Hospitals and the climate emergency

By Neil Ritchie

Do you remember the TV medical drama ‘ER’ that ran for 15 seasons starting in the mid-90s? It was a great show and featured the remarkable skills and intelligence of hospital staff, dealing with the kinds of things that hospitals do best – compassionately handle life-threatening emergencies. Today, hospitals are faced with a different kind of emergency that is perhaps more challenging than anything that has previously come through their doors – the climate emergency; the same climate emergency that was formally declared by the Parliament of Canada in June of 2019 and by over 475 municipalities in Canada since then.

While hospitals can point to a number of sustainability initiatives including energy, water and waste management that have made incremental improvements in their environmental performance, it’s simply not enough! Climate action can’t wait.

Since 2007, the United Kingdom has reduced its carbon emissions by 18.5 per cent despite a 27 per cent  increase in clinical activity and has recently committed to becoming “Net Zero” ahead of the national timeline. Yet in Canada, our health care-related emissions continue to rise. Canadian health care’s environmental footprint represents just less than five per cent of total national greenhouse gas emissions, but health care’s impact as a key influencer of business and public perception is enormous.

Unfortunately, competing priorities and lack of financial and staff resources have limited health cares’ environmental progress. But that’s starting to change as climate change takes centre stage nationally and internationally. The health care industry – providers, suppliers and funders – need to step up, show more leadership and set examples for other high carbon emitters.

The Canadian Coalition for Green Health Care has developed multiple tools and resources to help health care providers on their journey to climate-smart, resilient health care. Incorporating a climate-lens into what we do every day is a good place to start. Here are a few climate-smart steps that hospitals can take. They can be summarized as the “5 P’s.”

  1. 1.  People.  People who are willing to step up, put their shoulders to the wheel and initiate action make all the difference. Although like any major initiative, an executive sponsor is essential, informal leaders play a huge part. Just look at the example of youth activist Greta Thunberg. Effective Green Teams can be formed at the corporate, departmental or work unit level – it simply takes people who want to see great things happen to get together and decide to take action. Health care professionals also need to have appropriate training to both recognize climate-related impacts in the work they do and opportunities to adapt.
  2. Policy.  Development of an overarching climate-smart policy and related departmental policies is also essential and will no doubt evolve over time as initiatives gain momentum. Showing senior leadership support to develop a climate-smart hospital at the administrative, medical and Board levels will ensure that the hospital ‘ship’ is steered in the right direction
  3. Plan. A plan that builds both resilience to climate change and mitigation of its effects will ensure that everyone is on the same page and will also help promote action. Check out the Climate Change Resiliency Toolkit at  that can be used to help build resiliency actions. The plan should have defined priorities, targets and accountabilities and ultimately be linked to the organization’s strategic plan. Don’t wait for the plan to be perfect and think you should have all possible data. Our climate is changing and your plan will have to adapt as new information emerges.
  4. Process. Understanding the key processes that need to change; things like procurement, transportation, food, waste and energy behavior are at the heart of any improvement activity. Quality improvement frameworks and risk management tools can be applied to analyze processes that need to change while applying a climate-lens.
  5. Performance Indicators. Measuring progress against established goals throughout the enterprise, comparing performance to past years as well as the performance of peers can help manage improvements.  Free tools such as the Green Hospital Scorecard can help you do this.

Hospitals need to build resiliency to climate change and show leadership in reducing their carbon footprint. After all, emergencies are what we do best!

Neil Ritchie is the Executive Director of the Canadian Coalition for Green Health Care.  He can be reached at: