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Health care innovations in sustainability will protect both patients and the planet

The health care sector is uniquely positioned to be a leader in sustainability by implementing practices that mitigate the harms of the climate crisis while advancing public health.

A small globe in between the gloved hands of a medical professional

Source: Shutterstock/Treecha

This is the second in a six-part series examining decarbonization practices in the health care industry. The first column details the importance and value of integrating sustainability and ESG principles into health care operations.  

In their quest to create a healthier world, health care organizations are not just taking care of people. Taking care of the planet is just as important for long-term viability and corporate social responsibility. To that end, more health care providers are focusing on areas such as environmental stewardship and sustainability practices, complementing the core work of health care. 

If the global health care sector were a country, it would be the fifth-largest greenhouse gas emitter on the planet. As we address a changing climate and resource depletion in the face of continued economic growth, the health care sector is uniquely positioned to be a leading industry in sustainability, implementing practices that mitigate harm to the planet while advancing public health — a true embodiment of the Hippocratic Oath: "First, do no harm." 

From reducing carbon emissions to promoting eco-friendly supply chains, here are some key strategies and solutions health care institutions can use to address sustainability, reduce their long-term economic risks and fulfill their mission.

Implementing strategies for decarbonization

Health care facilities are carbon emitters through their operations and energy-intensive activities, and many organizations are committing to reducing their carbon footprint and transitioning to renewable energy sources. To accelerate decarbonization and health equity, the U.S. Department of Health and Human Services launched the Health Sector Climate Pledge, which includes commitments to reduce organizational emissions by 50 percent by 2030; designate an executive-level lead for work on reducing emissions by 2023 or within six months of signing the pledge and conduct an inventory of Scope 3 emissions by the end of 2024; and develop and release a climate resiliency plan for continuous operations by 2023 or within six months of signing the pledge. Health care-accrediting nonprofit The Joint Commission has launched a voluntary Sustainability Certification program for hospitals that focuses on decarbonization. 

In recent months, the CMS (Centers for Medicare & Medicaid Services) proposed an innovation model with a sustainability component: Transforming Episode Accountability Model (TEAM). This integration targets the health system’s sustainability by addressing individual health as well as the impact of climate change. All of these initiatives illustrate a sectorwide goal across the health care value chain to address decarbonization and health equity.

One of the primary decarbonization strategies employed by health care institutions is improving energy efficiency within their facilities. This includes upgrading energy-efficient lighting, HVAC systems and medical equipment (MRIs, bedside devices that increase plug load), as well as implementing smart building technologies to optimize energy usage. By reducing energy consumption through efficiency, health care organizations not only lower their operating costs but also minimize greenhouse gas emissions, contributing to a healthier environment for all.

The health care industry has an opportunity to lead, both as bastions of healing and well-being and as solution-makers.

Health care providers are also adopting sustainable transportation practices to reduce carbon emissions associated with patient transport, staff commuting and supply chain logistics. This may involve investing in electric or hybrid fleets, anti-idling, promoting public and alternative transportation options for employeesand implementing telemedicine services to minimize the need for clinician and patient travel, as well as improving route logistics and efficiency for shorter vehicular trips. 

In addition to facility operations and infrastructure, health care providers are addressing carbon emissions through the use of anesthetic gases and medical inhalers. For example, they are transitioning from desflurane — an anesthetic gas that is generally more expensive and has higher global warming potential — to sevoflurane; implementing efficient gas scavenging systems; and exploring options for recycling and waste reduction, reducing GHG and saving money. Moreover, health care providers are promoting the use of environmentally friendly inhalers, such as dry powder inhalers, and engaging patients in conversations about the environmental impact of their inhaler choices. Collaboration with manufacturers and research efforts to develop greener anesthesia techniques and sustainable inhaler technologies are also underway. 

Reducing waste, improving circularity  

Efforts to reduce waste in health care settings are particularly crucial, given the significant volume of medical waste generated daily. Hospitals produce more than 5 million tons of waste each year and more than 29 pounds of waste per bed per day. Health care facilities are implementing waste reduction strategies such as recycling, composting and waste-to-energy programs to divert waste from landfills. 

A novel way that waste management intersects with clinical treatment is the rise of single-use reprocessed devices. This is a strategy that reduces waste to landfill, addresses decarbonization, and saves the system money to reinvest in patient care.  

Furthermore, health care institutions are prioritizing the use of environmentally preferable products and materials that are healthier and safer for both patients and the planet. This includes phasing out single-use plastics and plastics in building materials. It also means adopting non-toxic cleaning agents and disinfectants, and sourcing eco-friendly building materials free of chemicals of concern for new construction and renovation projects.

Greening procurement 

Simply put, what we purchase today, if not reused, recycled, or discarded responsibly, becomes a toxic landfill for tomorrow. A key and strategic aspect of sustainable health care practices is the promotion of environmentally and socially responsible supply chain and procurement strategies, keeping the long view of eliminating waste and reducing and eliminating chemicals of concern in mind. Health care organizations are recognizing the importance of aligning their purchasing decisions with sustainability principles, considering factors such as product lifecycle, environmental impact, human rights, local economic and workforce development, and social responsibility.

By collaborating with suppliers to set and achieve sustainability goals, health care institutions can create a more resilient and environmentally sustainable health care ecosystem.

Prioritizing sustainable sourcing and procurement practices, health care institutions can support local economies, reduce their carbon footprint, and promote the production and use of eco-friendly products and services. This may involve partnering with suppliers who adhere to ethical labor practices, prioritize environmental sustainability, and offer products that are free from hazardous chemicals and materials. Healthcare Anchor Network is an organization that supports health care organizations and helps them leverage their purchasing power to drive positive change throughout the supply chain, advocating for transparency, accountability and responsible sourcing practices among suppliers and manufacturers.

Meanwhile, Kaiser Permanente, Vizient, Accenture and Sustainable Purchasing Leadership Council have joined forces to launch the CHARME (Collaborative for Healthcare Action to Reduce Medtech Emissions) initiative. CHARME is focused on convening health systems, medical device and equipment suppliers, distributors, GPOs (group purchasing organizations), and other key industry stakeholders to define, implement and champion best practices to reduce emissions from the med tech supply chain. By collaborating with suppliers to set and achieve sustainability goals, health care institutions can create a more resilient and environmentally sustainable health care ecosystem.

Financing sustainable health care practices 

Sustainable health care practices come in a portfolio approach, which can be prioritized based on the topics most material to the type of organization. Health insurers, biopharma, medical device companies and others can align their own goals and pathways of contribution to the larger decarbonization efforts.  

The health care industry has an opportunity to lead, both as bastions of healing and well-being and as solution-makers. Decarbonization is the lion's share of the most complex work, as it is directly tied to the carbon inventory, source-based solutions and a company’s infrastructure investment options. 

The question on everyone's mind is how to finance decarbonization. Implementing sustainable practices in hospitals can involve significant upfront costs. Key expenses include infrastructure upgrades, equipment replacement, waste management systems, purchasing alternative products, and also staff training and certification costs. These costs require long-term decisions regarding budget constraints, return on investment (ROI) considerations, regulatory compliance, planning, public image and operational efficiency.

Some solutions for financing sustainable health care practices include best practices from other industries as well as those unique to the sector:

  • Extended payback periods in capital planning for sustainability projects
  • Green revolving funds finance sustainability projects by using cost savings from completed initiatives to fund future ones, creating a self-replenishing cycle. Cleveland Clinic is a notable example: It established a green revolving fund in 2008 with $7 million in initial capital for energy conservation and sustainability initiatives.
  • Funds within system foundations can lead to unrestricted dollars for use supporting programs, projects and full time positions.
  • Government grants, congressional funding and programs: Examples include incentives from the Environmental Protection Agency, Department of Energy and state and local agencies, and the Inflation Reduction Act, of which Hackensack Meridian Health has leveraged the tax credits to cover $50 million of the costs of their current solar power and battery storage project.
  • Philanthropic funding from private foundations
  • Green bonds and environmental impact bonds: Examples include The Ohio State University Wexner Medical Center's $600 million green bond and Kaiser Permanente's $1 billion green bond, both used to support greener and environmentally friendly infrastructure.
  • Public-private partnerships

These solutions provide health care organizations with various options to fund sustainability initiatives, balancing immediate costs with long-term benefits and environmental impact. The financing solutions would have to be prioritized by organizations based on their resource alignment strategy and overall emphasis on climate action.

By prioritizing emissions reduction, health care organizations embark on a virtuous cycle of efficiency, cost savings, risk mitigation and health equity. The next column will spotlight practical resilience and adaptation strategies in health care.

The views expressed in this article are those of the authors and not those of their current or former employers.

[Streamline your supply chain at VERGE 24 (Oct. 29-31, San Jose), the hub for professionals driving transformative, decarbonized and profitable change.]

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