We know that climate change increases exposure to environmental disasters and infectious diseases, exacerbates non-communicable conditions, and worsens mental health. But we've seen little urgency from health care leaders to make organizational changes in response to or preparation for these threats. Many leaders believe that climate change problems are too big for any one actor to solve, and that their decisions won't ultimately have much impact on the overall trends.

However, facilities projects are some of the biggest investments that health care leaders make, and this is one area where climate considerations can't be overlooked. As the experts in facility design, your clients will be looking to you for help.

Facility developers are catalysts to help health care clients act on climate change

Facility firms know that it's important to plan for long-term changes in your designs, and in this role, you have an opportunity to help your clients prepare now. Advisory Board's recent infographic can help. The infographic highlights three ways inaction on climate change will lead to negative impacts on health systems' long-term bottom lines. This can help get the conversation started.

Of the three major consequences they've identified, I've pulled out the most relevant points for planning discussions.

1. Operating health systems will become more costly.

Health system expenditures and supply chain costs are growing. US health care costs are expected to increase by 6.5% this year, and 80% of US health systems saw significant supply chain price increases in 2021. As hospitals are operating on increasingly slimmer margins, they'll be looking for ways to reduce energy and water consumption. Additionally, authorities like the HHS are proposing new requirements for hospitals to cut emissions. Poorly performing facilities may be penalized.

Podcast: How health leaders can address climate change

2. Staff will leave to work for a more active employer with a better record of action against climate change, hurting health system ability to win the race for future talent.

Employees, especially millennials and Gen Z, want to work at organizations that are committed to ambitious sustainability goals. Studies found that 75% of American millennials said they would take a pay cut to work at a company with strong environmental values. Almost 40% said they have chosen a job because of company sustainability. And 70% of U.S. workers said that if a company had a strong sustainability plan, it would affect their decision to stay with the company long term.

3. Patients will opt for providers who take a stand against climate change, especially as regulators require reporting of environmental impact data.

Patient loyalty is not guaranteed. 40% of U.S. health care consumers are not loyal to a particular hospital or health system. An attrition rate of 7-10% can cost hospitals up to $100M in lost revenue per year. Patients still opt for convenience and low costs when selecting goods and services, but social and environmental consciousness is progressively factoring in their decisions. 94% of U.S. patients consider a hospital's sustainability programs to be important. And 75% of US millennials are willing to pay more for an environmentally sustainable product, compared to 57% of baby boomers—a factor that will be increasingly felt when millennials and Gen Z become the dominant health care using generations.

Planners need to educate health care leaders that climate-conscious investment is more than just green buildings

How can you make progress on environmental sustainability? By defining the problem and asking the right questions.

Health care leaders often don't know what it means to commit to environmentally sustainable practices, even as they recognize their importance to reduce costs, retain staff, and attract patients. Your clients will be looking to you to help them think through which options will help with these efforts.

Education on basics is critical, such as the fact that "The greenest building … is one that is already built" (to quote as Carl Elefante, FAIA, 2018 AIA President). On this point, while new buildings are inevitable, it's also important to retrofit existing facilities to reduce the large carbon footprint that results from demolition and new construction.

Using carbon-smart materials and renewable energy are just a couple of ways to reduce emissions. Educating your clients on the full range of options will be essential to partnering with them in planning for their future needs.