February 20, 2023
Greening the Healthcare Supply Chain
May 26, 2021
6 minute read
Healthcare pollutes and supply chain is the primary driver. Reducing emissions fits squarely within health systems’ social mission of improving the wellbeing of the communities they serve and within the global fight against climate change. Accurate measurement of emissions at the facility-level is the crucial first step to decarbonizing the healthcare sector. Hospitals can then set quantifiable targets for emissions reduction. Within the hospital supply chain, the key methods of decarbonization are:
The problem
The healthcare sector accounted for roughly 4.4% of global carbon emissions, or 1.6 gigatons worth, in 2014. In the United States the number was higher, at 7.9% of the national carbon footprint. Supply chain taken in aggregate, including pharmaceuticals and medical devices, makes up 82% of those emissions (Figure 1). As such, decarbonizing the hospital supply chain is critical to meeting national goals of cutting US greenhouse gas emissions in half by 2030 recently laid out by the Biden administration, as well as the IPCC’s international goals of keeping the global rise in temperature to under 1.5 degrees Celsius to avoid the most catastrophic effects of climate change. And climate health is human health -- pollution causes three times more premature death than AIDS, malaria and tuberculosis combined.US national health care greenhouse gas (GHG) emissions, 2018
Figure 1. Source: Health Care Pollution And Public Health Damage In The US.
The first step
“Health care systems should be required to measure and report greenhouse gas emissions and provide plans for reductions over time in alignment with science-based targets,” write Eckelman et al. As Figure 1 describes, establishing a baseline for current emissions requires quantifying several types of emissions: pharmaceuticals and chemicals, energy, water and waste, and medical supplies. Such reporting will likely require legislation or regulation from CMS that establishes sustainability metrics based on its Value Based Purchasing Program.However, in advance of such guidance, there are several steps hospitals can take toward sustainability.
Controlling energy use and waste management
Energy, water and waste can be measured and reported by hospitals themselves or in collaboration with an industry certification body. The Department of Energy has collected resources for doing so, including benchmarks. Steps hospitals can take include updating or building out:Contracting with green-certified manufacturers
There are also a variety of initiatives spanning the industry, from green certifications for medical device manufacturers to green chemistry pharma and chemical manufacturing. Though such certifications (Figure 2) and initiatives are voluntary and piecemeal, they provide a useful first step toward environmentally conscious purchasing and supplier vetting.
Figure 2
Reducing product shipping distance
Alongside certifications, information on product manufacturing location can be used to calculate emissions caused by shipping. Here, sustainability intersects with the conversation COVID-19 has inginited around domestic manufacturing, and its promise of shorter shipping costs, possibly with greater environmental oversight.Reprocessing, reusing and recycling medical supplies
Hospitals have both compelling environmental incentives and supply chain resilience incentives to reprocess more. That means contracting with manufacturers producing reusable medical devices, working with IT vendors with data to identify such items and increasing facility-level reprocessing capacity, like reusable sterilization containers.Purchasing chemical-free and plastic-free products
Alongside contracting with manufacturers who are green-certified and opting for reusable products, often times there are chemical-free and plastic-free alternatives to items that deserve consideration.Quantification is the important first step in reducing greenhouse gas emissions caused by hospitals. From there, there are many steps hospitals can begin taking today to improve their sustainability and prepare for CMS and government reporting mandates and purchasing incentives. As Debra Roberts, Co-Chair of IPCC Working Group II, stated, “the next few years are probably the most important in our history.”
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