In the media

Hospitals need to get ahead of regulations on climate change

Sierra Nesbit Jenna Phillips

By Sierra Nesbit, Jenna Phillips


09 March 2022

Climate change, an issue that hospital leaders should have voluntarily been working on following the catastrophes of Hurricanes Katrina and Sandy, is soon to be an issue they’ll have to work on, now that the Biden administration has incorporated environmental sustainability directives from the Department of Health and Human Services (HHS) as part of its broader initiative to halve U.S. carbon emissions by 2030.

The U.S. health care delivery sector has been relatively quiet on the topic of climate change and carbon emissions, even though it accounts for an estimated 8.5% of all U.S. carbon emissions and contributes significantly to the climate emergency that industries and governments are tackling worldwide. Health care delivery organizations must take more action to mitigate their contributions to climate change and act now to secure business resilience in the face of an uncertain future.

The Biden administration’s objective to significantly reduce carbon emissions comes with a set of wide-ranging targets and policies applied across U.S. industries, including the establishment of the Office of Climate Change and Health Equity. The administration has expressed its willingness to collaborate with hospital leaders to implement new sustainability practices, but has also emphasized its intention to also use financial penalties to hold hospitals accountable.

While specific environmental sustainability standards have not yet been released, HHS published a Climate Action Plan in October 2021 outlining five climate-related priorities it intends to ask health care delivery organizations to implement in the coming years. The actions most likely to affect hospital systems include reducing their carbon footprints, expanding climate resilience at the local level, and optimizing workforce and space management.

The administration plans to first deploy these initiatives at government-owned hospitals like the Veterans’ Administration or Indian Health Service as a way to learn and determine the best practices to reduce carbon emissions before rolling out the requirements to private-sector health care delivery organizations.

Staff and the public are also propelling hospitals to pay attention to environmental sustainability and demanding that health care organizations make changes. A 2021 article on the drivers of environmentally sustainable hospital foodservices — a major opportunity for sustainability in the health care delivery sector — for example, named “values of individuals” as a crucial initiating driver for sustainability-focused change.

By 2021, many large health systems had established some form of sustainability metric or business efforts. The Mayo Clinic, to use just one example, has made efforts to reduce energy consumption through energy efficient construction, utility upgrades, and changing onsite waste management practices, to name a few of its efforts, resulting in a 20% reduction in energy consumption since 2020.

To get ahead of forthcoming regulations, hospital leaders across the U.S. should start by measuring their emissions through audits of current supply chain and procurement practices, logistics, and in-house operations.

Here are two important steps hospitals and other health care organizations can take to begin their climate readiness journeys or move forward if they’ve already made a start.

Take a local approach to resilience and mitigation

The effects of climate change differ from place to place — so must the approach to managing them. In response to this diversity of experience, HHS is taking a local approach to climate resilience by mobilizing its operating divisions to develop localized resilience strategies as well as contributing to the knowledge base of the larger Office of Climate Change and Health Equity.

Hospital leaders need to think strategically about their own geographic context and identify the extreme weather events or climate-change effects to which their facilities are most vulnerable. For example, Hurricane Harvey devastated Texas and Louisiana in August 2017, forcing hospitals to strengthen their current disaster preparedness plans. In the aftermath of significant damage, flooding, and hundreds of patients who had to be evacuated, the Texas Hospital Association released new strategies and priorities for future disaster response.

Hospital leaders should also identify and collect data on the specific factors that drive their facilities’ carbon footprints, like heating and cooling systems, energy usage, and the generation of medical waste. Hospitals’ operations departments must consider how they could incorporate energy efficiency initiatives into their facilities.

To address the effects of climate change, leaders in hospital operations and patient experience departments should compile data to better understand the impact of local climate events on the health of their patient population and reexamine the readiness of their facilities by reviewing contingency plans, supply stock, and energy backup equipment.

Increase financial allocations to prioritize climate-related objectives

The projected financial impacts of climate change to the American economy and to the health care industry specifically are jaw-dropping, particularly for organizations and governments that are not well-prepared for this global catastrophe. By one estimate, the financial cost of the health care needs that result from climate change and pollution is more than $820 billion per year in the United States alone.

While HHS intends to make grants available as part of its climate agenda, federal grants are unlikely to cover all the efforts necessary to achieve sustainability targets. Hospital leaders would be wise to ensure that knowledgeable staff members are available not only to apply for these grants but also to complete total budget assessments to identify ways to pay for these initiatives. Individuals with experience managing new program roll-outs and costs related to sustainability can serve as a resource to hospitals pursuing this effort.

The Covid-19 pandemic continues to take center stage for most hospitals, and caring for acutely ill patients takes precedence over operational and sustainability focused innovation. Some hospital leaders have voiced concern that some federal regulations that support Covid-19 safety may also lead to increased energy usage by hospitals, thereby increasing carbon emissions.

The Covid-19 pandemic has reaffirmed that hospitals have a mission beyond providing high-quality patient care: supporting public health. Climate change will have a disproportionate effect on public health in lower-resource communities. Health care delivery leaders and government officials must jointly prioritize management of Covid-19 alongside sustainability projects that will significantly impact population health post-pandemic.

The visibility of environmental sustainability in the political, economic, and social landscape has created an urgent necessity for health systems to make significant strides in their own sustainability efforts and establish themselves as leaders among their peers. The effects of climate change are likely to accelerate in coming years and extreme weather events directly impact the health of patients. By prioritizing prevention initiatives to support climate readiness and collaborating with other stakeholders, health care organizations can both support their patients’ health and their own business resilience.

This article was first published in STAT

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