Sustainable hospitals: We know impact of climate change on health — we also know health care facilities are contributing to it

Dr. Lisa Cerceo has long counseled her patients about the impacts of climate change, its effect on their health and ways they can work to mitigate those issues.

For instance, she tells those with those with chronic obstructive pulmonary disease — what the commercials call COPD — about how to determine when there is a bad air-quality day and what to do about it.

“There’s certainly tangible things that we as physicians can act on with the one-on-one patient,” she said — referring to any ailment that is impacted by climate change.

Now, as the chair of the Health and Public Policy Committee of the New Jersey chapter of the American College of Physicians, she’s taking another approach.

Instead of just treating those suffering from the impacts of climate change, she’s helping in an effort to change the habits of those contributing to climate change. The group is starting in its own backyard: hospitals and health care facilities.

Last week, an ACP-NJ task force released its “Sustainable Initiatives to Guide Healthcare Transformation” report — providing recommendations to incorporate environmental sustainability into New Jersey’s health systems and facilities.

With statistics showing that health care contributes almost 9% of U.S total greenhouse gas emissions, and hospitals generating over one-third of those emissions, health care facilities find themselves challenged to adopt programs to decrease greenhouse gas emissions while reducing operating costs and promoting environmental resiliency, the report said. 

Three key recommendations

The report by the New Jersey chapter of the American College of Physicians’ “Sustainable Initiatives to Guide Healthcare Transformation” task force recognized the intersection of climate and health and identified 13 key categories for the state and its health systems to consider when making day-to-day decisions. Among the recommendations:

  • Have the Department of Health develop a state health care decarbonization strategy in line with national goal to reduce emissions by 50% by 2030 and net-zero emissions by 2050;
  • Direct the DOH to develop a comprehensive plan to address the physical and operational risks from climate change to public health systems and health care facilities, and to assist communities, public health departments and safety net and rural hospitals in preparing for and responding to the public health risks of the climate crisis, including mental health and food insecurity;
  • Provide funding, tax incentives and financing that health care facilities can use to reduce their greenhouse gas emissions and invest in clean energy and resilience.

“As a physician, it is not only important to recognize the impact of climate change on the health of our patients and communities in our daily practice, but also actively support measures to incorporate environmental sustainability into our own practices and at the health systems we work in every day.

The SIGHT report recognizes the intersection of climate and health and is a call on the state and our health systems to make environmental sustainability in health care a priority, the group said. The report identifies 13 key categories for health systems to consider when making day-to-day decisions, from leadership to construction.

Some are easy, Cerceo said.

“Just changing out lights to LED or decreasing the amount of air returns in ORs that aren’t in use — there’s very low-hanging fruit in a lot of sustainability that health systems can easily embark on,” she said. 

Even more, she said, it’s worth it to do.

“I’m not a finance person, I’m a physician, but there usually are cost savings associated with energy efficiency,” she said.

Cerceo and the six other members of the SIGHT Task Force are not taking on the challenge alone. In fact, Cerceo said the movement to make health care facilities more in line with sustainability goals is growing.

She rattles off international groups such as Health Care Without Harm and Practice Greenhealth, which focus on large health systems. Other groups, such as, provide sustainability tips for ambulatory practices.

In December, Dr. Victor Dzau, the president of the U.S. National Academy of Medicine, co-authored a report, “Decarbonizing the U.S. Health Sector — A Call to Action,” in the New England Journal of Medicine.

“There already is quite a movement in in health care to recognize that this is an issue,” Cerceo said.

The SIGHT report is meant to not only help others join the effort, but show them the way.

“We have a roadmap,” she said. “We know what steps we can take. If there’s new construction, we know how to make it more resilient. If there is another Hurricane Sandy or Ida, we know how to save money on energy efficiency. 

“There’s a clear path forward. It’s building consensus and making sure that everyone recognizes that this is good for patients, it’s good for health care systems and it’s good for New Jersey all around.”

The key, Cerceo said, is getting buy-in at the top.

“One of the easiest first steps a health system can enact is creating a green team or center for sustainability,” she said. “After engaging leadership, much of the conversation will flow from there.”

Cerceo said physicians are eager to do more.

“I think a lot of physicians who are really dedicated to the practice and dedicated to treating patients in an environmental justice community have an underlying interest in in climate change,” she said. “But I don’t think a lot of physicians necessarily see a path forward for how they can incorporate that into their daily practice. 

“Greening our own backyards is one very tangible action that we can take.”

The SIGHT task force

Members of the “Sustainable Initiatives to Guide Healthcare Transformation” task force include:

  • Dr. Lisa Cerceo: As chair of health and public policy, Cerceo has been advocating for sustainability efforts for health care systems. Cerceo also co-chairs Cooper University Healthcare’s Green Team.
  • Kyle Tafuri: As director of sustainability at Hackensack Meridian Health, Tafuri leads the development and management of corporate sustainability for the health network and ensures it is creating a healthier environment for patients, team members and the community.
  • Dr. Catherine Chen: An assistant professor at Robert Wood Johnson Medical School, Chen is an academic hospitalist with interest in the provision of high-value, quality and environmentally sustainable health care.
  • Carolyn Brown-Dancy: As the director of environmental health and safety at Atlantic Health System, Brown-Dancy’s leadership commitment is to implement programs to dramatically reduce waste and increase recycling in health systems to be a leader in sustainability.
  • Gregory Evans: As director of sustainability at Penn Medicine Princeton Health, Evans is working to develop a multiyear strategy to ensure Princeton Health meets key sustainability milestones that improve the overall health of patients, staff, and community. 
  • Howard Halverson: As director of environmental services at the Valley Hospital, Halverson is committed to minimizing the impact of hospital operations on the environment and contributing toward a more sustainable future.
  • Jill Aquino: As a school nurse and is now an environmental nurse, Aquino is a volunteer activist nurse for Alliance for Nurses and Health Environments, American Lung Association, New Jersey League of Conservation Voters, Clinicians for Climate Action N.J., and panelist for the American Lung Association’s Children’s Environmental Health Network Virtual Healthy Children’s Day.