hydrocarbon industry

Kigali agreement: India's HFC target is equal to shutting down 1/6th of its thermal power stations

India will reduce 75% of its cumulative hydrofluorocarbon emissions between 2015 and 2050, under the new agreement finalised in Rwanda.

India’s participation in a global agreement on climate change will reduce India’s greenhouse gases equal to closing one-sixth of India’s thermal power stations over the next 35 years, according to an IndiaSpend calculation, based on carbon-dioxide equivalent emissions from thermal power stations in 2012.

As many as 197 countries reached a legally binding agreement in Rwanda on October 15 to phase down the production and consumption of hydrofluorocarbons – gases that can have global warming potential up to 12,000 times more than carbon dioxide. The agreement will come into force on January 1, 2019, and avoid emission of 70 billion tonnes of CO2 equivalent globally – the same as stopping more than half of tropical deforestation.

India agreed to cut the production and use of HFCs starting 2028 – a more ambitious plan than India’s earlier proposal – according to a press release by Climate Action Network International, a network of non-governmental organisations working to limit climate change.

India will reduce 75% of its cumulative HFC emissions between 2015 and 2050, under the new agreement finalised in Rwanda, according to Vaibhav Chaturvedi, a researcher at Council on Energy, Environment and Water, a research institute headquartered in New Delhi.

Environmental impact

Developed countries will start reducing HFCs in 2019, followed by a group of developing countries including China, in 2024. India is in the group of countries which will reduce HFC consumption last, starting 2028.

The agreement is part of the Montreal Protocol, a global treaty for reducing the use of ozone-depleting substances, and now global warming gases.

“The agreement recognises the development imperatives of high-growth economies like India, and provides a realistic and viable roadmap for the implementation of a phase-out schedule for high global warming potential HFCs,” according to a press release by the Ministry of Environment and Forests.

HFCs are commonly used in air conditioners and refrigerators. HFCs would make up 5.4% of India’s global warming impact in 2050, as demand for air conditioners and refrigerators rises, according to a 2015 report by the Council on Energy, Environment and Water. The highest HFC emissions in 2050 are predicted to come from residential air-conditioning (35%) and commercial refrigeration (28%).

HFC emissions in the world are expected to grow by 10-15% by 2050, and could contribute to 200 billion tonnes of CO2 equivalent emissions. Preventing the rise of these emissions could reduce the warming of the earth by 0.5 degrees Celsius, according to this 2015 brief by Institute for Governance and Sustainable Development, an advocacy and research organisation headquartered in Washington DC.

Ambitious plan

The new agreement for HFC reduction for a group of countries – which includes India, Pakistan, Iran and Iraq – is more ambitious that the previous Indian proposal for developing countries but less intensive that the North American proposal.

India had earlier proposed a plan for developing countries to freeze HFC consumption by 2031, which means HFC use and production would be highest in that year, and decrease every year after 2031. A counterproposal by North America had suggested developing countries freeze HFC production and consumption in 2021.

An earlier freeze and baseline under the agreed amendment means that India will mitigate more CO2 equivalent that its original proposal.

Under the new agreement, India will freeze HFC consumption and use by 2028, while phasing down HFCs, by 2047, to 15% of the average consumption and use over 2024-2026.

It would approximately cost India $16.48 billion (Rs 1.1 lakh crore), Chaturvedi of the Council on Energy, Environment and Water said.

Another group of developing countries, including China, has agreed to freeze HFC consumption and use even earlier, by 2024. By 2045, these countries will reduce HFCs by 80% of the average consumption between 2020 and 2022.

Developed countries, such as the Unites States and western European countries, have agreed to freeze HFC consumption and use in 2019, and by 2036, phase down HFCs to 15% of the average use and consumption between 2011 and 2013.

“The flexibility and cooperation shown by India as well as other countries has created this fair, equitable and ambitious HFC agreement,” Prime Minister Narendra Modi tweeted on October 15.

India, and other developing countries, will be financially assisted by the Multilateral Fund of the Montreal Protocol, philanthropies, and other developed countries, as they switch from HFCs to other alternatives, with lower global warming potential, as IndiaSpend reported on October 14, 2016.

The Indian government also passed an order on October 13 for all producers to destroy HFC-23, a gas with a global warming potential 12,500 times that of CO2, according to the United Nations Environment Program. This will result in eliminating emissions of 100 million tonnes of CO2 equivalent in India, over the next 15 years, according to Chandra Bhushan, the director of Centre for Science and Environment, a research and advocacy organisation, reported Livemint.

This article first appeared on IndiaSpend, a data-driven and public-interest journalism non-profit.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.