In accord with their healing missions, more than 15% of all private sector and federal hospitals and health systems in the U.S. have committed to at least cutting in half their carbon pollution by 2030 and achieving net-zero emissions by 2050.1 One of those systems is Mass General Brigham (MGB), which has been proactively working to integrate environmental sustainability into all facets of its healthcare system and is collaborating with Guidehouse to understand the sources of its carbon pollution.
In a recent Health Care Sharing on Sustainability (SOS) podcast, Dr. Wynne Armand, associate director of the Mass General Center for the Environment and Health, interviewed Joe Bialowitz, Guidehouse’s director of healthcare sustainability, to understand what’s involved in conducting an emissions inventory as a foundational step in eliminating a healthcare organization’s carbon pollution.2 Highlights from their conversation and a link to the podcast are below.
“Healthcare is very pollution-intensive and a large part of the world economy,” said Bialowitz, who completed Kaiser Permanente’s first-ever greenhouse gas emissions (GHG) inventory and helped the organization achieve carbon neutrality by 2020. “Around 4.5% of the world’s emissions come from hospitals and healthcare activities in general, and in the U.S. that number is above 8%.”3,4
As Guidehouse’s healthcare sustainability expert, Bialowitz shared several reasons why hospitals and health systems should conduct a comprehensive carbon footprint analysis as a first step in their decarbonization journey.
“It goes back to the Hippocratic oath, ‘First, do no harm,’” he said. “It’s about avoiding harm to patients and communities, as well as future generations and other species, through our pollution. Much of the pollution that we cause is avoidable and can be eliminated.”
Stakeholders also want to know the environmental impacts and climate risk exposure of the organizations they invest in or have affiliations with, he said. And there are wider benefits to reducing carbon pollution.
“When you set emissions targets for your suppliers, it has a ripple effect,” he noted. “It starts to expand emissions reductions into the supply chain and into countries where climate action might not be as high of a priority. So, it’s a way of multiplying the good that you’re doing by reducing your own emissions.”
Bialowitz explained that there are three general types of emissions.
Data on energy usage is generally acquired from utility bills. For purchased goods and services, reports are typically generated from enterprise resource planning systems to ascertain the volume or weight of items purchased, dollars spent, and emissions associated with each item throughout its life cycle — from raw materials extraction and manufacturing to transportation, use, and disposal. Supplier-specific emission numbers are increasingly becoming available directly from suppliers that have completed a full life cycle assessment of the emissions associated with their products.
Bialowitz noted that completing the emission inventory process could take six to 12 months but largely depends on organizational size, resources, and data quality and availability.
“As consultants, we create the framework that our clients use to collect that data — and then we help to evaluate the data, quality assure it, and apply the emissions factors,” said Bialowitz, co-author of Practice Greenhealth's How-To Guide to Scope 3 Emissions Accounting for Hospitals and Health Systems. “We do the emissions accounting and create an inventory management plan so that the process can be repeated annually.”5
Bialowitz shared an example of how one Los Angeles medical center that successfully underwent an emissions inventory involved everyone in its efforts to minimize its environmental impact. After team leaders educated staff about sources of emissions, employees brainstormed solutions in their own units. For instance, housekeeping workers noticed that TVs were being left on in waiting rooms and committed to turning them off overnight when not in use. They also transitioned away from single-use batteries to rechargeable ones for the many automated towel dispensers in restrooms.
"When you do a carbon footprint analysis for a hospital, you demonstrate to everyone from the boiler room to the boardroom where they are personally responsible for emissions,” said Bialowitz. "Employees know their own workflows and processes better than anyone else, so it’s important to equip them with the knowledge that they are emitting…and then they can find opportunities to streamline wherever they are.”
The next steps after completing a full carbon accounting exercise involve setting emissions reduction targets, developing emissions abatement plans, financing and implementing those plans, and identifying and mitigating the most significant climate-related risks across an organization’s value chain (including its patients, staff, facilities, suppliers, and communities).
As MGB’s emissions data comes back and is fully analyzed, its leaders are looking forward to publicly disclosing the results and further reducing MGB’s environmental impacts.
“It’s been a pleasure working with MGB on their emissions footprint,” said Bialowitz. “It is one of the most comprehensive footprints I’ve ever seen done by a healthcare organization, so the results when shared with stakeholders will be very useful for everyone to see.”
While conducting an emissions inventory is an essential first step to decarbonization and reimagining resilience, it’s important to take a holistic approach. To get the most out of sustainability investments, healthcare leaders need to consider a range of complexities, such as aging infrastructure, the effects of climate change on human health, and equity-related issues, which are converging in terms of their impact on society. Silos must be broken between these interrelated topics in order to successfully design, build, and operate innovative, patient-centric solutions that maximize impact.
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