May 29, 2013 — We rely on hospitals and other health care facilities to keep us healthy, but that care comes at a hefty environmental cost. Health care is one of the top consumers of energy in the U.S., and it’s estimated that health care facilities in this country create more than 6,600 tons of waste every day.

But that picture is beginning to change. A growing cohort of hospitals, nonprofits and businesses is working to kick-start a movement to make health care leaner and less harmful to the environment.

To be sure, there are financial reasons to embrace sustainability: Hospitals are facing rising costs along with declining financial reimbursement from government and health insurance companies for medical procedures. But advocates say institutions that provide health care also have a moral imperative to contribute to the health of the environment in their communities.

The Healthier Hospitals Initiative, launched in 2012 by a group of large health systems and three nonprofit organizations, has recruited hundreds of hospitals in the U.S. to take on a set of three-year challenges to improve their environmental footprint. In April, HHI released its first milestone report showing steps hospitals had taken toward its six key challenge areas: engaged leadership, healthier food, leaner energy, less waste, safer chemicals and smarter purchasing. Although the program is still young, “over 330 hospitals reported progress in one or more areas,” says John Messervy, director of capital and facility planning for Partners HealthCare and chair of HHI. “I think that’s really remarkable.”


Similar organizations have been working to improve health care sustainability in Europe, and the Global Green and Healthy Hospitals Network was launched in 2012 to create an international community of institutions similar to HHI.

Low-Hanging Fruit

Concern for the environment hasn’t exactly been a top priority for health care — health and safety of patients and staff have understandably come first. The result has been long-standing inefficiency and waste. Relatively simple changes to recycling, energy use and waste management can make a big difference, however. “There’s a lot of low-hanging fruit out there when we start engaging with the hospitals,” says Laura Wenger, executive director of Practice Greenhealth, a membership and networking organization that runs the annual conference CleanMed and provides practical tools and resources to help institutions interested in health care sustainability.

A vivid example is the operating room. To ensure ORs are available when needed, hospitals often ventilate and heat or cool them around the clock, even when not in use. Energy-intense lights bathe the rooms during operations. Surgical instruments are sterilized with harsh chemicals or with energy-sucking steam. Hazardous and biological wastes from ORs require special processing. Anesthetic gases, if allowed to escape into the atmosphere, contribute greenhouse gas emissions. And ORs use prolific amounts of supplies — one study estimated that more than half of an OR’s costs were devoted to supplies — which often arrive from vendors double- or triple-wrapped in packaging. Even though they occupy just a small portion of the square footage of a typical hospital, ORs generate up to 30 percent of its waste, Wenger says.

Hospitals making the most dramatic changes in their environmental footprint are saving money doing it.But health care organizations have found they can reconfigure operating rooms without compromising patient or staff safety. Changes include using energy-efficient LED lights, recycling packaging, capturing anesthetic gases, reprocessing and reusing supplies such as cardiac catheters and surgical instruments that otherwise would be discarded, and installing more efficient systems for sterilization, temperature control and ventilation.

Saving Money

A report by the Commonwealth Fund released last November showed that hospitals making the most dramatic changes in their environmental footprint are saving money doing it. Susan Kaplan, lead author of the report, says that while there’s a widespread assumption that sustainability measures are costly, “we found that every one of the activities we studied saved money.”