Healthcare Design - June/July 2023 - 24

DEEMERWHA STUDIO STOCK.ADOBE.COM
HEN THE HEALTHCARE industry first started
discussing climate change nearly two decades
ago, conversations focused on addressing how
much energy the sector-including hospitals,
doctor's offices, and clinics-uses. " We always
felt like there was a big opportunity for
healthcare organizations to reduce not only
the environmental impacts of that energy
use, but also the operating cost associated
supply chain) by 2050. " Many of our clients who
are participating in that are now coming back to
the A/E/C industry and saying, 'You need to help
us fi gure this out,' " Shinn says.
STATE OF DECARBONIZATION IN
HEALTHCARE
with it, " says Kim Shinn, principal and sustainability wizard at TLC Engineering
Solutions (Brentwood, Tenn.).
Climate change, which refers to long-term shifts in temperatures and
weather patterns, can be caused by natural factors, such as fl uctuations to the
sun's activity or volcanic eruptions, as well as human activities, primarily due
to the burning of fossil fuels like coal, oil, and gas. These emissions, particularly
carbon dioxide and methane, trap the sun's heat, raising temperatures.
As understanding about climate change and the effects of greenhouse
gas emissions on people and the planet has evolved, the healthcare sector,
which accounts for approximately 8.5 percent of U.S. emissions, realized
its potential to play a more signifi cant role in addressing it. " We've begun
to understand that climate change has health impacts, " Shinn says. " Higher
temperature events can put people in danger from heat exhaustion, the
changing climate can introduce new diseases into places where they didn't
exist before, and the downstream eff ects of energy generation in terms of
air pollution have negative impacts on populations. "
Concurrent with this connection was a shift in the industry toward population
health. Healthcare organizations now consider how their services
and facilities impact the health of the communities they serve, spurred
by value-based reimbursement models where they're rewarded for keeping
people healthy and out of hospitals. " If we reduce the negative health
consequences of the climate crisis, the healthcare system is less burdened, "
says Ramé Hemstreet, vice president of operations for national facilities
services at Kaiser Permanente (Oakland, Calif.). " There are both ethical
and fi nancial reasons to do so. "
As a result, the industry is moving beyond lower energy consumption
to a much broader aim to decarbonize healthcare, addressing the overall
carbon dioxide and other greenhouse gas emissions that its buildings and
associated activities release into the atmosphere. (The term " decarbonization "
refl ects the shorthand use of " carbon " to represent the full range of
greenhouse gas emissions, which includes carbon dioxide, methane, and
nitrous oxide.)
To accomplish these goals, healthcare systems are considering new technologies
and strategies, including all-electric hospitals and microgrid systems.
Such moves would help lower or eliminate the burning of fossil fuels
such as natural gas in power plants and boilers, which releases emissions
into the atmosphere. Systems are also being moved to action by new voluntary
or mandated building codes and local and state regulations targeting
building performance or effi ciency standards. Since last year, many organizations
have also signed on to the White House and Department of Health
and Human Services' (HHS) Health Sector Climate Pledge. The pledge
calls on healthcare stakeholders to help tackle the climate crisis through
goals such as reducing their emissions by 50 percent by 2030 and achieving
net zero (where a company reduces its emissions across its entire
24
JUNE/JULY 2023
The Greenhouse Gas Protocol, a widely accepted
metric for accounting and reporting emissions,
classifies these substances as Scope 1, 2, or 3.
Traditionally, as healthcare organizations have
worked to reduce their emissions, their main
focus has been on direct emissions from facilities,
known as Scope 1, and indirect emissions
that result from the production of energy by utility
providers, known as Scope 2. For example,
Scope 1 strategies for healthcare can involve being
better stewards of anesthesia gases, using
refrigerants that have a lower global warming
impact, and employing equipment that reduces
the amount of energy needed for space heating.
Addressing Scope 2, organizations can contract
with energy providers that use renewable energy,
such as wind or solar, to produce electricity
instead of fossil-fuel based energy.
To get to net zero, systems must employ strategies
targeting Scope 3: supply chain emissions
or those related to business activities such as
pharmaceuticals, construction materials, transportation,
and investments. " In the U.S., about
three-quarters of the greenhouse gas emissions
associated with a healthcare business like a hospital
system is Scope 3, " Shinn says, adding that
the remaining 25 percent is almost evenly divided
between Scope 1 and 2 emissions.
For more than a decade, Kaiser Permanente
has been on the front lines of addressing climate
change and in 2020 achieved carbon neutral
status (when an organization's carbon dioxide
" EMBODIED CARBON IS WHERE
LEED WAS 15-20 YEARS AGO, IN
ITS INFANCY WITH A FEW EARLY
ADOPTERS. BUT EMBODIED CARBON
WILL BE A VERY PREVALENT CONCEPT
WITHIN THE VERY NEAR FUTURE. "
-RAMÉ HEMSTREET, KAISER PERMANENTE
HCDMAGAZINE.COM
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Healthcare Design - June/July 2023

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