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Want to get your hospital or health system headed in a more environmentally friendly direction? It's OK to start small, Miranda Skaaning, MBA, said Tuesday at a webinar on decarbonizing healthcare sponsored by the National Academy of Medicine (NAM).

"If I had to start all over, I would start with energy [conservation]," said Skaaning, director of sustainability and energy conservation at Parkland Health in Dallas, Texas. "It's really got a huge impact not only on your emissions, but also money. There's so much money to be saved whenever you're reducing your energy use. So it's also good for the system itself."

For example, one way to save energy might be by running a chiller at 60% rather than at 100%, which would also increase the life of the device, she said. "But if you're not able to start with energy, all I would say is, start somewhere. We started with recycling -- first, it was cardboard, and then it was batteries, and after batteries it was single-stream," said Skaaning. "So, that's where we started."

Skaaning recommended soliciting help from vendors. "If you're part of a group purchasing organization (GPO), reach out to them, and they may be able to run a report on products that are more 'green' but also save money."

Shane Dunne, manager of sustainability at the Memorial Sloan Kettering (MSK) Cancer Center, in Brooklyn, New York, agreed that GPOs are a valuable resource in this area. "Talk about your priorities for sustainability or sustainable sourcing, or even supply chain efficiencies," Dunne said. One example of the latter, he added, is reformulating operating room kits to avoid including items that no one is using. By doing so, "you avoid those purchases and you avoid the waste."

"We even have a paper reduction program," Dunne continued. "We track the paper usage and work on the digital tools that we have available to us internally. And we're not only reducing the paper that we consume, we're reducing the toner that we need to purchase for the printers, and reducing the transportation impacts of the paper coming to and from [our facilities]. We're in New York City for a lot of our facilities; space is at a premium and there's not even really space to store things like paper. So there's a lot of kinds of those efficiencies from low-hanging fruit."

And continuing with Skaaning's focus on energy savings, "we have an industry-leading energy program," said Dunne. "Our plant operations team is constantly pursuing things like LED lighting and HVAC [heating, ventilation, and air conditioning] setback in the operating rooms when they're not in use, and timers on autoclaves."

"We even have a computer shutdown program," he said. "Our information technology team built a little scheduler into our workstations so that you can set a schedule to shut down our work on all of our workstations overnight; we save over $350,000 a year by shutting over 16,000 computers down overnight."

MSK also participates in the , according to Dunne; that effort is aimed at getting institutions to serve more plant-based foods. "We submit our food and beverage purchases annually and they calculate the greenhouse gas emissions" from them, he explained. "They provide us with tailored, polished reports every year for us to track our progress towards the agreed-upon goal of a 25% reduction in greenhouse gas emissions [for the food we serve] by 2030."

Other sustainability resources mentioned at the webinar included:

• A on reducing healthcare carbon emissions
• The , for measuring and comparing your building's energy to similar buildings, past consumption, or a reference performance level
• A , for healthcare organization accounting of emissions embodied in goods and services
• A , an accounting tool designed to help healthcare organizations measure their greenhouse gas emissions
• NAM's , designed to teach healthcare organizations about their greenhouse gas emissions and the three "scopes" of areas for improvement
• NAM's healthcare organizations can take to reduce their greenhouse gas emissions

Skaaning said her organization is looking at how to "really just integrate sustainability into our daily work. How do we make this something that's part of what we do, not something extra? We're looking at how we integrate this into our goals for the whole organization." As for specific projects, Parkland is looking into adding rooftop solar panels and expanding electric vehicle charging stations, she said.

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