Why is sustainability an issue for hospitals in the US?

In the US, the healthcare sector accounts for 8.5% of national carbon emissions, and is the largest contributor to the world’s healthcare footprint, making up around 27% of the sector’s emissions globally. The effects of climate change on communities and human health are increasingly being felt across the US, as with the rest of the world. 

Despite growing awareness of the need to integrate sustainability into healthcare delivery, some of the biggest challenges reported by hospital leaders in the US include not knowing where to focus efforts, the false belief that sustainable healthcare increases costs, and facing difficulties in identifying how to drive progress and impact for the community the hospital serves.  

What are the climate and health challenges in West Virginia?

Heidi L Porter, Vice-President Quality and Regulatory Affairs, Wheeling Hospital, West Virginia University Medicine, shared her motivations for using the SAT in her organization to support their sustainability journey.

West Virginia (WV) is a very health disparate State. When we first started out on this journey, we wanted to truly understand our patient population. What are the key drivers impacting care. It kept coming back to issues outside of the hospital’s control. We started to understand WV’s climate and how it impacts our patient population.

We’ve seen an extreme rise in weather events in WV, from flooding to excessive heat, strong spring and winter storms, poor air quality and so much more – and all of this equates to a health outcome at the end of the day for the patient. When we look at extreme weather: it’s already here, and sadly it’s progressively getting worse.

In the state of WV, zip code matters when looking at health access and health disparities, and ultimately climate impact. Important considerations for climate vulnerability in WV include age, economic resources, and location. All of those are compounded when you look at climate, and the impact of climate. So, we started this journey from a social determinants of health and health equity standpoint. How can we, as a healthcare entity, really change the face of our community?

Getting started on the journey

We started to look at the BRACE Framework (a national framework from the CDC for Building Resilience Against Climate Effects). We’ve identified the severity of climate impacts in our patient population, and we know who is vulnerable. We’ve also looked from a health outcomes perspective at the effects of climate change on our patient population. But where do we go as an organization?

I can say that when we started this journey about a year and a half ago – we were at ground zero – we had no climate adaptation plans, no strategy map plans. We had a hazard vulnerability analysis as we’re regulatorily required to have, but we really didn’t have any “What if this happened?” “Where are our resources?” “Do we have this collective pool of community resources that we can bring together for the benefit of our patients and community?”

So, we started to develop written plans. We started to evaluate the effectiveness of our plans. And everything led me to the three pillars of the Health Care Climate Council: How do we look at mitigation? How do we reduce greenhouse gas emissions? How do we prepare our facility and our community to be more climate resilient? How do we get leadership, and everyone involved in this sector, to realize that climate change is real? And, at the end of the day, how do we influence behaviour so that we can lessen this impact?

I did a lot of searching, a lot of research in this process. And that led me to the Geneva Sustainability Centre.

How can the Sustainability Accelerator Tool (SAT) help healthcare organizations?

We completed the Sustainability Accelerator Tool maturity assessment and what we found out honestly was surprising. We did have some things in place where I thought we had nothing. We did have a lot of programmes in place. We do have opportunities for improvement. Around health equity and wellbeing, we’ve done a lot of work over the past five years with our community, community-based organizations, community-based partners. And all of those were links to further our climate journey as well. So, we started to look at our environmental impact. No longer serving Styrofoam in the cafeteria, which was a big win for me. And then we have leadership and governance support through showing this tool, showing what we can do, showing the ROI (return on investment), showing sustainable procurement – all of the different things.

We’ve set the groundwork and path to really drive change within our organization, our community, and our State from a climate perspective. And we’re creating a climate-positive environment. We have a sustainability team. We’re working with County State community partners on how we can mitigate risk to our patient population, to our community. We have several internal programmes, staff have come out of the woodwork to be involved in this sustainability journey. We have a lot of momentum, we have a lot of excitement. We have a lot of external partners, a lot of community programmes being created that were never created in the past, for example, for extreme heat.

So literally we’ve gone from ground zero all the way to having adaptation resiliency plans in a little over a year. And I think the tool’s embedded in the SAT really have been our catalyst to show “Here’s Point A – we’ve got to Point B – how are we going to get to Point C?” with some guides, with looking truly in-depth from a self-assessment perspective to see where we’re going.

Ask your leadership team to imagine a future where we collaborate to improve health outcomes through sustainability

How did I get initial buy-in from hospital leadership to use this tool? ROI. I did a lot of research on ROI. And I will be honest, the cost of the tool is not tremendous – I expected it to be a lot more than it was when we first started out on this initiative. But I showed the ROI for the tool to our leadership, talked about our health outcomes, and at the end of the day I put the patient at the centre of it and how this was going to change health outcomes for our patients, and when you do that I think from a leadership perspective, that’s why we’re all here and what we’re driving for from a change perspective.

SAT is now a strategy map item in our strategy map goal. There’s a shift in looking at sustainability and capital maintenance improvements at the hospital. As part of our budget process this year, our CFO and I sat down when we were creating our strategy map, our capital budget, our budget and planning, and all of that. And that’s something we have never done in the history of this facility. We’re taking this approach now to the northern region of WV moving forward and will aim to expand use of the SAT to the additional facilities soon.

You can hear more from Heidi in this SAT webinar for healthcare leaders across the US, recorded in October 2024.

The US can show leadership on low-carbon, resilient, equitable, and sustainable healthcare

In the words of Michelle Hood, Executive Vice-President and Chief Operating Officer, American Hospital Association:

David Rabinowitz, Principal of Life Sciences & Health Care at Monitor Deloitte added:

“Healthcare organizations are increasingly seeking tools and resources to advance a holistic sustainability journey that integrates environmental and social factors with clinical and operational strategies. The Sustainability Accelerator Tool equips executives with actionable insights into their performance while fostering collaboration and shared learning across the global healthcare ecosystem.”