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  • Josh Shkrab

Sustainability and The Healthier Hospitals Initiative

Updated: Aug 29, 2023




The Healthier Hospitals Initiative (HHI) is an industry wide movement designed to incorporate the principles of sustainability into current health care practices. When the healthcare industry realized that sustainability could produce cost savings, while simultaneously mitigating environmental impacts, the development of a comprehensive plan became a top priority. HHI is an invitation for healthcare organizations across the country to join the transition to a more sustainable business model, and a challenge for them to address the health and environmental impacts of their industry. The HHI model was created with the help of eleven of the largest health care providers, comprising 490 hospitals, with 90,000 beds and 700,000 employees nationwide.


According to U.S. Environmental Protection Agency (EPA) estimates, the healthcare industry generates approximately 7,000 tons of waste every day, which includes solid, hazardous, and infectious wastes. Additionally, hospitals and related healthcare providers consume large amounts of energy needed to illuminate buildings, provide hot water, sterilize medical equipment, and supply heat and air conditioning. Water consumption is another area where hospitals can make significant improvements through incorporation of sustainable practices. The need to address these inefficient, and often times wasteful, status quo practices is clear, and HHI can provide the tools to do just that.


Collaboration among health care industry experts has led to the creation of numerous tools designed to make measuring and collecting environmental data as easy as possible. The primary goal of HHI is to guide hospitals in the implementation of sustainable practice identified by six primary categories. The HHI program challenges healthcare organizations to reduce the environmental impact by engaging leadership, providing healthier foods, using energy efficiently, producing less waste, using safer chemicals, and purchasing products in a smarter way.


The Engaged Leadership category seeks to bring all healthcare officials, including directors, administrators, and the board of trustees together, so commitment and support is developed from the beginning. Strong communication between staff and leadership is essential, as dissemination of information is paramount to the success of sustainable initiatives. The developers of HHI suggest the creation of a sustainability report for leadership, which tracks the progress of each goal. This report can also be made available to hospital staff and patients, which increases awareness and participation.


The current methods employed in the production, processing, packaging and distribution of food in the U.S. have negatively impacted human health and the environment. As a result, the Healthier Foods guide suggests that hospitals exercise greater discipline when purchasing foods and beverages. Hospitals are encouraged to purchase food grown locally and sustainably, translating into healthier and happier patients, staff, and visitors. Healthier beverages in vending machines can replace soda and other sugar-filled drinks. A prime example is MedStar healthcare, which took several steps to incorporate sustainable principles for healthier foods, including the purchase of recombinant bovine growth hormone (rBGH) free milk, sustainable or local beef, and locally grown produce.


The HHI Leaner Energy program gives healthcare organizations critical guidance and support needed to reduce energy consumption, increase energy efficiency, purchase alternative sources of energy, and save significantly on costs. The development of this category is attributed to astonishing statistic showing hospitals accounting for more than 8% of the nation’s energy consumption. This substantial percentage results in the generation of harmful emissions, including greenhouse gases (GHG). Moreover, air pollutants can contribute to chronic bronchitis, asthma attacks, respiratory symptoms and premature death. The formation of an energy team can help prioritize and track energy related goals, and report the progress of the program to all employees, patients, and visitors of the hospital.

Waste reduction is an essential component of the HHI program because, as mentioned before, hospitals generate around 7,000 tons of waste per day. Through the creation of facility-wide recycling programs and education about proper medical waste disposal, substantial amounts of waste can be diverted from landfills. Construction or remodeling projects can incorporate recycling practices that also divert materials from landfills.


Patients and healthcare workers are exposed to numerous chemicals on a daily basis. Many of these chemicals have been shown to have serious negative effects on individual health, public health and the environment. The Safer Chemicals program challenges healthcare organizations to develop strategies that reduce the amount of, and toxicity of chemicals used in daily operations. Simple strategies such as replacing noxious cleaning agents with eco-friendly equivalents can produce positive and environmental and public health outcomes. Additionally, hospitals can avoid purchasing materials and supplies that commonly contain mercury, polyvinyl chloride (PVC), and bis(2-ethylhexyl)phthalate (DEHP). Risks associated with patient and staff exposure to harmful chemicals can be significantly reduced by implementing these simple initiatives.


Lastly, healthcare organizations can develop smarter purchasing procedures for medical supplies and devices. Healthcare organizations are encouraged to develop an Environmentally Preferred Purchase (EPP) plan, which demands cleaner, healthier, and environmentally safer products from vendors. The Smarter Purchasing program urges hospitals to form a team responsible for creating a standardized environmental questionnaire, which can assist in the purchase and decision-making process. The standardized environmental questionnaire is simply a guideline that allows the purchasing team to determine whether the product is safe for the public and the environment.


The need for an environmentally sound standard of practice for the healthcare industry is apparent, and HHI is the method for achieving such standard. The creators of HHI have outlined strategies that work, as demonstrated through the success of hospitals around the country. The information is now available, so it remains to be seen whether more healthcare organizations will participate in the Healthier Hospitals Initiative.


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