Making Strides in Sustainability: Health Leaders Share Lessons on Pathways to Climate Action, an interview with Dr. Rod Hochman, President and CEO of Providence

Climate change is increasingly affecting the health and well-being of people across the United States, leading to worsening health outcomes that disproportionately impact communities that have been historically marginalized. Hospitals and health systems are committed to supporting the health and well-being of the communities they serve, and there is growing recognition across the health sector about the need to address its own environmental impact and reduce carbon emissions. Through facility operations, purchased energy supply chain of goods and services, and investments, the health sector produces 8.5% of U.S. carbon emissions. Health care organizations are increasingly prioritizing sustainability initiatives that reduce this environmental impact and create a more sustainable and resilient health sector, while also having significant health, social, and economic benefits.

Rod Hochman. Photo courtesy Providence

The National Academy of Medicine spoke with hospital and health system leaders about the sustainability initiatives their organizations are championing and how others in the field can take action, including concrete actions that come with up-front and long-term benefits. In this interview, Dr. Rod Hochman, president and CEO of Providence, discusses the importance of local advocacy work and how to build leadership support needed to push forward an organization’s sustainability efforts.

Why is decarbonizing the health sector an issue that is important to you and your organization?

At Providence, we are Mission driven. Our Mission statement reminds us to serve all, especially the poor and vulnerable, reinforcing our commitment to equity. Our core value of justice reminds us that we are to care wisely for our people, our resources, and our Earth. Our founding sisters led the way in the wise use of resources, and they ask us to be good stewards, and to be good models of stewardship.

The communities we serve are being impacted by climate change and other pollution. Wildfires and persistent smoke are more common. Heat and drought, or conversely flooding, are impacting us more often, including the Pacific Northwest’s incredible heat dome in 2021. Hundreds more people died during that event than would have had the temperatures been normal. And the people who were most impacted were the more vulnerable among us. Called by our Mission and driven by our vision of health for a better world, we must respond.

Our caregivers are concerned, as are our board and sponsors. There is broad understanding and acceptance of the environmental challenges we face and a sense of urgency to address it. We know the workforce we are building for tomorrow is committed to climate action, and we need to be addressing it today.

And not to be forgotten, health care is a polluting enterprise. We create thousands of tons of carbon dioxide pollution, millions of pounds of waste, we use harsh chemicals and pharmaceuticals, and we consume immense amounts of resources in goods and services and in our complex buildings. For us to act with integrity, we must work to decrease this unintended harm.

What successes have you had within your organization related to decarbonization, and what do you attribute those successes to? How have these accomplishments helped your organization in unexpected ways?

We have achieved many successes, though we have a long way to go. We have reduced our greenhouse gas emissions by 11.5% in the past two years. We have meaningfully measured our resource use, cost, and carbon emissions across a range of environmental elements and have automated the data monthly for all 51 hospitals. We have integrated environmental stewardship with our commitment to health equity, particularly through our population health and community health teams, our focus on environmental justice, and climate resiliency planning. We have also successfully anchored our initiative in our Mission, echoing the wishes of Pope Francis who reminds us that it is our duty to care for our common home—the Earth. And not to be forgotten, we are savings millions of dollars each year through more efficient operations and clinical care delivery, which is remarkable during the worst financial crisis in the history of health care.

Addressing an initiative this far-reaching in a complex health system is a significant undertaking. Several important elements are crucial for our successes thus far. First, we have had clarity and alignment among our leadership team, including executives and board members, and our Catholic sponsors. Second, we enjoy a strong team of content experts with years of experience focusing on environmental stewardship in hospital operations and clinical care. Our environmental stewardship team is experienced, knowledgeable, educated, and effective. They have led the way for 30 years and this developed a history and culture of conservation at many of our sites. Third, our commitment to innovation has contributed, including our prescient investment in our Providence Global Center. Our engineers and technical experts have supported the development of the WE ACT Scorecard, which gives us clarity into our success, challenges, and goals.

We announced our carbon reduction goal in April 2020, weeks after Providence admitted the first hospitalized COVID-19 patient in the nation. Along with the whole world, our caregivers were overwhelmed. It surprised me that even so, they came forward to tell us how glad they were that we were addressing climate change. It has been a bright spot. Our caregivers are proud of this work. I am proud of this work and find it valuable for the organization. We think of value in more ways than cost savings, though that is important, too. Our environmental commitment has brought value in many ways, including greater efficiency, safety, caregiver engagement and new caregiver recruitment. We see consistency and clarity regarding regulatory compliance regarding waste management, building efficiency, and emergency preparedness. We can demonstrate Mission fidelity by our attention to our environmental crisis. Each of these brings value that we may not have seen without a bold commitment to action.

What barriers did you face when you began your decarbonization journey? How did you overcome these?

We had a head start, based on the contributions from many committed caregivers who were addressing and solving environmental challenges in particular ministries. We also had a longstanding practice of tracking resource use through our utility database. And, our Mission, core values and heritage make it very clear that we need to care for our common home.

Nonetheless, there have been many challenges, including the pandemic and financial crisis, the most significant in the history of U.S. health care. In addition, we had to account for the complexity of Providence delivering care from critical access hospitals to quaternary medical centers given the size of our health system, which spans seven states. Like our organization, our environmental footprint is large and complex, and some of our biggest challenges are related to this fact. We are aligning our efforts by including our carbon reduction goal in our system strategic plan and in executive incentive pay. We are working to hardwire environmental stewardship actions throughout operations by working with our management teams at each ministry. We work to reach 120,000 caregivers through strategic and robust communications efforts. We measure and report results regularly.

Our internal work is strong, yet our success is dependent on changes in our society and economy at large. Our advocacy team has been instrumental in crafting local regulations, in advocating for support in laws like the Inflation Reduction Act, and in having a constant voice at the White House, Congress, and with leading national groups who are addressing the decarbonization of health care.

We continue to have many challenges—we are truly trying to transform how our health care is delivered—but we have a path forward, and given our legacy of addressing big problems boldly, I am confident we will continue to transform our work and sector.

How can leaders in the health sector contribute to and lead sustainability efforts?

As a leader, I see the many caregivers who are doing the work of Providence, and I am eternally impressed and grateful. Yet, leadership support is crucial to the success of any initiative, including environmental stewardship. As mentioned, we have leadership alignment about our environmental stewardship work, in fact, this initiative reports directly to our Executive Council. That imparts a powerful message to the rest of the organization. By our executives talking about it, setting goals, linking incentives, we are heightening the potential for success, even if we are not, as leaders, in the details of how to get it done.

Leaders can help set the pace and the tone. Leaders can help build accountability and consistency through an organization. Leaders can identify and allocate resources, and help to find the right people, with content expertise to do the work. We see that across our many initiatives and divisions. It is no different for environmental stewardship.

The voice of leadership in health care, and in particular, clinical leadership, is enormously important. We need to speak out, to tell our stories, to celebrate successes, to learn from each other. This decade is so important—we need to make meaningful progress in health care— which is significantly polluting. Leadership is required. Responding to this challenge is both our obligation and our opportunity.

Why should other health care organizations join this movement to mitigate fossil fuel pollution and the effects of climate change?

At Providence, we have identified addressing climate change as a moral, strategic, and economic imperative. From my perspective, all health care organizations would share this truth. In fact, I really don’t see how health care can afford not to do this. There are too many benefits – the value it brings, including a sense of optimism as it is solutions-based and innovative, while addressing a difficult to solve issue with data, planning, and by involving as many caregivers as we can. This would be valuable to any health care organization.

The ethical response weighs heavily on us. Climate change is driving illness and premature death today, with untold harm predicted if we don’t act now, this decade. And health care is significantly responsible. None of us in health care want our legacy to be that we knew about the problem and did nothing to solve it. So, we are all in. Sometimes, I wish we had made our bold goal earlier. Now is better than later, and I’m pleased about where we are, but there is no time to waste.

Rod Hochman is a co-author of a June 2023 article in Modern Health Care, “Embracing sustainability makes good business sense,” and portions of this interview informed the article.

More Resources from the National Academy of Medicine

Carbon Accounting 101. Learn more about the basics of carbon accounting through a recorded webinar series with related resources and real-world examples.

Key Actions to Reduce Greenhouse Gas Emissions. Read a shortlist of key actions for hospitals and health systems to reduce their greenhouse gas emissions.

Share the Health Leaders Interview Series

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