Healthcare Climate Initiatives Without Teeth – But Possibilities Emerge

A few months ago I wrote on this blog about “healthcare climate accountability”: “Healthcare climate accountability starts with suppliers: It’s time for more suppliers in healthcare to stop making excuses and start providing real solutions to carbon footprint measurement and reduction in healthcare.” Measuring scope 3 emissions (emissions from suppliers) is becoming a hot topic for hospitals and other healthcare providers. Demand that hospitals measure and reduce carbon emissions abound, but until this month, government institutions and agencies have stayed out of it, leaving hospital administrators with very loud demands, but no available pathways to address them - and no accountability for the suppliers who contribute the largest share of hospital carbon emissions.

Being able to measure carbon emissions is a necessary starting point in creating healthcare climate change. Healthcare Without Harm and Practice Greenhealth have played an important role in making tools available for this, including Practice Greenhealth’s Healthcare Emissions Impact Calculator.

However, measurement without accountability does not drive change. Carbon emissions initiatives need tools for leveraging measurements in new initiatives and practices, and they need the involvement of institutions that can punish and reward carbon emissions behavior – directly or indirectly.

...measurement without accountability does not drive change.

In October, we saw two government institutions actively engaging this challenge. The Joint Commission launched its Sustainable Healthcare Certification: “Across the health care sector, hospitals and health systems are pursuing decarbonization efforts without a common framework for setting priorities, creating baselines, and measuring and documenting greenhouse gas (GHG) reductions across the industry. This certification provides a framework to help organizations expand or continue their decarbonization efforts and to receive public recognition of their commitment and achievements in contributing to environmental sustainability.”

The certification guidelines tout five benefits associated with the certification: Environmental impact reduction, cost savings, improved health outcomes, enhanced reputation and community engagement, and regulatory compliance and risk mitigation. These are all important for hospitals, but the “reward” isn’t exactly tangible.

Further, there is really only one requirement for the certification (well, two, if you count signing up): That the hospital can demonstrate improvement over 24 months on three identified greenhouse gas emission sources. The problem with this certification is right here: When you set the bar low, you get broader participation, but results will be unimpressive. Why would I strive for a certification that everyone has?

The National Academy of Medicine launched their Sustainability Journey Map: “The Sustainability Journey Map & Resource Repository is an interactive visual that intends to support health care suppliers in initiating or accelerating their decarbonization and sustainability efforts.” The journey map outlines five stages of the sustainability journey: Understanding and navigating the regulatory landscape; governance and organizational planning; tackling scope 1 and 2 emissions; tackling scope 3 emissions; and continuous improvement.

The map comes with resources, planning templates and a bunch of other tools. Compared with Joint Commission’s certification, this is much more involved and will require more resources and more organizational commitment.

What’s in it for the hospital? Well, for the hospital that is 100% committed to carbon reduction, this will create real – and positive – change. However, the “Journey Map” suffers from the opposite problem of the Joint Commission certification: The engagement and resource commitment needed will leave preciously few hospitals actually “taking the journey”, especially because there is no tangible punishment or reward involved.

...for the hospital that is 100% committed to carbon reduction, this will create real – and positive – change.

Just a few weeks ago, a third initiative came from a government agency, and this initiative is likely to be more impactful. I am talking about the proposed U.S. Securities and Exchange Commission (SEC) climate rules: Rules to Enhance and Standardize Climate-Related Disclosures for Investors. The proposed rules would “require companies that are publicly traded in the United to report detailed information about risks to their businesses posed by climate change, including ways the businesses could be harmed by the escalating climate crisis and risks associated with their own contribution to climate change.”

In healthcare, the rules would only directly impact certain publicly traded for-profit entities, but this type of disclosure tends to trickle down even to organizations with no formal requirement, as these have an interest in emulating the practices of larger, more regulated institutions.