By Britt Harter and Derek Rushing
“It is time to tackle climate change now,” Health and Human Services (HHS) Secretary Xavier Becerra declared in an interview with The Wall Street Journal — and hospital carbon emissions are a primary target.
As the newly created Office of Climate Change and Health Equity works to combat the health risks that climate change poses, especially for poor and minority communities, it’s time to become more intentional about reducing the impact of waste emissions on the health of our communities.
Moreover, from rising energy costs to strains on physical infrastructure that threaten disruption of operations, carbon emissions can also create resiliency challenges in health systems.
Health Care’s Environmental Value Proposition
Today, air quality and water quality are considered social determinants of health. Poor air quality can trigger new cases of respiratory illness, from asthma to chronic obstructive pulmonary disease to emphysema, and worsen symptoms of asthma, as well as emphysema and other lung disorders. Meanwhile, exposure to water pollution has the potential to induce gastrointestinal, neurological, and respiratory issues. It also can pose risks to reproductive or developmental health.
For health care organizations, taking action to create a more sustainable approach to energy use is not only a matter of social responsibility. In the eyes of government officials and the American public, it is quickly becoming a way of demonstrating an organization’s commitment to community health — and expectations that health care leaders act with intention are high.
Developing a more sustainable approach to energy consumption in hospitals and health systems also strengthens an organization’s financial health—and its resilience. The U.S. health care system spends $8.8 billion per year on energy, with energy use accounting for 51 percent of facility expenses. As health care volumes struggle to return to baseline levels post-pandemic, investing in more energy-efficient approaches to heating, cooling, ventilation, and lighting could save millions of dollars.
Consider Robert Wood Johnson University Hospital Somerset, in Somerville, N.J., where a $5.7 million investment in energy efficiency improvements will save the hospital more than $600,000 annually in energy costs. The improvements include a major upgrade to the hospital’s air conditioning chiller plant, installation of energy-efficient lighting fixtures and controls, and replacement of motors, fans, and pumps with more energy-efficient models.
Similarly, association member University of Vermont Medical Center, in Burlington, Vt., has led several initiatives to increase sustainability, including reducing greenhouse gas emissions by 8.8 percent, reducing water use by 9 percent on the main campus, and eliminating use of ethylene oxide, a cancer-causing sterilizing agent. Further, the medical center since 2011 has diverted nearly 100 tons of single-use devices from the landfills through a reprocessed medical device program, saving $6.7 million. The hospital also developed sustainable procurement guidelines and integrated sustainability criteria into its request for proposal scoring matrix.
And even as hospitals have struggled during the COVID-19 pandemic, work to increase sustainability remained top-of-mind. For example, The Ohio State University Wexner Medical Center, an association member in Columbus, Ohio, collected and sterilized used N95 masks to reduce waste and ensure adequate supply.
These approaches decrease both organizational risk and redundancy. They enhance the health of the hospital or health system’s patients, as well as its employee population and their dependents.
Beginning the Journey to Sustainability
Developing a robust plan for energy efficiency and sustainability makes good business sense for hospitals and health systems. It’s also the right thing to do. However, this type of work is complex and requires long-term investments and commitment to change energy consumption patterns, improve energy efficiency, and upgrade fleets and buildings. Further, supply chains — a major source of emissions — are deep, tiered, and dispersed, involving thousands of vendors and suppliers, each with their own economic pressures and business priorities.
However, the rising tide of incentives for environmental sustainability initiatives can make this transition financially feasible. With leadership and buy-in from across the organization, hospitals and health systems can drive momentum and excitement for a more sustainable future.
Creating a robust action plan for environmental sustainability relies heavily on technical planning and an understanding of the organization’s norms and systems, as well as the needs and concerns of stakeholders. The key to creating a foundation for demonstrable change is a clear, five-step plan — one informed by data, backed by science, and tailored to the organization’s specific goals and ambitions.
Step 1: Establish baseline performance.
Before planning can begin, organizations must take stock of their environmental activities, pressures, and impacts. This includes understanding environmental, social, and corporate governance (ESG) pressures, measuring the organization’s existing greenhouse gas footprint, and assessing current activities and organizational structures related to energy consumption. By engaging stakeholders and executing data analysis — including benchmarking peer activities — the team can better understand where the organization stands and where opportunities for improvement exist.
Step 2: Use the data to develop a strategy for energy efficiency.
With good data in hand, leaders can prioritize key ESG initiatives and develop a road map for future endeavors. This strategy could include a bold climate reduction target, which should be underpinned by solid forecasting and planning.
Step 3: Undertake abatement and execution planning.
This step involves identifying the specific initiatives and action plans for achieving the organization’s unique climate-action goals. Key considerations typically include the types of technology and efficiency solutions needed, as well as steps toward securing organizational buy-in and necessary funding.
Step 4: Develop a plan for implementation.
After the steps above have been completed, it’s time to launch the initiative. Developing a targeted communications campaign can keep the momentum going and help stakeholders stay engaged as the organization begins to deliver on its climate-related activities.
Step 5: Establish a robust reporting mechanism.
As implementation begins, the team should make sure it has the processes and tools in place to capture and analyze data, track emissions, and measure the organization’s progress. Reporting on the strategy and performance of actions and improvements is an essential part of the journey to keep teams accountable and motivated and to ensure stakeholders remain informed.
Resilience by Design
While the challenge of implementing an environmental sustainability program might seem daunting, the risks of inaction are too significant to ignore. As climate change action gains momentum, hospitals and health systems that invest in energy efficiency will become better positioned to meet the expectations of federal regulatory agencies while solidifying trust with the communities they serve.
This is the first in a series of blog posts focused on hospitals’ role in promoting sustainability. An upcoming companion post will highlight how essential hospitals have taken steps to mitigate the climate crisis.
Britt Harter is a partner in the energy, sustainability, and infrastructure segment of Guidehouse, an America’s Essential Hospitals corporate affiliate member. Derek Rushing is a director in the health segment of Guidehouse.