leaders’ minds. Collectively, healthcare is an extremely energy intensive
industry, spending $6.5 billion a year in energy costs, which is second
only to retail food establishments. ( 4) Surgical procedures can be a pri-
mary consumer of a hospital’s total energy consumption.
There are many renewable energy sources emerging, such as wind and
solar power, but smaller, more manageable changes are a realistic first step
for many hospitals, and these changes can still produce big results. For
example, installing LED lamps throughout the OR has been found to use
35 percent less energy without compromising lighting for surgeons. ( 5)
Public Reporting and Transparency
Reporting the impact of sustainability efforts is now quite common
among corporations and is starting to catch on in some hospitals. By devel-
oping a sustainability reporting framework, organizations have the ability to
monitor and track the results of programs and initiatives and then disclose
the environmental impact to their community. The tracking progress helps
hospitals make informed decisions about future sustainability efforts and is
also a valuable tool in fostering transparent relationships. In addition, shar-
ing the program results is an opportunity to educate stakeholders and com-
munity members on the benefits and impact of its efforts on the community.
Creating a more sustainable healthcare facility reaps many benefits,
including cost savings and a healthy environment for staff and patients.
But when hospitals first venture into sustainable program development, it’s
important to remember that patient safety is the number one priority. The
Cleaning Industry Research Institute (CIRI) provides excellent guidance
when making purchasing decisions related to the multitude of cleaning
products available, stating that, first and foremost, products must clean for
health and hygiene, then the environment. There are some things that can-
not be compromised when “going green,” and patient safety is one of them.
Education is another key component to a successful sustainability
program. Having internal champions across departments who can work
together to make smart purchasing decisions as well as educate staff on
the importance of hospital initiatives and policies can aid in program
adherence and outcomes.
Having frequent conversations with your suppliers can provide insight
into the types of sustainable products currently being offered. Since these
products are increasing in demand, there are a number of commonly used
healthcare products with environmentally preferable alternatives to help
reduce waste and conserve energy. For example, a product’s packaging
and dispensing features can be designed to be recycled and reduce waste,
storage space, and shipping costs, or even be automated to help conserve
water and energy. The Environmental Protection Agency (EPA) also sug-
gests incorporating environmental language into requests for proposals
and purchasing contracts.
Working closely with healthcare sustainability professionals can also help
hospitals control the amount of waste brought into the hospital in the first
place. For instance, Practice Greenhealth, a nonprofit aimed at encouraging
best practices in sustainability across healthcare facilities, recommends work-
ing with suppliers to customize OR kits. If there are items in the kits not com-
monly used, adjusting the quantities can limit what ends up in the trash.
While trends tend to come and go, sustainability initiatives within hospitals
and ORs are likely to continue to expand as technology advances and organi-
zations strive to build a healthier environment for patients and communities.
Here are a number of programs and initiatives aimed at providing
information to help hospitals implement sustainable programs:
• The Greening the Operating Room Initiative – A Practice
• Healthier Hospitals Initiative – A joint effort by leading health sys-
tems, Healthcare Without Harm, Practice Greenhealth and The Center
for Health Design.
• Healthcare Without Harm – An international coalition of hospitals
and health care systems, medical professionals, community groups,
health-affected constituencies, labor unions, environmental and environ-
mental health organizations, and religious groups.
• The Sustainability Roadmap – A joint effort of the American
Society for Healthcare Engineering, the Association for the Healthcare
Environment, and the Association for Healthcare Resource & Materials
Management of the American Hospital Association.
Emilio Tenuta is a sustainability expert with over 30 years of experi-
ence. He currently serves as Vice President of Corporate Sustainability at
Ecolab in St. Paul, Minn. For more information about Ecolab Healthcare
(1) Estimate of the Carbon Footprint of the US Health Care Sector. JAMA.
2009;302( 18):1970-1972. doi: 10.1001/jama.2009.1610.
( 2) “Waste.” Sustainability Roadmap for Hospitals. Web. 1 May 2013.< http://www.sustain-
( 3) "Greening the OR News." Practice Greenhealth. Web. 1 May 2013. <https://practice-
( 4) Tonya Boone, PhD, . "Health Care Research Collaborative." Creating a Culture of
Sustainability. Health Care Without Harm. Web. 1 May 2013. < http://www.collaborationhealth-
( 5) Rita Tatum. "Energy Efficiency Prescriptions for Health Care Facilities." FacilitiesNet.
Mar 2008: n. page. Web. 31 May. 2013. < http://www.facilitiesnet.com/energyefficiency/article/
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