practitioners (Harper & Maloney, 2022), and consider how your organization might address environmental concerns through an equity lens.

Stay tuned for an episode of NPD Forecast featuring Dr. Sermersheim coming soon!

References

Environmental Protection Agency. (2023). Climate equity. https://www.epa.gov/climateimpacts/climate-equity#:~:text=Climate%20equity%20is%20the%20goal,benefits%20of%20climate%20protection%20efforts

Greenaction (n.d.). Environmental Justice and Environmental Racism. https://greenaction.org/what-is-environmental-justice/

Harper, M., & Maloney, P. (Eds.). (2022). Nursing professional development: Scope & standards of practice (4th ed.). Association for Nursing Professional Development.

Koh, H., Bantham, A., Geller, A., Rukavina, M., Emmons, K., Yatsko, P., & Restuccia, R. (2020). Anchor Institutions: Best Practices to Address Social Needs and Social Determinants of Health. American Journal of Public Health, 110(3), 309-316. DOI: 10.2105/AJPH.2019.305472 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7002960/

Practice Greenhealth. (n.d.a). About Us. https://practicegreenhealth.org/about/about-us

Practice Greenhealth. (n.d.b). Climate and Health. https://practicegreenhealth.org/topics/climate-and-health/climate-and-health

Santamouris, M. (2020). Recent progress on urban overheating and heat island research. Integrated assessment of the energy, environmental, vulnerability and health impact. Synergies with the global climate change. Energy and Buildings, 207. https://doi.org/10.1016/j.enbuild.2019.109482

Schwarz, D. (2017). What you need to know about hospital roles in community investment. Robert Wood Johnson Foundation Website. https://www.rwjf.org/en/insights/blog/2017/03/can-hospitals-defy-tradition.html#:~:text=Hospitals%20have%20a%20long%20tradition,and%20building%20new%20clinical%20facilities