Stage 1
Recognizing the Benefits of Environmental Sustainability and Resilience
In Stage 1, “Recognizing the Benefits of Environmental Sustainability and Resilience,” hospitals and health systems will learn about the compelling reasons for embarking on a journey to environmental sustainability.
This stage emphasizes the multifaceted benefits of environmental sustainability, including alignment with organizational missions; quality and value improvement; staff well-being, recruitment and retention; decreased cost of care delivery, emergency management and resilience improvements; health equity opportunities, reputational benefits, and regulatory and accreditation support. Understanding these benefits can help integrate environmental sustainability into core health care operations.
Stage 1
Recognizing the Benefits of Environmental Sustainability and Resilience
Stage 2
Implementing Business Practices, Organizational Planning and Accountability Structures
Stage 3
Measuring and Reporting Direct and Energy Emissions
Stage 4
Measuring and Reducing Supply Chain Emissions (Scope 3, categories 1 and 2)
Stage 5
Measuring and Reducing Other Emissions
Stage 6
Striving for Continuous Improvement
Stage 1
Recognizing the Benefits of Environmental Sustainability and Resilience
Stage 2
Implementing Business Practices, Organizational Planning and Accountability Structures
Stage 6
Striving for Continuous Improvement
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Actions
Alignment with Organizational Mission
Pollution affects health and well-being. There is an urgent need to address climate change-related harms to our patients and the public. Hospitals and health systems have a responsibility to protect the overall health of their patients and have a moral imperative to act collectively to protect and improve human health. By reducing greenhouse gas emissions and other pollutants generated by health care delivery, there are substantial savings to society due to unnecessary health care costs avoided, lost productivity, and improved staff well-being and retention.
- Improve public health by reducing pollution and environmental hazards that contribute to acute illnesses, chronic diseases, and fatalities stemming from poor air quality, extreme weather events, and changing disease vectors
- Foster stronger community health by communicating a commitment to environmental stewardship and public health and inviting input from the local community
- For nonprofit health systems, use impactful community benefit allocations to address pollution and climate-related health impacts consistent with maintaining nonprofit status
Climate Resilience for Frontline Clinics Toolkit
Key Actions to Reduce Greenhouse Gas Emissions by U.S. Hospitals and Health Systems
Nurses Climate Challenge
ANHE Climate Change Resources
Why Decarbonizing Matters for the U.S. Health Sector
Quality and Value Improvement
Many strategies to reduce pollution from hospitals and health systems align with improving quality and high-value care. For example, several actions to promote reduced greenhouse gas emissions can also reduce the cost of care delivery while optimizing resource consumption, minimizing environmental impact, reducing waste, improving patient experience, and improving population health.
- Implement practices that enhance care quality and patient outcomes while delivering care in the least energy- or waste-intensive setting
- Maximize the use of telehealth, primary care, ambulatory care, or acute care at home when appropriate vs. resource incentive emergency or inpatient care
- Avoid low-value tests, procedures, and treatments that are not only costly but can harm patients
- Access resources through professional medical societies and physician networks to identify specific practice improvement and/or stewardship strategies for clinicians and other caregivers
Alliance of Nurses for Healthy Environments (ANHE)
ANHE Sign-Up
ASHE Sustainability
Clinical Decarbonization Prioritization Tool (Health Care Without Harm)
Estimated Carbon Emissions Savings With Shifts From In-Person Visits to Telemedicine for Patients With Cancer
Medical Society Consortium on Climate and Health
NAM Initiative to Accelerate the National Climate and Health Movement
Nurses Climate Challenge
Patient transport greenhouse gas emissions from outpatient care at an integrated health care system in the Northwestern United States, 2015–2020
Planetary Health Alliance
Practice Greenhealth
Shifting gears to green: A pilot study on decarbonizing patient transport
Travel-Related Environmental Impact of Telemedicine in a Radiation Oncology Clinic
Staff Well-being, Recruitment, and Retention
Staffing challenges are a top concern of health care organization leadership, which include personnel shortages and staff burnout. Many staff members, particularly younger workers, are actively seeking employers committed to reducing the impact of climate change and caregiver surveys show that the majority want their health care organization to be involved in climate initiatives. Organizational commitments to addressing climate change and sustainability are increasingly important for attracting and retaining top talent.
- Develop and highlight strong organizational commitments to environmental sustainability in recruitment programs to attract health care professionals and other workers
- Foster a culture of environmental responsibility to improve job satisfaction and retention among staff. Communicate environmental initiatives and engagement opportunities in staff well-being programs
- Engage clinical staff by soliciting and acting on their ideas to promote changes in processes and practices that support environmental sustainability
- Elevate key clinical leaders to lead sustainability initiatives, ensuring greater success, cost savings while maintaining clinical quality, and opportunities for mentorship that help younger caregivers avoid burnout and remain in the profession
ANHE Climate Change Resources
Nurses Climate Challenge
Decrease Cost of Care Delivery
Hospitals and health systems often face significant financial challenges, and financial performance remains a top concern for CEOs.
- Identify opportunities for cost savings through energy efficiency, waste reduction, optimizing transportation and telehealth, and judicious resource use
- Reassess procurement protocols to avoid buying supplies that are frequently unused but discarded and to reduce the use of single-use plastics and other disposable supplies
- Optimize consumption of all supplies and materials to reduce downstream waste
- Collaborate with physician leadership to implement policies for opening single-use instruments only when needed, standardizing surgical trays to reduce variability, and adopting minimal draping standards to decrease material use
- Enhance waste segregation strategies, recycling, and reuse, which can lead to significant cost savings by lowering disposal costs and reducing the need to purchase new supplies
- Enhance resilience to climate-related disruptions by adopting sustainable practices that ensure continuity of care and minimize financial losses during extreme weather events and other environmental challenges
- Assess the impacts on your organization of failing to act, such as increased operational costs, regulatory penalties, and reputational damage
- Leverage the use of local, state, and federal funding opportunities, including the Inflation Reduction Act, to support clean energy and resilient operations
- Prioritize improvements that decrease ongoing operating costs
ASHE Sustainability
Climate Resilience for Frontline Clinics Toolkit
The Joint Commission Sustainable Healthcare Resource Center
Key Actions to Reduce Greenhouse Gas Emissions by U.S. Hospitals and Health Systems
Sustainability Accelerator Tool
Emergency Management and Resilience Benefits
Risk from extreme weather events is increasing, posing greater risks to human lives and the physical infrastructure of health systems and supply chains. Facilities designed to operate through extreme events and prioritize energy and water efficiency may be able to deliver care more reliably and operate unassisted longer when energy, water, and supply sources are limited or interrupted.
- Develop sustainable infrastructure and practices that enhance the ability to prepare, respond to, and recover from emergencies
- Review your hazard vulnerability analysis to identify current and future climate-related risks to mitigate
ASHE Sustainability
Climate Resilience for Frontline Clinics Toolkit
The Joint Commission Sustainable Healthcare Resource Center
Sustainability Accelerator Tool
Health for Everyone, Everywhere
Climate change, ground-level air pollution, and other environmental hazards disproportionately affect low-income communities, people with chronic diseases or disabilities, people with outdoor jobs, such as farm workers, and children and older adults, among others. Many health systems are committed to initiatives that support health for all and have the opportunity to reduce emissions as part of these goals.
- Develop strategies to mitigate environmental health risks that disproportionately affect certain populations
- Partner with local organizations working to improve health and well-being, especially for populations disproportionately impacted by climate change
- Invite affected communities to advise on sustainability initiatives
- Utilize the Community Health Needs Assessment to identify and implement sustainability efforts with community health priorities
ANHE Climate Change Resources
Climate Resilience for Frontline Clinics Toolkit
Reputation and Reputational Risk
Actively working to reduce the environmental impacts of health care operations could lead to increased patient loyalty, better community relations, increased ability to attract funding, and more positive media coverage. Protection of physical and social infrastructure requires assessing and addressing risks related to climate change; access to capital, insurance, and finances may be impacted without these steps.
- Build a positive reputation by communicating sustainability and environmental stewardship actions with patients, staff, and communities
- Use global standards and protocols for target setting and measurement of emissions
- Transparently disclose initiatives to reduce greenhouse gas emissions and publicly report performance to avoid risks of greenwashing
- Mitigate reputational risks by ensuring compliance with environmental standards
- Communicate these actions and results in recruitment materials to appeal as an employer of choice
ANHE Climate Change Resources
Nurses Climate Challenge
The Joint Commission Sustainable Healthcare Resource Center
Key Actions to Reduce Greenhouse Gas Emissions by U.S. Hospitals and Health Systems
Sustainability Accelerator Tool
Why Decarbonizing Matters for the U.S. Health Sector
Regulatory and Accreditation Landscape
With uncertainty around future federal policies and regulations, it is increasingly important for health care organizations to stay informed about existing climate-related initiatives, both voluntary and mandatory, especially those at the state and local level. Organizations should monitor evolving expectations from regulatory bodies, accreditation agencies, and other influential actors, and be proactive in aligning with initiatives that may foreshadow future requirements.
- Understand and adhere to key laws and regulations such as emissions disclosure and resilience requirements at the national and state/local levels
- States that have implemented climate laws and regulations that impact health care facilities currently include California, Massachusetts, New York and Washington
- Participate in The Joint Commission’s Sustainable Healthcare Certification
The Joint Commission Sustainable Healthcare Resource Center
Sustainable Healthcare Certification
Recap
This Journey Map contains implementation guidance for health care leadership, clinicians, and others who want to make health care organizations and communities more resilient, equitable and environmentally sustainable. While some new resources will be needed to pursue the recommendations, many of the actions are within the skillsets, functions, and budgets already in place. Taking action now will mitigate the growing risks of climate change on health care operations while addressing critical health impacts to patients and communities.
