The global health care sector is responsible for 4.4% of net emissions—and in the United States, health care drives a full 10% of all national greenhouse gas emissions. But while other nations have implemented initiatives to reduce health care's carbon footprint, U.S. efforts to reduce carbon emissions remain ad hoc and mostly industry-driven.

How health systems can fight climate change at the grassroots level

To reduce the industry's climate impact, U.S. health care organizations can advocate and enforce sustainability measures regardless of policy requirements. Specifically, hospitals can reduce their emissions and at the same time cut costs by implementing sustainable changes to optimize energy, waste, and water. 

Here are three key strategies for hospitals to consider.

1. Ditch the outdated lights for energy savings

Lighting is responsible for 16% of electricity end use in U.S. hospitals. LEDs use one-third of the energy consumed by fluorescents, and their lifespan is five years longer. By making the switch to LEDs, hospitals and health systems can minimize maintenance costs, improve quality of lighting, and reduce emissions.

Cleveland Clinic replaced fluorescent bulbs with LEDs and realized $2.5 million in savings annually with a four-year payback period. The University of Utah implemented a LED retrofit solution that reduced annual energy consumption by more than half and eliminated 31.41 metric tons of carbon dioxide emissions annually. The project's payback period was only 2.3 years.

2. Reduce operating room waste

Operating rooms are responsible for 30% of total hospital waste. Hospitals can reduce operating room waste by switching from one-use supplies to reusable options, improving recycling programs, and reducing medical supply waste by identifying the biggest culprits.

One key contributor is ventilation, which is required in operating rooms to reduce the risk of infection, but which is responsible for 12% of major fuel consumption at U.S. hospitals. While some ventilation is necessary, excess air exchanges unnecessarily increase waste and costs. To address this issue, Cleveland Clinic adopted a system to regulate air exchanges according to medical necessity, resulting in $2 million in annual savings. 

Anesthetic gases are also a key contributor to hospital emissions: The NHS has concluded that 5% of the carbon footprint of hospitals is attributable to anesthetic gases. Changing the anesthetic gas used in an operating room, when medically appropriate, could significantly reduce emissions and also provide substantial savings. For example, an anesthesiologist at Providence St. Joseph Health found that one of the anesthetic gases used in their operations was more expensive and worse for the environment than alternatives. As a result, the doctor and hospital leadership worked together to choose an anesthetic gas that reduced emissions by 80% and costs by 60%.

3. Implement sustainable procurement principles

The supply chain is responsible for a majority of greenhouse gas (GHG) emissions in the health care sector. However, according to the EPA, the bulk of organizations' GHG emissions are due to the value chain, and they represent a large opportunity for emissions reductions across industries. The EPA classifies value chain-related emissions as those attributable to downstream activities such as use of sold products, processing, transportation, distribution, and disposal.

Kaiser Permanente recognized the importance of hospital sustainability efforts and in 2017 implemented an environmentally preferable purchasing program (EPP) that uses multiple strategies to identity opportunities to reduce emissions across the supply chain. Kaiser's current and prospective vendors are required to adhere to their EPP standards, which outline criteria about chemical use and waste. Although this initiative aligns with Kaiser's mission to improve health, it also has a tangible return on investment. Since the initiative launched, it has saved 2,400 tons of waste, 87,000,000 kWh of energy, and $63 million.

How to finance climate-friendly investments

It is no secret that hospitals and health systems operate on razor thin margins. Many leaders are evaluating how to simply survive with little time or resources to explore the initiatives listed above. Still, there are funding mechanisms available to plan for a climate-responsive and resilient future while cutting costs.

For some sustainability projects, there may be alternative sources of funding. For instance, if you're considering installing solar panels, you might consider a power purchase agreement (PPA) in which a hospital pays a predetermined amount for energy that the electricity producer installs and maintains on purchaser's land. The producer maintains ownership of the energy and infrastructure and, as such, is responsible for all costs related to installation and maintenance. A PPA allows hospitals to reduce their upfront costs to zero and retain a stable power source over the life of the contract.

While hospital leaders navigate many strategic challenges, building a climate-responsive and resilient health system is imperative for the health of your patients and balance sheet.