5 things HHS says hospitals can do to reduce emissions


The Agency for Healthcare Research and Quality has tips for how healthcare organizations can cut emissions and achieve net-zero operations by 2050.

The Health and Human Services Department branch recommends healthcare entities—particularly hospitals—establish systems to track and manage greenhouse gas emissions, appoint leaders to oversee progress, set goals and timelines, and invest in technology that measures their environmental impacts.

The AHRQ jointly developed the guidelines, issued Sept. 22 and published in JAMA Nov. 22, with the Institute for Healthcare Improvement. A growing number of healthcare institutions are making commitments to significantly decrease their environmental footprints. Here are 5 things hospitals can do to meet those goals, according to the AHRQ:

1. Reduce energy use and transition to zero-carbon fuel sources. Hospitals can conserve energy by reducing air changes in unused operating rooms, using LED lights, installing timers and motion sensors for lighting systems, and purchasing equipment with favorable Energy Star ratings. Long-term, hospitals should transition to cleaner energy sources, implement renewable energy projects and pursue power purchase agreements.

2. Manage emissions from transportation and the supply chain. Healthcare organizations can centralize internal and supplier transportation information to coordinate deliveries and reduce fuel use, and utilize route optimization technology to shorten driving times. AHRQ also recommends purchasing from distributors that participate in the Environmental Protection Agency’s SmartWay program. Hospitals should decarbonize their vehicles and encourage employees to do the same. Organizations should seek electric or low-emissions vehicles and install charging stations for staff and the community. Companies could also survey employees about their commutes, increase the use of telehealth and fund local public transportation options that limit emissions.

3. Minimize leaks and excess use of anesthetic gas. Emissions from gasses used to keep patients unconscious during surgery account for just 5% of a hospital’s carbon footprint but hospitals can do better, according to AHRQ. They can add gas flow alerts to electronic anesthesia records to reduce the quantity of gas used on patients. Leaders could also work with clinical teams to determine what gasses can be eliminated. For example, AHRQ recommends terminating the use of desflurane (also known as Suprane) due to its cost and climate impact. The agency also cautions hospitals against central nitrous oxide piping, which is subject to excessive leaking.

4. Find climate-friendly solutions for pharmaceuticals and medical devices. Medical devices and certain pharmaceuticals generate greenhouse gas emissions, but environmentally friendly options are increasingly available. Traditional inhalers that release carbon into the air can be replaced with dry-powder or soft-mist devices, for example. Hospitals can evaluate purchasing contracts to address excess waste in manufacturing and shipping. Finding alternatives to plastic, shifting away from single-use devices and creating circular supply chains could reduce waste and save money.

5. Prevent food waste and shift to plant-based options. Food makes up 12% of healthcare facility emissions, according to AHRQ. To cut back, hospitals could offer made-to-order inpatient food services, create patient-adjusted portions, track food waste, compost and donate excess food the local organizations. Hospital nutritionists could design plant-based food options for patients, which are often healthier and have a lesser environmental impact.

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