Today, on the 54th anniversary of Earth Day, America’s Essential Hospitals recognizes the work of essential hospitals to reduce their carbon footprint and build climate resiliency, including for the people and communities they serve.

Initiatives to mitigate the harm climate change causes have taken root in essential hospitals, part of an economic sector — health care — responsible for 8.5 percent of all U.S. carbon emissions. These emissions occur through facility operations, purchased energy and steam, and the supply chain of food and other goods.

As awareness of how health care contributes to greenhouse gas emissions — and, in turn, the health of communities — grows, essential hospitals have stepped up to lead mitigation and resiliency work. University of Arkansas for Medical Services (UAMS), an essential hospital in Little Rock, Ark., offers one noteworthy example.

Staff of Essential Hospitals Institute, which leads research on climate resiliency and mitigation for America’s Essential Hospitals, spoke recently with UAMS Sustainability Lead Joe Wolf about aids and barriers to UAMS’ sustainability strategies. We share his thoughts here.

A History of Sustainability

A leader in the sustainability space, UAMS has committed to the U.S. Department of Health and Human Services Climate Pledge, participated in the National Academy of Medicine (NAM) Climate Collaborative, and acknowledged its role as a teaching institution to educate the next generation of medical professionals about how health care affects climate change.

As a result, UAMS has achieved a 39 percent reduction in Scope 1 and 2 greenhouse gas emissions, saved $5.6 million in annual energy costs, and saved $3.2 million in annual operational costs. The health system has been home to one of the largest heat pump chillers in the United States since 2008 and has added other units to reduce natural gas consumption and cost. Savings from these pumps have funded other energy efficiency work, including replacing aging equipment.

In a Kresge Foundation–funded research initiative in 2021, Essential Hospitals Institute worked with UAMS and other member hospitals to support climate resiliency and mitigation projects. UAMS audited its elevator energy use and calculated the potential return on investment from implementing sensors to trigger lighting only during elevator use.

Wolf stresses that having leaders and teams that support climate mitigation work is critical. Many of the largest buildings on the UAMS campus were built in the 1960s, and finding the time, staff, and budget to maintain the buildings and equipment is difficult. UAMS is consistently in the process of renovating, replacing, and modernizing old equipment and buildings.

Wolf says collaboration between departments can be challenging, due to the intricacies of the buildings and equipment. For example, repairing or improving a pump that feeds water to the building requires coordination among three responsible departments: facilities and plant, electric, and plumbing. “Reliability is savings,” Wolf says, by way of helping staff understand the importance of efficiency and sustainability. This attitude fuels the commitment of staff at all levels to work together toward the institution’s sustainability goals.

In addition to internal collaboration, Wolf stresses the importance of UAMS’ external partnership with Bernhard, a privately owned engineering and contracting firm focused on promoting a sustainable future. This partnership provides energy project management, as well as a measurement and verification program. UAMS also collaborates with other University of Arkansas entities to share ideas for new and existing sustainability programs.

Ensuring Return on Investment and Centering Community

Return on investment (ROI) is crucial to achieving sustainability goals. At UAMS, the facilities team calculates ROI in different ways. For example, the health system calculates ROI for its heat pump chiller system by measuring how much equipment does not need to run when the heat pump chiller is running optimally. The consistent tracking of ROI is an integral part of this process. UAMS has established an extensive measurement and verification framework that allows meter-by-meter energy tracking, which helps identify trends and abnormalities. Replacing old equipment generates the highest ROI because the savings are easily predictable, Wolf says.

Centering community in sustainability work is important to UAMS. Wolf explains that the most important thing is keeping the hospital doors open during climate-related events, so the community can access care. During winter 2023, UAMS and its surrounding community experienced a freeze that threatened access to the hospital. Many teams and departments worked to ensure the hospital’s pipes would not freeze and that roads leading to and on hospital property were safe.

Long-Term Goals

Currently, UAMS is conducting a systemwide survey on Scope 3 emissions to identify opportunities for improvement. Possible projects include adding two heat pump chillers, as well as replacing outdated equipment.

Overall, UAMS’ commitment to sustainability aligns with its goal to improve community health by mitigating environmental risks. UAMS Chancellor Cam Patterson, MD, MBA, noted this important connection in a recent interview with the NAM, in which he discussed the health system’s climate work and opportunities for the health care sector to become more climate conscious.

To learn more about climate initiatives at essential hospitals, or share a program of your own, visit For more information about the Climate Mitigation and Resilience Interest Group, visit our website.