The established link between the energy-intensive healthcare sector and climate change represents a two-fold motive for a greener healthcare system; not only would more sustainable healthcare improve the health of the planet, but it would also improve public health as well. However, the impetus to change healthcare, like many aspects of society, lies not in abstract thought but in political and regulatory actions. Fortunately, there are a plethora of pragmatic reasons for greening the healthcare industry, even beyond the obvious health benefits.
Much of the uncertainty behind ‘greening’ the healthcare industry can be mitigated by looking at successful examples of healthcare systems outside of the United States. A comparison between U.S. hospitals in the Pacific Northwest and Scandinavian hospitals can provide some insight. The U.S. hospital industry spends over $8 billion annually on energy costs, a figure which could be greatly reduced by following the Scandinavian model; the typical Scandinavian hospital uses one-half to one-quarter the amount of energy of the average Pacific Northwestern hospital [1]. Investing in efficiency now could potentially save billions of dollars in the long run, while subsequently reducing the impact of hospitals on the environment and public health. Moreover, the money saved due to increased efficiency could be re-directed towards sanitation, food, renovations, and technological innovations that improve patient care.
This is not to say that the U.S. is completely devoid of green hospitals; there are a handful of LEED (Leadership in Energy and Environmental Design) certified hospitals that have been built with the intention of embodying social, economical, and environmental sustainability in their form and function. A comparison between LEED and non-LEED hospitals showed cost savings associated with lower energy and water consumption, and an overall savings of over $2 million compared to the replaced facility or to other newer hospitals [2]. Even beyond these pragmatic results, patient satisfaction was found to be 3.6% higher in LEED hospitals than in non-LEED hospitals [3]. Clearly, there are many convincing reasons to take the plunge into making healthcare greener on a large scale, ranging from economic benefits to improved health and satisfaction outcomes.
Understanding the potential benefits of a widespread shift to greener hospitals represents only half the battle. We must also understand the potential barriers to ‘greening’ in order to take a pragmatic approach that considers all factors. For example, strict infection control protocols, high volumes of heavy chemical use, and the need to function uninterrupted around the clock are just some of the inherent aspects of hospitals that challenge sustainability and efficiency [4]. Of course, within hospitals, there are various contributions to energy use that should be examined individually. For example, a procedure-heavy field like gastroenterology has a larger carbon footprint than others [5]. It may be fruitful to prescribe the responsibility of greening to individual departments rather than cost-intensive complete overhauls of hospitals. Perhaps the most resource-intensive departments could be identified first and could form subcommittees of their own employees to collaborate and determine the most logical next steps for greening that sector of the hospital.
Unfortunately, green hospitals also receive the occasional negative evaluation that may outweigh improvements in inefficiency. In one study, green hospitals generated more revenue on average than non-green hospitals, but also necessitated higher operating costs [6]. This is an important point to consider, though the ultimate price to pay is the continued degradation of the environment and public health if the healthcare industry continues to contribute to greenhouse gas emissions and climate change. In other words, a potential increase in initial cost is well worth the end result: a sustainable green hospital that conserves resources lowers emissions and ultimately does not contribute to the global and public health crisis of climate change.
References:
1. Burpee, H. McDade, E. (2014). Comparative Analysis of Hospital Energy Use: Pacific Northwest and Scandinavia. Health Environments Research & Design Journal. https://doi.org/10.1177/193758671400800104
2. Harris, D.D. (2014). Return on investment of a LEED platinum hospital: the influence of healthcare facility environments on healthcare employees and organizational effectiveness. Journal of Hospital Administration. 3(6). DOI: 10.5430/jha.v3n6p37
3. Golbazi, M. Aktas, C.B. (2020). LEED Certification and Patient Wellbeing in Green Healthcare Facilities. Journal of Green Building. 15(4):3-18. doi: https://doi.org/10.3992/jgb.15.4.3
4. Dhillon, V.S. Kaur, D. (2015). Green Hospital and Climate Change: Their Interrelationship and the Way Forward. Journal of Clinical & Diagnostic Research. 9(12): LE01–LE05. doi: 10.7860/JCDR/2015/13693.6942
5. Swapna, G. (2020). Environmental Impact of Endoscopy: “Scope” of the Problem. The American Journal of Gastroenterology. 115(12): 1931-32. DOI: 10.14309/ajg.0000000000001005
6. Sadatsafavi, H. Walewski, J. Taborn, M. (2014). Comparison of a Sample of Green Hospitals With Non-Green Hospitals With Respect to Operating Expenses and Patient Revenue. Journal of Green Building. 9(3): 163-188. https://doi.org/10.3992/1943-4618-9.3.163