Study Finds Heath Care Sustainability Has Tangible Financial and Job Growth Benefits

Health Care Research Collaborative Finds Leadership Engagement Key to Success

(Washington, DC)  Embracing sustainability has tangible financial rewards and creates jobs, according to a new report  by the  Health Care Research Collaborative. The report, “Creating a Culture of Sustainability:  Leadership, Coordination and Performance Measurement Systems in Healthcare", was conducted by the Health Care Research Collaborative, a collaboration of Health Care Without Harm and the Healthier Hospitals Initiative, and sponsored by the Robert Wood Johnson Foundation.  Report author Tonya Boone, PhD, found three elements that are key to a successful program:  1) there must be an executive champion, or advocate, 2) sustainability values must be reflected in the organization’s mission, vision or values and 3) performance measurement systems must be used to monitor and track sustainability activities.

“The report found that leadership engagement and incorporation of sustainability as a high-level goal was key to the success of the program,” said Dr. Boone.   “We also found that jobs are being created as health systems are finding that sustainability efforts need dedicated staff who are responsible for it.  And the good news is that the cost savings inherent in sustainability help pay for these staff members as well as to make investments in other hospital programs.”

Dr. Boone found that an executive-level champion is an essential part of each hospital’s success.  Executive level leadership was found to be essential for 1) securing resources for sustainability activities,2) advocating for sustainability within and outside of the organization, 3) removing any institutional barriers to sustainability, and 4) overseeing the activities of the sustainability director.

“This report confirms that sustainability is a strategic business proposition for the healthcare sector,” stated Gary Cohen, President of Health Care Without Harm, “Commitment from leadership and incorporating sustainability organizational structure and incentives is a path that improves quality care
saves money and positions hospitals as anchors for community and environmental health.”

“The Healthier Hospitals Initiative considers leadership a key element of achieving sustainability,” stated John Messervy, AIA, Chairman of the Healthier Hospitals Initiative, a coalition of leading health care systems along with HCWH, Practice Greenhealth and the Center for Healthcare Design, dedicated to speeding the development of sustainability in health care.  “We included “Leadership” as one of the HHI Hospital Challenges, a recently launched program of HHI that gives free technical assistance to any hospital seeking to engage in one of six areas of sustainable operations.  The Leadership challenge includes goals such as introducing sustainability as part of the hospital culture, hiring staff dedicated to sustainability efforts, and implementing metrics for measuring sustainability performance.”

While Dr. Boone found that having a person responsible for overall sustainability efforts is important, she also noted that the sustainability coordinators serving in the systems had a wide variety of backgrounds.  This is consistent with findings elsewhere that showed sustainability coordinators within hospitals are often staff members selected for the work because of their interests.  What all of the sustainability professionals of the eight hospital systems demonstrated in common, however, was some knowledge of the workings within the health care sector, and a willingness to learn and take on new challenges.

“One of the things that Practice Greenhealth has provided for a number of years to its membership is training for sustainability professionals,” stated Laura Wenger, RN, executive director of Practice Greenhealth, a membership organization for hospitals and businesses engaging in sustainable health care.  “We have found that there is a limited number of staff that are experienced in sustainability so this is an area of job growth and career advancement within the health care.”

Most of the hospitals developed measurements for their sustainability program, which allowed them to determine cost savings associated with sustainability efforts.   As they found savings in one program, such as waste management, they were more encouraged to implement sustainability into other programs, such as purchasing.  The hospitals also benefitted from setting goals for their sustainability programs, both to focus staff efforts and to provide systematic introduction of the program.

Finally, Dr. Boone noted that many hospitals in the study have already moved beyond cost and efficiency into opportunities to improve community health and quality of life. “People want meaning in their work,” Dr. Boone stated.  “Sustainability offers a way to connect employers with their employees and communities in a powerful way.”

The report was based on research conducted among eight hospital systems identified from within the Practice Greenhealth membership   as having successful sustainability programs.  Interviews were conducted with the person responsible for sustainability at each system. Dr. Boone studied the leadership structure, the background and skills of the primary sustainability leadership, mechanisms used to coordinate the sustainability initia¬tive across departments and integrate the activities into overall organization processes, and sustain¬ability performance measurement systems. Additional information was collected through archival data and company documents.  

The report contains case studies from the eight successful health systems.  Download Complete Report.

The Research Collaborative was initiated by Health Care Without Harm (HCWH), an international nonprofit coalition that promotes envi¬ronmental responsibility in health care, and is coordi¬nated by faculty of the University of Illinois at Chicago School of Public Health, with support from the Pioneer Portfolio of the Robert Wood Johnson Foundation.  The Collaborative also interacts closely with the Healthier Hospitals Initiative (HHI), a group of health systems that are leading the way in implementing green practices in healthcare.  This paper is the latest in a series of papers in which the Collaborative provides research and analysis of factors influencing patient, worker and environmental safety and sustainability in the healthcare sector. The editors of this series are Peter Orris, MD, MPH and Susan Kaplan, JD.


Case studies included in the report are from the following health systems:

Bon Secours Health System
Providence Health & Services
Catholic Healthcare West (now Dignity Health)
Cleveland Clinic
Gunderson Lutheran Health System
University of Maryland Medical Center
Spectrum Health
Kaiser Permanente

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