By JULIE MINDA
Given the dire stage of the climate crisis, pressure is mounting on the health care sector to do more to reduce its oversized environmental footprint. And given their own mission imperative to safeguard human health and the planet, many Catholic health systems and facilities are intensifying their efforts and aiming to get quicker results.
A 1,000-pound palette of baled blue wrap is ready to be recycled at a distribution facility in Wilsonville, Oregon. Many PeaceHealth facilities recycle the blue wrap that is used as packing for surgical instruments. Photo courtesy of Cohear
Those leading efforts at environmentally forward ministry systems say some paths that hold the most promise in the near term include benchmarking to identify and further invest in what is working, physical plant improvements and closer involvement of clinicians in identifying ways to reduce the environmental burden.
"We know we in health care have a huge effect on the climate, and the focus on this is integral to our mission," says Sr. Mary Ellen Leciejewski, OP, system vice president of environmental sustainability for CommonSpirit Health. "Because we are responsible for our negative impact on the environment, our voice is critical (in achieving change). We're making great strides, but it's not happening fast enough." More momentum is needed, she says.
Race to zero
According to information from Practice Greenhealth, the nonprofit membership organization for sustainable health care:
- Health care facilities consume close to 10% of the total energy used in U.S. commercial buildings and spend more than $8 billion on energy every year.
- The health care sector is responsible for 8.5% of U.S. greenhouse gas emissions.
- Hospitals produce more than 5 million tons of waste each year.
- Hospitals use approximately 7% of all water consumed in commercial and institutional U.S. facilities.
- Operating rooms produce more than 30% of a facility's waste.
Kaiser Permanente holds the honor of being the first U.S. health system to achieve carbon neutrality, doing so in 2020. It is pushing to be net carbon positive by 2025, meaning the system will be buying enough clean energy and carbon offsets to remove more greenhouse gases from the atmosphere than it emits.
Providence St. Joseph Health aims to be net carbon negative by 2030. CommonSpirit has pledged to cut in half its operational emissions by 2030 and has set a goal of removing more carbon from the atmosphere than it generates by 2040. Ascension is aiming for net zero carbon by 2040.
Last year was the first year the United Nations Climate Change Conference focused on health care, illustrating the attention health care pollution is gaining worldwide. Representatives from CommonSpirit and Providence St. Joseph Health spoke at the November meeting held in Glasgow.
During a panel discussion on energy, Shelly Schlenker, CommonSpirit executive vice president and chief advocacy officer, called climate change a health equity issue. She said CommonSpirit's environmental commitment has "grown out of decades-long work to examine our own practices and move the rest of the health care industry with us to examine their impact on the environment."
Elizabeth Schenk, executive director of environmental stewardship at Providence, told attendees about the vital roles nurses can play in addressing the climate crisis.
The U.S. was among 50 countries at the U.N. gathering to commit "to develop climate-resilient and low-carbon health systems." The Office of Climate Change and Health Equity, established by the U.S. Department of Health and Human Services, will assist in this work.
Most ministry systems and facilities have long-standing commitments to environmental stewardship and sustainability. Julie Trocchio, CHA senior director of community benefit and continuing care, says this commitment is due in large part to the influence of Catholic health care providers' sponsors.
Executives from CommonSpirit, PeaceHealth, Providence, SSM Health and Trinity Health said their systems and facilities pursue a wide variety of tactics to reduce environmental impact including in the supplies they purchase, reuse and recycle; the food they serve; and the waste they generate. Their facilities have joined with health care sustainability organizations including Practice Greenhealth and Health Care Without Harm to share best practices and get better at the work.
Some of the areas where these ministry systems report great progress, or where they are gaining much traction, include: eliminating the use of mercury in health care delivery, reducing the use of environmentally harmful anesthesia gases, cutting back on energy use and tapping into more renewable sources of energy, increasing the use of locally grown and other sustainable food sources, cutting back on waste that goes to a landfill and following environmental sustainability standards in construction projects.
Often employing third party contractors, CommonSpirit, Providence and Trinity Health are collecting data from all their facilities on energy use and emissions; water consumption; heating, ventilating, and air-conditioning system performance; and waste management. Through data analysis, they refine tactics and rank where individual facilities fall on the performance spectrum.
CommonSpirit's Sr. Leciejewski and Providence's Schenk say their systems see much potential in decarbonization initiatives — the work to achieve net-zero greenhouse gas emissions.
Both systems will be doing this by identifying and installing new energy-efficient technologies and encouraging their vendors to do the same.
Providence categorizes its decarbonization work into five areas: waste, energy and water, agriculture and food, chemicals, and transportation. Approaches are multi-layered. For example, it is reducing energy consumption through the widespread use of advanced building automation to control temperature, humidity and lighting; heat pump technologies that heat and cool air without the use of fossil fuels; using ground to help cool buildings where feasible; avoiding unnecessary ventilation when spaces are not in use; and it is moving away from natural gas use toward more electricity from renewable sources.
Lou Fierens is executive vice president of administrative services for Trinity Health. He sees a high potential return on investment for capital spent on constructing or renovating facilities to be more energy efficient, and the system is funding such projects at the rate of about $35 million annually.
He said Trinity Health pilots have shown automation systems can greatly reduce the use of resources, including for heating, air, ventilation, lighting and water in hospitals.
He cites Trinity Health St. Joseph Mercy Ann Arbor in Michigan as a region that has realized significant savings through its sustained efforts to improve energy efficiency: Between January 2004 and January 2021, that region decreased its natural gas consumption by 28%, its electricity use by 29% and its water use by 57%.
SSM Health is benchmarking the energy consumption of each of its hospitals this year against similarly sized facilities nationwide, using Energy Star Ratings for Hospitals, the measure provided by the U.S. Environmental Protection Agency. Each SSM Health hospital is being held accountable for improving its rating by 2024.
Ask a clinician
In February 2021, Brian Nelson became the sustainability programs manager at PeaceHealth Southwest Medical Center in Vancouver, Washington, the first person assigned full time to focus on sustainability in the PeaceHealth system. He said the system is using Southwest Medical to pilot green ideas to move out to other PeaceHealth sites.
Nelson said clinicians are becoming increasingly involved in assessing the environmental impact of their work, and many green programs at Southwest Medical were initiated by physicians and other frontline providers. Given that an estimated 30% of waste is generated in operating rooms, Nelson said he's particularly interested in having O.R. staff identify opportunities to green-up the surgery suites.
Already, through clinician involvement, numerous ministry sites have gotten rid of or greatly reduced the use of environmentally harmful gases including anesthesia gases and cut waste in medical equipment and packaging. Clinicians are helping facilities reduce the use of single-use, disposable equipment as well as the use of prepackaged surgical kits that come with many instruments that may not be needed for specific procedures.
Beyond reducing system energy use and medical and other waste streams, SSM Health is among the many ministry facilities that are engaging as many people in the organization as possible in asking what they personally can do to reduce the environmental footprint of their own work — as well as their footprint at home.
Laura Richter, SSM Health system vice president of formation and spirituality, said "It's about thinking of ourselves as part of a natural ecosystem and being in solidarity with each other." Involving as many associates as possible will propel the environmental work, Richter said.
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