What Is Sustainability in Health Care?

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Smiling health care workers.Two formidable challenges facing the health care industry are making communities more resilient to health threats and reducing the industry’s impact on climate change. Health care represents 18% of the U.S. economy and 10% of the world economy, so health care leaders have an opportunity to directly address the industry’s environmental footprint while simultaneously improving the health and well-being of the neighborhoods and communities they serve in the face of potential climate change threats.

Sustainability in health care facilities has three aspects:

  • Constructing and managing health care facilities following sustainable practices
  • Designing sustainable health care processes
  • Promoting daily sustainable practices for health care employees and departments

Health care leaders play important roles in driving the transformation of the industry into a model of social and environmental responsibility. They can do so by highlighting the direct link between the social determinants of health and climate change. Environmental sustainability in health care is now perceived as vital to enhancing public health.

How Sustainability Benefits the Health Care Industry, Workers and Patients

The greatest impact of adopting sustainable practices in health care is in addressing the environmental and social determinants of health at the source: by creating healthy living and work spaces. The goals of sustainability in health care are in three areas:

  • Protecting public health from the effects of climate change. The World Health Organization (WHO) forecasts that climate change will cause an additional 250,000 deaths each year between 2030 and 2050. It will also cause between $2 billion and $4 billion in damage to the health care industry each year by 2030.
  • Transforming the global health care supply chain. The purchasing power of the health care industry can be used as leverage to promote products and services that are produced ethically and sustainably.
  • Promoting leadership in environmental health. Health care professionals will be at the forefront in supporting human rights, environmental protections and the public’s right to health.

The reinvention of the health care industry using a sustainable model begins by building facilities that exhibit three characteristics:

  • They incorporate sustainable and natural materials.
  • They are well lit and ventilated.
  • They provide ready access to nature.

An example of a sustainable health care facility is the Palomar Medical Center West hospital and several other new green buildings on the campus of Palomar Medical Center in Escondido, California. The two principles that guided the design of the facilities were reducing their environmental impact and creating work spaces that promote health and healing.

The hospital’s cooling system, lighting and landscaped roof are designed to reduce energy and resource consumption. Natural building materials were used whenever possible. The patient care and work areas in the health care facilities enhance the quality of care through the use of same-handed rooms: patient rooms that use the same layout, so beds and medical equipment are always located in the same place. This has been shown to make patient care practices more consistent while reducing errors. It also minimizes the response times of health care workers in high-stress situations.

Techniques for Promoting Sustainability in Health Care

Sustainable practices enhance the provision of health care services in several ways, from reducing facilities’ environmental impact to leading efforts to address public health threats due to climate change.

  • Anesthesiologists are being encouraged to limit their use of desflurane, nitrous oxide and other anesthetics that release high amounts of greenhouse gases into the atmosphere.
  • Gundersen Health System, based in La Crosse, Wisconsin, switched from complete reliance on coal for electricity and complete reliance on natural gas for heating to using gas from a local landfill and unused hardwood chips from local lumber mills to generate heat and electricity. After a decade of work improving its sustainability, the facility has achieved complete energy independence.
  • Health care facilities are taking more care in their use of disinfectants to avoid harming workers and patients. The Centers for Disease Control and Prevention (CDC) has issued guidelines for employers to ensure that people and the environment are protected against potentially hazardous disinfectants and cleaners.
  • To ensure the safe management of pharmaceuticals, the U.S. Environmental Protection Agency (EPA) provides information on the safe production, storage and disposal of hazardous waste pharmaceuticals, including new regulations that affect health care facilities and reverse distributors.

Among the techniques that health care services use to promote sustainability are zero-waste policies, water conservation and telehealth services that reduce carbon-based fuel consumption.

  • Zero-waste policies cover both solid and medical waste disposal in health care facilities. The policies rely on educating and training staff to recognize opportunities to reduce or eliminate waste and to reuse and recycle when possible.
  • To help the health care industry conserve water resources and reduce wastewater pollution, the Healthcare Environmental Resource Center (HERC) offers water conservation programs and techniques for facilities to reduce their water use and identify opportunities to reuse water.
  • Health care providers are increasingly relying on telehealth services, especially in the aftermath of the COVID-19 pandemic, to reach patients more conveniently and economically, as well as to reduce driving. They also promote regional mass transit systems to minimize carbon-based fuel consumption.

The Role of Health Care Leaders in the Transformation to Sustainability

Health care leaders have a tremendous opportunity to champion the sustainability movement and make a lasting positive impact on the industry and on the long-term health of their patients, their communities and the world. For example, industry leaders are striving to make global health care supply chains more sustainable via policies that promote ethically manufactured and environmentally friendly products and services.

A recent study of sustainability in the supply chains that several hospitals throughout the Middle East use found that when institutions worked together to identify and promote shared sustainability goals,  they were more effective at making health care workers consider the environmental impact of their actions, from their use of water and energy to the disposal of potentially hazardous medical waste.

This demonstrates the important role of health care leaders in promoting sustainable communities as a key to ensuring the health and safety of their patients, within health care settings and outside of them. The leadership starts at the highest levels of the organization by making sustainability a central component of the organization’s strategic plans. Human resources must be committed to creating “green teams” that educate employees on sustainability practices and ensure that the processes are widely adopted.

Health care leaders are also working with architects and construction firms to create environmentally sustainable facilities that meet the physical, emotional and spiritual needs of patients, families and employees. The WHO has released guidelines for designing and building health care facilities that are more climate resilient and environmentally sustainable. Such facilities are able to meet the health care needs of their patients more effectively and optimize natural resources.

Another important role for health care leaders in promoting healthy populations is to educate the public about the impact of climate change on their health and the practices they can adopt to reduce their consumption of energy and natural resources. The CDC’s five-step approach for making the public more resilient to the effects of health care recommends developing and implementing a climate and health adaptation plan. The guidelines prepare health care providers to mitigate and respond to climate-related hazards for nine specific regions of the U.S.

Preparing Tomorrow’s Health Care Leaders for a Sustainable Future

“Think globally, act locally” has never been more critical to the health and well-being of populations around the world. Professionals who have dedicated their careers to protecting the health of their communities are taking the lead in addressing the many serious challenges that climate change poses for public health. Wake Forest University’s online Master of Healthcare Leadership (MHL) program teaches health care professionals the skills and techniques they will need to adopt and promote socially and environmentally sustainable practices in health care environments.

Learn more about how the online MHL degree program prepares tomorrow’s health care leaders to make a positive impact on the health of their neighbors and the world.

Recommended Readings

Championing Change to a Value-Based Model for Health Care

Why Is Global Health Important and What Is the Role of Healthcare Leadership?

5 Essential Leadership Skills for Health Care Professionals


American Nurse Journal, “Healthcare’s Role in Environmental Sustainability”

California Society of Anesthesiologists, “We Have the Ability to Reduce the Environmental Impact of Our Anesthesia Techniques and Strive for Sustainability”

Centers for Disease Control and Prevention, Hazard Communication for Disinfectants Used Against Viruses

Centers for Disease Control and Prevention, Preparing for the Regional Health Impacts of Climate Change in the United States

Department of Toxic Substances Control, Site Mitigation & Restoration Program

FacilitiesNet.com, “How Gundersen Health System Achieved Energy Independence”

Health Care Without Harm, Mission and Goals

Healthcare Environmental Resource Center, Facilities Management—Water Conservation

Modern Healthcare, “Healthcare Should Link Social Determinants with Environmental Sustainability”

Practice Greenhealth, Why Sustainability

ReliefWeb, “WHO Guidance for Climate Resilience and Environmentally Sustainable Health Care Facilities”

ResearchGate, “Exploration of SocialGlobal Sustainability in Healthcare Supply Chain”

Sustainability Roadmap for Hospitals, Getting Leadership Support

The BMJ, “How Healthcare Can Help Heal Communities and the Planet”

The Journal of Healthcare Contracting, “Sustainability Is Key to the Health System of the Future”

U.S. Environmental Protection Agency, Management of Hazardous Waste Pharmaceuticals

World Health Organization, Climate Change and Health