The Cleveland Clinic started thinking “green” more than a decade ago, as sustainability and energy efficiency were just starting to gain traction in serious conversations about climate change. Since then, the Ohio medical center’s environmentally conscious practices have become part of its culture, with everyone getting involved.

They are recycling, turning off lights and computers, planting trees in the community, and buying Energy Star-certified equipment, from MRI and ultrasound machines to kitchen appliances. They are reducing water usage through low-flow fixtures, cutting waste, and controlling operating room air to ensure it’s clean and fresh during surgery, but not squandered when the OR is empty.

Equally impressive: the facility aims to become carbon neutral within the next ten years. They hope to accomplish this by increasing their renewable energy sources, and expanding all of their existing efficiency and emission-reducing programs.

Cleveland Clinic Miller Family Pavilion. Source: HealthMonitor

“There is a linkage between environmental health and human health,” said Jon Utech, director of the clinic’s office for a healthy environment. “Cleaner air and cleaner water makes our patients healthier. The thinking was we could find solutions where everybody wins — the environment, the economic bottom line and human health.”

Thus far, the Cleveland Clinic hospital and health care system have saved an estimated $50 million in energy costs, $30 million in purchases, saved more than 600,000 trees and shifted more than 100,000 tons of material from landfills, according to Utech. “We have 30 million square feet of buildings and 51,000 people who work in every corner of them, and they are all very engaged in this,” Utech said.

The Cleveland Clinic was one of the early adopters of the sustainability movement, but it is no longer alone. An increasing number of hospitals are getting on board, recognizing the health industry’s contribution to emitting greenhouse gases (GHG) that drive global warming. The health care sector, in fact, accounts for 10 percent of carbon pollution in the United States, according to one study.

Residents, students and caregivers at the Cleveland Clinic plant trees in Fairfax, Ohio. Source: Cleveland Clinic

“In 2017, global climate change came home to Americans, moving from an issue that impacted polar bears on melting ice caps to an issue that affects the health and security of us all,” said Gary Cohen, president and co-founder of Health Care Without Harm and Practice Greenhealth. “Hospitals are committing to clean and renewable energy because their leaders recognize our continued reliance on fossil fuels is already creating an air pollution crisis at the community level, and creating a climate crisis at a global level.”

Practice Greenhealth has a network of about 1,800 hospitals — one-third of them in the United States — all of them committed to reducing their carbon footprint in any number of ways, according to the organization. It is difficult to track all of their practices, although the organization provided a small snapshot of what they know so far. In 2015, with 109 hospitals reporting the results of their energy efficiency programs, overall savings totaled 1.3 billion kBtus, the equivalent of 68,926 metric tons of carbon dioxide. This equals removing 14,759 cars from the road, or powering 10,331 homes, the organization said.

LED lights reduce energy consumption at Cleveland Clinic. Source: Cleveland Clinic

“All hospitals can and must do something, from waste reduction to energy reduction to local sourcing of food,” said Colleen Groll, the manager of sustainability programs at Seattle Children’s Hospital, which has a long history of environmental awareness. “Some hospitals have made incredible environmental commitments, like Cleveland Clinic and Kaiser Permanente. But even small hospitals with little resources can start a carpooling program to reduce air pollution and greenhouse gas emissions from their staff commuting.”

In 2012, Kaiser Permanente adopted a national sustainable energy policy and launched a strategy to reduce greenhouse gas emissions by 30 percent by 2020 (compared to 2008 levels), through long-term agreements for large-scale solar and wind power, as well as through on-site solar generation at its medical office buildings and hospitals. “When it became clear we would meet that goal earlier than expected — by the end of 2017 — we raised that goal to be carbon net positive by 2025,” said Kathy Gerwig, Kaiser’s environmental stewardship officer. “To do this, we will increase our renewable energy use and purchase carbon offsets.”

Kaiser, the largest integrated health care system in the country, began its environmental practices more than 20 years ago with goals to reduce carbon emissions, minimize waste and eliminate certain harmful chemicals from the products it uses.

“When we initially embarked on a sustainability program, people were excited about the work and there was a vast opportunity in front of us to make an impact,” Gerwig said. “However, as with any large organization, it took time for the mindset of sustainability and new ways of doing things to really take hold. For example, we would eliminate a certain chemical, and later see it had crept back into some products we were buying. But over time we saw great success in eliminating flame retardants, antimicrobials, PVC and other harmful chemicals from medical products and building materials.”

Seattle Children’s Hospital in Washington. Source: Sage Ross

At Seattle Children’s Hospital, the two largest sources of greenhouse gas emissions come from natural gas combustion and staff commuting. The facility has adopted measures to address both. “We are working on operational improvements to reduce natural gas consumption, and believe we can get a 5–10 percent reduction,” Groll said, adding that their infrastructure upgrade plan to condensing boilers, scheduled for 2020, “will really make a difference in natural gas reduction.”

The hospital is also working with its anesthesia department to reduce emissions of anesthetic gases, potent heat-trapping substances.

On the commuting side, Seattle Children’s sponsors subsidized transit passes, carpooling and vanpooling options, and daily commuting bonuses for those who leave their cars at home, as well as a smaller bonus for teleworking. The hospital loans fully-fitted commuter bikes — which include a rear rack, lights and a lock — to any staffer who agrees to commute by bike at least two days a week, year-round. They also receive a voucher for a helmet, two free annual bike tune-ups, secure bike parking at the company, and access to showers, lockers and towels.

In the coming years, the hospital plans to participate in an annual tree-planting program that will “offset” ten percent of its emissions over the life of the trees. At the first event in March 2018, staff volunteers will plant Pacific Northwest native conifer seedlings in a diverse neighborhood in Tukwila, Wash., adjacent to the Duwamish River, an industrial area near the Seattle-Tacoma International Airport and near an Environmental Agency Superfund site. The hospital specifically requested to plant in a heavy industrial site, with underserved neighborhoods.

“Tree planting is not a slam-dunk for global climate change, that’s for sure,” Groll said. “But the co-benefits for our communities are still a win for us — improving air quality, reducing storm water run-off and preventing soil erosion, providing shade and attracting wildlife.”

On the East coast — in upstate New York — Rochester Regional Health, which serves Western New York, the Finger Lakes and beyond, recently announced plans to use all-renewable power sources by 2025, and already has begun installing on-site solar panel generators at one of its campuses.

Solar panels atop Rochester Regional Health center in NY. Source: Mike Waller, Rochester Regional Health

“What’s great about solar projects is that all of the equipment has a warranty for 20 years, and we expect its life to be 30 years,” said Michael Waller, the system’s director of sustainability. “Also, it has a four-year payback, meaning after four years, we will have paid off the upfront capital costs from the savings.”

Rochester Regional will trim electricity use through equipment updates, facility modernization and routine maintenance, for example, replacing its old lighting with LEDs. In order to reduce waste and encourage recycling, the facility will buy products with less packaging. It also will avoid buying materials with pollution-causing chemicals, and ensure that its vendors comply with good labor practices and maintain a “clean” supply chain.

Rochester Regionals’ efforts are believed to be the most ambitious sustainability commitment by any health system in the state.

“Climate change is causing human health problems, and we in the health care industry are starting to realize that we are a part of it, and are beginning to make changes,” Waller said, adding, “We are the perfect industry to lead the way.”

Marlene Cimons writes for Nexus Media, a syndicated newswire covering climate, energy, policy, art and culture.