8.5% of emissions come from healthcare — 6 things to know to improve sustainability

In the United States, 8.5 percent of all greenhouse gas emissions are caused by the healthcare industry, and few standards exist to mitigate them, according to a June 30 report published by Yale Insights.

Jodi Sherman, MD, a physician at Yale New Haven (Conn.) Health and sustainability researcher at Yale University, spoke with Yale Insights on the healthcare industry's effect on the climate and what can be done to improve sustainability.

Six things to know:

1. Health damages caused by air pollution are as harmful as accidental injuries from medical errors. For medical errors, hospitals measure the problem, formalize patient safety and put in extensive work to mitigate patient harm. The same process should be applied to solving healthcare sustainability, Dr. Sherman said. 
   
   
2. Healthcare already has a social mission that implies the goodwill of hospitals and makes some healthcare workers feel as if that's enough. There is also not enough information showing healthcare's direct effect on climate change, and since the harms feel distant, it's not as urgent as patient care delivery is, she said.
   
   
3. The National Health Service in England found 2 to 3 percent of its carbon footprint comes from inhaled anesthetic gases. For perioperative services, inhaled anesthetics account for about half of emissions. The inhaled drug used is a potent greenhouse gas, Dr. Sherman said. There are indoor controls to mitigate occupational exposure, but there are no regulations for disposing of the gas. The drugs are vented out of hospital rooftops and can be destructive to the ozone layer.
   
   
4. Some organizations are trying to integrate research findings into clinical practice. The University of Michigan in Ann Arbor uses data to build sustainability reports at the provider and institutional level. Electronic alert tools guide providers in the operating room to reduce waste of inhaled anesthetics. At Yale New Haven, the health system is working to integrate environmental emissions information into its EHR records.
   
   
5. If a health system wanted to be more sustainable, tackling the medical supply chain would help reduce emissions in an area that accounts for 70 percent of healthcare's carbon footprint. The first sustainability initiative people lean toward is recycling. However, Dr. Sherman said, focusing on recycling takes too much time away from more effective ways of reducing emissions. Instead, focusing on using reusable supplies may be a bigger opportunity for change.
   
   
6. There are no established best practices in the U.S. for health systems to aspire toward, Dr. Sherman said. Only a few health systems report their sustainability performance: Oakland, Calif.-based Kaiser Permanente and Cleveland Clinic. Yet these reports frequently omit emissions caused by their supply chain, where most of emissions stem.