Sustainability must be part of healthcare’s core mission

Not because we have to, but because we can: how hospitals can lead on sustainability

Aline Mittag, Sustainability Expert in Healthcare, and IHF YEL 2024 alumna, shares her insights into why sustainability must be part of healthcare’s core mission and not just a regulatory requirement.

Why is sustainability so important for healthcare leaders?

Sustainability is becoming a central part of corporate responsibility – including in the healthcare sector. This reporting increases transparency and trust and creates the ability to compare performance. It also calls on all managers to consistently align their behaviour and actions with ecological, social, and ethical criteria.

Hospitals have a particular responsibility here: as central institutions providing public services, we are directly confronted with the consequences of climate change – whether through increasing extreme weather events, the care of vulnerable patient groups or rising demands on infrastructure and energy supply. At the same time, we are major employers, and significant consumers of resources and energy. This gives hospitals considerable opportunities for positive change.

What are the governance considerations for your region’s hospitals?

The European Union has taken a decisive step towards greater transparency and a stronger commitment to sustainable corporate governance with the Corporate Sustainability Reporting Directive (CSRD). Large companies – and in future also public institutions such as hospitals – must report comprehensively on their impact on the environment, society, and governance (ESG).

The CSRD offers a great opportunity for the healthcare sector in particular. Hospitals could not only make their environmental and social responsibility visible through systematic sustainability reporting, but also strengthen operational resilience and efficiency. The directive can therefore drive greater sustainability in the healthcare sector.

However, there is growing concern that the CSRD could lose relevance through political softening or a lack of implementation. This would be a step backwards, especially for a sector that is more directly affected by the consequences of climate change than almost any other – be it through extreme weather events, supply bottlenecks or increasing health burdens in the population.

As a professional working on sustainable healthcare, I believe that hospitals should not wait for regulatory requirements, but proactively integrate sustainability into our strategies and daily activities. Those who invest today – in climate adaptation, energy efficiency or social responsibility – will be better prepared, more resilient, and more trustworthy for patients, the workforce, and society tomorrow.

Why is sustainability so integral to healthcare strategy?

Even if political conditions such as the CSRD can change, sustainability is not a passing trend. It is a permanent success factor – for our supply, our financing, and our future viability. A look at the financial sector shows that banks, investors, and funding providers included sustainability as a key evaluation measure. Those who act in a credibly sustainable manner will have better access to capital, more stable financing conditions, and greater resilience to risks in the future.

It must be clear that sustainability should be a central strategic concern – regardless of how the regulatory framework develops. We should see it as our task not only to react to change, but to take responsibility and actively shape change – for the benefit of our patients, the workforce, and future generations.

We have gained important insights from our preparations for CSRD reporting: it forces us to look at sustainability as a cross-cutting issue that affects all areas – from purchasing to energy supply to patient care.

For hospitals, sustainability should be an integral part of our strategic orientation for several reasons.

1. Financial benefits and long-term profitability. Sustainability initiatives such as energy efficiency, waste avoidance or sustainable procurement help to reduce operating costs and minimize risks due to volatile markets. Sustainability practices also open doors to better financing options, as banks and investors are paying increasing attention to ESG criteria.
2. Improving the quality of care and workforce satisfaction. Sustainable hospital design – such as improved air quality, natural lighting, and the use of eco-friendly materials – creates an environment that supports recovery and reduces the risk of infections and other health hazards. At the same time, it ensures better working conditions – highlighting the commitment and performance of the teams. Just as important are low-carbon clinical practices, such as optimizing resource use in diagnostics and treatment, choosing reusable over single-use items when safe and appropriate, and reducing unnecessary interventions. These practices contribute to reduce the environmental impact of how we deliver care and also enhance patient safety and clinical quality, which aligns sustainability with the core mission of healthcare.
3. Climate change as a health risk. Climate change has a direct impact on public health – through increasing heat stress, air pollution, or new disease patterns. Healthcare providers should see it as their responsibility to actively address these challenges, take precautions, and ensure the security of care for their patients.

Sustainability must be part of our self-perception as a modern healthcare organization: for the protection of health, to ensure the respectful use of resources, and in the commitment to shaping the future responsibly.

Where can hospitals start addressing sustainability?

Hospitals are among the most resource-intensive facilities in the public sector – and so we have high potential for reducing carbon emissions and environmental impacts. The sustainable transformation of a hospital is a complex task, but there are key levers that are particularly effective and should be prioritized.

Energy supply and building technology: A significant lever for decarbonization lies in energy consumption. The switch to renewable energies, the energy-efficient renovation of buildings and the modernization of technology (e.g. ventilation, heating, cooling) are key measures that have a long-term impact. They require investment, but these pay off both ecologically and economically.

Procurement and supply chains: Sustainable procurement guidelines and the selection of environmentally and socially responsible suppliers and products can massively reduce the ecological footprint. But sustainable procurement is not just about what our suppliers offer, it is a shared responsibility. As consumers, we can have great influence through the way we choose and use products. By critically evaluating clinical and non-clinical practices and questioning what is truly necessary, we can shape the demand for more sustainable products. Establishing a strategic supplier management system remains essential, but it must go together with behavioural change initiatives to build a sustainable procurement model in the long term.

Food supply: Switching to seasonal, regional, and plant-based food has a positive impact on the climate, health, and patient satisfaction. Reducing food waste is an additional effective lever with high savings potential.

I know from experience that the first steps can have a big impact and there are some particularly suitable ideas for getting started.

• Raising awareness and training the workforce: Sustainability starts with attitude. Training on topics such as waste separation, energy saving, or the sustainable use of materials quickly leads to changes in awareness in everyday life.
• Doing away with non-essential disposable gloves: The excessive use of non-sterile disposable gloves is often neither medically necessary nor sustainable. Campaigns for indication-based use can have a rapid impact – for the benefit of hygiene, skin health, and the environment.
• Reducing paper consumption and printing: Consistent digitization of administrative processes, surgical protocols, or patient information can significantly save paper and toner.
• Promoting sustainable employee mobility: Offers such as public transport tickets, bicycle leasing, or shuttle services can be implemented with little effort and increase workforce satisfaction at the same time.

By combining structural measures and pragmatic, low-threshold initiatives, sustainability in hospitals can be advanced step by step – with positive effects for the environment, economy, and security of supply.

Our opportunity for change

The healthcare sector has a unique responsibility and opportunity to set an example with our actions. Sustainability is not an add-on to healthcare – it is an integral part of modern, responsible healthcare.

But for this to succeed, we need leadership. It needs decision-makers who show attitude, take a strategic approach to change and take others with them. Hospitals can become beacons of sustainability – in their region, in their sector, in their impact on people. Taking on this role is not only necessary, but a real opportunity.

Progress in sustainability is not a minor matter, it is central to managing the climate crisis – and it is crucial for the health of current and future generations. Clean air, a stable climate, healthy food, secure supplies – these are all essential for good health outcomes. Sustainability not only protects the planet, but directly protects the lives and wellbeing of the people we serve.

The effects of climate change do not stop at political agendas or administrative borders. They affect us all – and in the healthcare sector in particular, we are experiencing them in a very concrete form: through more heat damage, new disease patterns, increasing demands on our infrastructures and processes.

This is why we must not see sustainability as a reaction to regulation, but as an active, formative task. And this is precisely where our responsibility – and our opportunity – lies.

The healthcare sector has people’s trust, as well as proximity to social challenges – and the leverage to bring about real change. We can be pioneers: in the way we provide care, the way we do business and the way we act as an employer.

Now is the time to act. Not because we have to – but because we can. Because it is our job to ensure health – today, tomorrow, and in the long term. A healthy future needs a sustainable healthcare system. And we all contribute to this.