Report

Greener Hospitals: Building Consensus for Health Care Sustainability

Until recently, health care was not a major part of the sustainability discussion. And the reverse was just as true: Few within the health care industry thought much about sustainability. Yet the two fields overlap in many important ways.

Health care has a sizeable impact on the environment. In her book, Greening Health Care, Kathy Gerwig, vice president of employee safety, health and wellness at Kaiser Permanente, notes that hospitals are the second-most energy-intensive commercial buildings in the U.S. and that the industry is responsible for 8% of the country’s greenhouse gas emissions. “Health care institutions are consistently among the top 10 water users in their communities,” she writes, and they are “the single-largest users of chemical agents.” The volume of waste flowing out of hospitals is mammoth — more than 2.3 million tons per year — including everything from paper and cardboard to infectious materials and radioactive waste.

The impact of the environment on health care is just as significant. One often-cited study from 2002 shows that social and environmental factors vastly outweigh medical care in determining people’s health (see Drivers of Health).

All of which begs the question, how do we spark meaningful dialogue between sustainability and health care professionals?That was the question addressed at the October 2014 Wharton San Francisco conference, “Metrics that Matter; Messages that Motivate,” co-sponsored by Johnson &Johnson and Wharton’s Initiative for Global Environmental Leadership (IGEL).

The answer depends on who’s involved in the discussion. Almost everyone in healthcare is concerned one way or another with finances. A great deal may be in flux within the U.S. healthcare industry, but one truism remains unshakable, even among non-profit institutions: no margin, no mission. Whether it is the executives in the C-suite, the managers of departments or even the vendors and suppliers who do business with hospitals — all clearly see a direct link between hitting their financial goals and keeping their business afloat.

That’s why many at the Wharton conference emphasized the importance of focusing on the business benefits of sustainability. As the first article in this report emphasizes, it’s not difficult to make a strong business case for any number of sustainability efforts. After all, a more sustainable operation is almost always more efficient, and a more efficient organization is almost always financially stronger in the end.

One challenge facing some sustainability efforts, however, is how long it can take to realize the business benefit. CEOs of public companies have to keep their eyes on the next quarterly report, and virtually everyone with control of a budget has short-term goals they miss at their peril. So how do hospitals move beyond sustainability efforts that make a significant business contribution in the short term to include others—just as important—that may take longer to benefit the bottom line, or may only impact it indirectly? The second article looks at a few key strategies that emerged both during the Wharton conference and in interviews with industry experts afterwards.

The final section of this report looks at the ways in which health care employers and employees are talking to each other about sustainability. It’s a two-way conversation. In some cases, senior management is fostering green activities among employees; in others, employees are the driving force within the organization. Frequently, it’s a mutually reinforcing combination of the two.

In all these efforts, success hinges on the most basic tenet of salesmanship: Don’t talk about what you want. Talk about what your customer wants.

The Triple Bottom Line: Making a Convincing Case for Sustainability

Sustainability can be a tough sell to financially-stressed hospitals, because many in health care still associate “green” with increased costs. But research confirms that environmental stewardship often leads to substantial savings. Hospitals are generally not willing to pay more for a greener product, but companies are finding ways to create affordable products that improve patient outcomes and the environment. Such innovations benefit patients, hospitals and the planet — a compelling triple bottom line.

How to Talk about Sustainability When It’s Not a Simple Win-Win

When a sustainability project fails to “pencil out” in the short term, it’s a mistake to promote it solely as a way to save the planet. The challenge is to show how the effort is relevant and beneficial to a hospital’s interests and those making purchasing decisions. Sometimes short-term costs yield long-term savings. Other times sustainability initiatives offer employee and community health benefits that improve financial performance. And when it comes to maintaining an unblemished reputation, it’s hard not to invest in sustainability.

Employees Can Be a Powerful Force in Sustainability

Sometimes individuals can drive important changes on their own, but there’s strength in numbers. In general, interdisciplinary “green teams” play an important role, bringing together people from all parts of an organization — including some departments that are rarely consulted — to launch sustainability initiatives that benefit everyone. Most successful are those institutions that find ways to incorporate the enthusiasm of green champions into the culture of the workplace.