Stage 2
Implementing Business Practices, Organizational Planning and Accountability Structures
In Stage 2, “Implementing Business Practices, Organizational Planning and Accountability Structures,” hospitals and health systems will focus on integrating sustainability into their core business practices and organizational planning.
This stage emphasizes the importance of stakeholder alignment, internal accountability, and navigating competing priorities. Establishing robust governance structures and decision-making processes is crucial to ensure that sustainability goals are met, and that the organization can effectively respond to environmental challenges.
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 2
Implementing Business Practices, Organizational Planning and Accountability Structures
Stage 3
Measuring and Reporting Direct and Energy Emissions
Stage 1
Recognizing the Benefits of Environmental Sustainability and Resilience
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Actions
Engage leadership and stakeholders
Leadership commitment and support for sustainability initiatives may require the actions outlined below to overcome skepticism or competing priorities. Actions can be taken by anyone, including green teams, medical directors, department managers, and frontline staff, and create visibility among senior leaders.
- Secure commitment from organizational leadership and key stakeholders by presenting a compelling case for environmental sustainability, including return on investment (ROI), operational resilience, and competitive advantage
- Build partnerships with other health systems, community organizations, and governmental agencies to enhance sustainability efforts and share best practices
- Create momentum by actively sharing environmental success stories within the health system and from other health care organizations
Climate Change Resources (Alliance of Nurses for Healthy Environments)
Climate Resilience for Frontline Clinics Toolkit
Decarbonizing Health Care: Engaging Leaders in Change
Engage and Support your Suppliers (World Economic Forum)
The Field Guide to Decarbonization Planning (Ameresco)
Funding health care sustainability initiatives (HFM Magazine)
Global Consortium on Climate and Health Education – Resource Bank
Health Care Climate Council (Health Care Without Harm)
Health Sector Commitments to Emissions Reduction and Resilience (U.S. Department of Health and Human Services; archived)
Inflation Reduction Act
The Inflation Reduction Act Brings New Opportunities for Health Care’s Climate Action (Health Care Without Harm)
Key Actions to Reduce Greenhouse Gas Emissions by U.S. Hospitals and Health Systems (National Academy of Medicine)
Sustainability Roadmap for Health Care (American Hospital Association)
Sustainable Healthcare Certification (The Joint Commission)
Sustainable Procurement in the Health Care Sector
The Office of Climate Change and Health Equity (OCCHE) Quickfinder for Leveraging the Inflation Reduction Act for the Health Sector (OCCHE; Archived)
Create a sustainability champion/lead/officer
Building a sustainability program and making meaningful progress in reducing emissions and waste requires a designated leader with the authority and ability to create and execute a plan. The following actions are typically carried out by the CEO or their designee and can be adapted to any size facility.
- Appoint a lead sustainability executive and form a cross-functional, multi-disciplinary team to define and drive the sustainability strategy, including setting short, medium, and long-term goals
- This can be an existing or new executive leader with a reporting relationship that includes easy access to the C-suite
- Appoint a Medical Director of Environmental Sustainability to lead changes from a clinical perspective
- This can be an existing or new leader who has a reporting relationship to a clinician leader (e.g., Chief Medical Officer)
Decarbonizing Health Care: Engaging Leaders in Change
Global Consortium on Climate and Health Education – Resource Bank
How Clinicians Can Lead Climate Action to Protect Patients and the Planet (Commonwealth Fund)
Mandatory Reporting of Emissions to Achieve Net-Zero Health Care
Establish operating protocols
Creating and implementing an environmental sustainability program requires the same steps and skills familiar to every health care organization as they initiate new programs and innovations. The following actions are typically carried out by a sustainability leader or a manager/executive carrying out those duties (e.g., leaders of Facility Operations, Quality, Procurement, Environmental Health & Safety).
- Develop and execute a plan. This plan should:
- Review existing operations to identify where environmental sustainability can become part of day-to-day activities
- Integrate sustainability into both clinical and non-clinical decision-making processes
- Outline roles, responsibilities, and accountability measures
- Include oversight by the board/trustees or other governing body
- Integrate environmental sustainability into the organization’s strategic plan and align it with other organizational goals, such as quality care, patient satisfaction, and financial performance
- Ensure adequate resources and capacity are allocated to sustainability initiatives, including investments in human capital and organizational systems
- Use the Community Health Needs Assessment to identify sustainability efforts with community health priorities
6 Cost-Conscious Strategies for Healthcare Decarbonization (Ameresco)
Better Buildings: Financing Navigator (S. Department of Energy)
Choosing Wisely Canada
Climate Resilience for Frontline Clinics Toolkit
Climate Resilience Planning (Practice Greenhealth)
Decarbonizing Health Care: Engaging Leaders in Change
Engage and Support your Suppliers (World Economic Forum)
The Field Guide to Decarbonization Planning (Ameresco)
Funding health care sustainability initiatives (HFM Magazine)
GHG Protocol
GHG Protocol Online Training
Inflation Reduction Act
The Inflation Reduction Act Brings New Opportunities for Health Care’s Climate Action (Health Care Without Harm)
Key Actions to Reduce Greenhouse Gas Emissions by U.S. Hospitals and Health Systems (National Academy of Medicine)
The Office of Climate Change and Health Equity (OCCHE) Quickfinder for Leveraging the Inflation Reduction Act for the Health Sector (OCCHE; Archived)
Sustainability Accelerator Tool (Geneva Sustainability Centre)
Sustainability Program Fundamentals (Practice Greenhealth)
Sustainable Healthcare Certification (The Joint Commission)
Sustainable Healthcare Resource Center (The Joint Commission)
Sustainable Procurement in the Health Care Sector
Set targets and measure progress
Navigating the many definitions, measurement options, and the changing regulatory requirements can seem onerous. There are many resources focused on making this process easier for health care organizations. The following actions are typically carried out by the Sustainability lead in consultation with stakeholders such as Legal, Compliance, Facilities Operations, Procurement, Finance, and Performance Improvement.
- Establish targets that are aligned with scientific evidence of emissions reductions needed to avoid the worst impacts of climate change
- Characterize emission by source, and select metrics and standards
- Track and report progress using dashboards that are easily accessible to the leadership
Climate Resilience for Frontline Clinics Toolkit
Climate Resilience Planning (Practice Greenhealth)
Clinical Decarbonization Prioritization Tool
Engage and Support your Suppliers (World Economic Forum)
The Field Guide to Decarbonization Planning (Ameresco)
GHG Protocol
GHG Protocol Online Training
Key Actions to Reduce Greenhouse Gas Emissions by U.S. Hospitals and Health Systems (National Academy of Medicine)
Sustainability Accelerator Tool (Geneva Sustainability Centre)
Sustainability Program Fundamentals (Practice Greenhealth)
Sustainable Healthcare Certification (The Joint Commission)
Sustainable Procurement in the Health Care Sector
Enact reporting and internal accountability mechanisms
Implement rigorous accountability mechanisms and expertise for environmental sustainability. The following actions are typically carried out by the Sustainability Lead in partnership with executives overseeing key functions.
- Implement transparent reporting mechanisms for internal and external stakeholders to track progress and ensure accountability
- Engage with Communications staff to initiate regular internal and external messaging about the organization’s commitments, progress, and results
- Assess internal expertise and capacity and consider investing in training to build required expertise, and in consulting services to supplement internal capacity as needed
- Nurture a sustainability-focused culture through continuous education, engagement, and leadership support
- Establish effective systems for collecting and reporting sustainability data, including data sources that are dispersed across different functions
Climate Change Resources (Alliance of Nurses for Healthy Environments)
Clinical Decarbonization Prioritization Tool
GHG Protocol
GHG Protocol Online Training
Sustainability Program Fundamentals (Practice Greenhealth)
Sustainability Roadmap for Health Care (American Hospital Association)
Sustainable Healthcare Certification (The Joint Commission)
Sustainable Healthcare Resource Center (The Joint Commission)
Educate staff on health risks of climate change on patients
- Incorporate information about climate impacts on health of patients in Continuing Medical Education programs for physicians, and continuing professional development for other health care professionals
- Offer training to communicate effectively about climate and health with patients. Support the training with patient education materials
- Educate all staff on the health impacts of climate change, and actions they can take to support healthier, more resilient communities
Climate Change Resources (Alliance of Nurses for Healthy Environments)
Climate Resilience for Frontline Clinics Toolkit
Global Consortium on Climate and Health Education – Resource Bank
How Clinicians Can Lead Climate Action to Protect Patients and the Planet (Commonwealth Fund)
Consider joining or leveraging a peer group and/or other associations/entities
- Join the National Academy of Medicine Initiative to Accelerate the National Climate and Health Movement
- Use resources and peers as part of your membership in State hospital associations and the American Hospital Association
American Hospital Association
Health Care Climate Council (Health Care Without Harm)
Health Sector Commitments to Emissions Reduction and Resilience (U.S. Department of Health and Human Services; archived)
NAM Initiative to Accelerate the National Climate and Health Movement
