Health care providers save lives every day, but hospital operations also consume large amounts of energy and water and generate significant waste. In the United States, the healthcare sector is responsible for around 8.5% of national greenhouse gas emissions.
A team of researchers has now developed a framework to help healthcare organizations better measure and improve their environmental performance. Their findings were published in The Lancet: Planetary Health.
"Hospitals need to track their environmental impact," said corresponding Patrick Romano. "Our team is advocating for the inclusion of environmental sustainability measures in healthcare quality reporting."
Romano is a professor of internal medicine and pediatrics at UC Davis Health and is affiliated with the Center for Healthcare Policy and Research.
The researchers emphasize that measuring and reporting the environmental impacts of hospital operations is essential for making meaningful progress. Consistent tracking can help hospitals identify priorities, evaluate improvements and integrate sustainability into routine decision-making.
Sustainability efforts remain fragmented
Although many healthcare organizations have pledged to reduce their environmental footprint, progress has been uneven. One challenge is the lack of standardized methods for measuring and tracking sustainability, which makes it difficult to compare performance and identify areas for improvement.
"A standard set of measures could help healthcare organizations reduce their environmental footprint and make sustainability a core part of their quality mission," Romano said.
Evaluating key sustainability measures
The team evaluated environmental measures commonly used in healthcare. They grouped the most frequently reported measures into five categories:
- Greenhouse gas emissions
- Water use
- Energy use
- Travel
- Solid waste
Their analysis showed that all six measures were important, but some had limitations. For example, tracking travel by patients and staff, as well as calculating greenhouse gas emissions across supply chains, can be challenging because reliable data are often unavailable.
Recommended reporting standards
Based on their findings, the authors proposed a minimum set of sustainability measures for hospitals. They recommended three metrics:
- Greenhouse gas emissions from direct operations and purchased energy
- Water consumption
- Solid waste production
They also recommended adjusting the data based on patient activity so hospitals of different sizes can be compared fairly.
Sustainability as part of healthcare quality
The researchers argued that sustainability should be treated as an essential part of healthcare quality, similar to patient safety.
"Measuring and reporting patient safety has helped drive major improvements in care over the past two decades," Romano said. "A similar approach could help healthcare organizations reduce their environmental impact while improving the health of communities and the planet."
The authors believe the framework could help quality and accreditation organizations incorporate sustainability into existing healthcare performance standards.
Measuring and reporting patient safety has helped drive major improvements in care over the past two decades. A similar approach could help healthcare organizations reduce their environmental impact while improving the health of communities and the planet." -Patrick Romano, professor of internal medicine and pediatrics
"Rather than creating a separate sustainability reporting infrastructure, the proposed measures could be incorporated into existing quality measurement systems," explained Michael Padget, the first author of the article. Padget is an epidemiologist at The Center for the Environment and Health at Massachusetts General Hospital. "This would allow environmental performance to be considered alongside well-established domains of safety, effectiveness, efficiency, equity and patient-centeredness."
The coauthors on the paper are Gregg Furie of Brigham and Women's Hospital, Dionne Kringos of the University of Amsterdam, and Jonathan Slutzman of Massachusetts General Hospital and Harvard Medical School.
UC Davis Health earned recognition from Practice Greenhealth with the Emerald Award, as an outstanding sustainable hospital in the top 20% of the nation. It was recognized in five Circles of Excellence areas: Food, Sustainable Procurement, Water, Transportation and Green Building.
Learn more about UC Davis Health sustainability progress.
