UCSF Sustainability Stories

Deborah Fleischer, Green Impact, August 2017

Connecting Sustainability and Clinical Pharmacy: Spotlight on Katherine Gruenberg, PharmD, BCPS

For 2017, the Sustainability Award in the Student Category went to Katherine Gruenberg, PharmD, BCPS, Pharmacy Resident, who was recently appointed an assistant professorship in the Department of Clinical Pharmacy.

Katherine’s interests in sustainability go back to college, where she served as a representative for the environmental club, GreeND. In this role, she developed an awareness and interest in living sustainably. Katherine explained, “However, as a pharmacy student and resident at UCSF, I learned about the health implications of climate change and the importance of creating a focus on sustainable healthcare practices.”

“From drug development to disposal, pharmaceuticals impact the environment. Additionally, the effects of climate change are projected to have a significant effect on patient health, which translates to greater pharmaceutical demand. It’s imperative for healthcare trainees and professionals to be aware of these relationships in order to reduce the effects of the healthcare systems on the environment,” stressed Katherine.

Developing Curriculum
Nominated by Associate Dean Tina Brock, Katherine designed and led a one-hour CME program open to all pharmacists and trainees about issues of drug selection, procurement, distribution, use, and their relationship to UCSF’s environmental sustainability goals.  This session not only highlighted areas in which UCSF’s purchasing could be improved, but also how pharmacists can influence the attainment of environmental sustainability goals more broadly.

She also designed and led a three-hour teaching session for all third-year pharmacy students (N=116) in a required Health Policy course about issues regarding sustainability and pharmacy. This included preparatory work, an interactive case-based session, and an inter-professional panel (medicine, respiratory therapy, pharmacy, the sustainability office, and a simulated patient) looking at the implications of an actual UCSF medical center formulary/practice decision. Following this, several pharmacy students chose to focus their course proposals on sustainability policies.

The goal of the teaching session was to develop awareness of climate-related illness and to encourage sustainable healthcare practices, including patient education about the environmental impact of pharmaceuticals. The learning objectives of the course were:

1) Explain the importance of the relationship between climate change and healthcare;
2) Describe at least one effect of climate change on health and state which drugs you anticipate will garner greater use;
3) Discuss the environmental opportunity costs in each step of a pharmaceutical lifecycle from drug development to disposal;
4) List challenges and limitations of maintaining a sustainable healthcare system at UCSF; and
5) Identify existing and future pharmacist-led strategies that promote a sustainable healthcare system at UCSF Medical Center.

Katherine has made her innovative teaching materials freely available for use by other pharmacy instructors globally by sharing them on http://pharmacademy.org/. She also stepped in to mentor and assist two Carbon Neutrality fellows in putting together a 10-week elective course called EarthHealth – Sustainability in Health Care – and presented at one of the sessions.

“I look forward to continuing my work on sustainable pharmacy education. I also hope to disseminate this mini-curriculum for adaptation and collaboration with other schools of pharmacy,” explained Katherine.

Engaging the Wider Pharmacy Sustainability Community

Katherine has engaged in the wider pharmacy sustainability communities – locally, nationally, and internationally.  Locally, she presented her work at the UCSF Department of Clinical Pharmacy Research Symposium and the UCSF Inquiry Symposium where she received an Honorable Mention.  Nationally, she has collaborated with an environmental toxicologist, Dr Helen Smith, to map the accreditation standards for pharmacy degrees to sustainability concepts and submitted an abstract for a session at the American Association of Colleges of Pharmacy Annual Meeting. Internationally, Katherine recently presented about teaching sustainability in pharmacy curricula at the 9th Annual Monash University Pharmacy Education Symposium. This conference attracts pharmacy educators from around the world to share educational scholarship and to provide a forum for global collaboration.

“I delivered an oral presentation entitled ‘Sustainable Pharmacy: Piloting a brief curriculum surrounding pharmaceuticals, climate change, and sustainability within a U.S. pharmacy program’. The presentation focused on the design and assessment of this novel curriculum. I was honored to receive the award for ‘best talk on teaching innovation’ in the first time attendee category,” said Katherine.

UCSF Call to Action

Katherine encourages the UCSF community to reduce the effects of pharmaceuticals on the environment through patient education about medication disposal. “Encouraging the use of pharmaceutical take-back programs, rather than flushing or disposing in the trash, reduces the likelihood of pharmaceutical contamination of water supplies and bioaccumulation in wildlife,” said Katherine.

“When a patient is started on a new medication, take time to discuss proper medication disposal. In San Francisco, we’re very fortunate to have the Safe Drug Disposal Stewardship Ordinance, which requires pharmaceutical companies to finance and manage disposal of prescription and OTC medications. Patients can visit this website to find a drug disposal site or to request a free prepaid mail-back envelope to mail in unused or expired medications,” explained Katherine.

For a listing of disposal sites in the greater California area, she suggests referring patients here.

Congratulations Katherine for your outstanding work and on earning the Sustainability Award in the student category.