A Call For Healthcare Climate Accountability

Every quarter when we meet with our hospital partners to discuss results of single-use device reprocessing, we talk about dollars saved, we talk about options to invest savings in improved patient care – and we talk about reduction in carbon footprint. Thanks to Lifecycle Analysis (LCA) studies, we can measure and report the reduction in carbon emissions obtained by using reprocessed catheters instead of new ones. We can do this thanks to LCA studies on the carbon impact of reprocessing EP catheters from Fraunhofer that were later confiormed by studies from the University of Brighton in the UK, and from Denmark. Carbon emissions reductions from reprocessing in cardiology/electrophysiology labs are often 3-5,000 pounds, a substantial number.

In each of these meetings, we are met with gratitude that we can actually provide numbers. Unfortunately, this is rare. Hospital Sustainability Directors (and others with similar responsibilities) are usually tasked with quantifying the environmental impact of various green initiatives taken by the hospital; but actual accounting is hard to come by. 

We know the topline numbers: Health care’s climate footprint is equivalent to 4.4% of global net emissions, and the vast majority of greenhouse gas emissions from hospitals are scope 3 emissions — “71% are primarily derived from the health care supply chain (Scope 3) through the production, transport, and disposal of goods and services, such as pharmaceuticals and other chemicals, food and agricultural products, medical devices, hospital equipment, and instruments.” 

Health care’s climate footprint is equivalent to 4.4% of global net emissions...

This means that when hospitals are asked to account for their carbon emissions, they primarily rely on their suppliers to provide these numbers. 

Recently, the National Academy of Medicine (NAM) hosted a series of webinars to teach healthcare organizations effective carbon accounting - including Scope 3 emissions. "Carbon accounting is the process of measuring, tracking, and reporting an organization’s greenhouse gas emissions. This helps organizations understand how they are contributing to climate change and how they can most effectively reduce their emissions." NAM says. "This helps organizations understand how they are contributing to climate change and how they can most effectively reduce their emissions." The pre-recorded webinar series covers the basics of carbon accounting while adhering to the Greenhouse Gas Protocol, including what data to collect, how to measure and report data, and real-world examples. Hospitals and health systems can browse the Carbon Clinics and related resources below for steps to reduce their carbon footprint. This was also reported by the Association of Medical Device Reprocessors. 

More recently, Practice Greenhealth has taken this even further by providing their own emissions impact calculator for healthcare. This powerful tool will allow health systems and facilities to measure Scope 1, 2, and 3 emissions, helping them “take their first step on the path to emissions measurement, reporting, and reduction efforts.” It is the first free, publicly available tool of its kind for health care organizations. The calculator was developed following the GHG Protocol, the world’s most widely used GHG accounting standard.

It is the first free, publicly available tool of its kind for health care organizations.

These initiatives are helpful, and they demonstrate the need for healthcare to become accountable for their carbon emissions footprint. They also make a critical point: You can’t effectively address the climate impact of healthcare until you can put NUMBERS on carbon emissions. Up until this point, there is no accountability, only talk.  

To operationalize carbon emissions reductions in healthcare, we need four things:

1.  Standards and goals for carbon emissions reductions in hospitals – probably defined at the federal level
2. More LCAs that are applicable across the hospital supply chain
3. Calculators – like the one provided by Practice Greenhealth – to quickly and accurately attach numbers to carbon emission footprint
4. Diligent governance by hospital of their supply chain to favor supplies with the lowest carbon footprint

Now, hospitals use a vast majority of very different types of supplies, and it is unrealistic to expect that each product will come with its own LCA. However, based on LCA studies of major product categories, we can arrive at fairly healthy approximations. For example, The Fraunhofer study that Innovative Health references for carbon emissions footprint of devices is based on the reprocessing operations of a different reprocessing company (Vanguard in Germany, a member of the Association of Medical Device Reprocessors), it is based on one type of electrophysiology device, and it assumes certain transportation distances, chemical uses, number of reprocessing cycles, etc. Thankfully, University of Brighton scholars added a sensitivity component to their review of the Fraunhofer study, so we know that variability caused by these differences do not dramatically alter the results.  

The point is, to create climate accountability in healthcare, we need carbon emissions calculators and we need more LCA studies. And since hospitals today have zero visibility into scope 3 carbon emissions, good approximations are better than nothing.