Strategic Planning for Sustainable Healthcare

Managers’ decisions surrounding environmental initiatives will have a direct impact on patients, associates and communities.

By Dan Scher


One of the most significant trends of 2022 was the transition of healthcare sustainability from a public relations opportunity to a stakeholder expectation. With the healthcare sector responsible for 8.5 percent of greenhouse gas emissions in the United States, healthcare facility managers can make a substantial difference by integrating environmentally conscious initiatives into long-term plans and daily operations. 

Prioritizing sustainability in long-term plans is necessary and easier than ever. While it is true that expectations have increased, so has external support, such as government incentives. As the broad impacts of climate change become evident, new efforts are connecting sustainability initiatives to facility operations and to the health and resilience of local communities. 

Managers’ decisions surrounding environmental initiatives in their facilities will have a direct impact on patients, associates and communities. The success of these programs relies on thorough and effective planning. 

Compliance and sustainability 

Sustainability initiatives were once considered “nice to do” projects, but they have become a higher priority in recent years. At the federal, state and even municipal government levels, code requirements are increasing. 

One easy place for managers to start the sustainability journey is understanding existing and proposed local ordinances for key issues, including recycling, energy management and decarbonization. Depending on a facility’s location, this step could establish a list of initiatives for short-term prioritization. 

Fortunately, the federal government is investing billions of dollars in incentives to modernize and decarbonize the physical environment over the next decade. Recent federal legislation, including the Infrastructure Investment and Jobs Act and Inflation Reduction Act, offer new incentives and tax credits — including direct-pay options for non-profit facilities — for implementing renewable energy projects or supporting the transition to electric vehicles. Proactively incorporating these incentives into capital plans allows managers and their organizations to extend their limited financial resources and accelerate the internal and external benefits. 

A sustainability strategy 

Once managers establish a short-term plan to ensure compliance, the next step is to understand the organization’s approach to sustainability and the role the facility team needs to play to ensure success. Some organizations have a dedicated sustainability team, while others include this responsibility under strategy, advocacy, finance or facility management. 

Regardless of the structure, most sustainability initiatives involve coordination with more than one functional area within the organization, so broad engagement and collaboration are vital. 

An organization’s sustainability priorities eventually impact all aspects of facility maintenance and management. Examples include energy efficient operations, leveraging environmentally preferred purchasing and transitioning to renewable energy sources. Waste reduction plans also can have a significant impact because hospitals produce more than 5 million tons of waste every year. 

Short-term plans, long-term goals 

Once managers understand their organization’s sustainability goals, it is time to integrate them into long-term plans. Large-scale changes are not accidental and are challenging for managers to complete unless they are thoughtful in planning for the future. 

The years 2040 or 2050 might seem far away until managers consider the significant changes required to reach net-zero carbon in a physical healthcare environment with millions of square feet and processes that consume large amounts of energy. Sequencing foundational initiatives in support of long-term interests is an important part of prioritizing sustainability projects. 

When planning for long-term unknowns and the routine changes physical healthcare environments undergo, facility managers need to make their plans flexible by using available data and filling in the gaps with projections and predictions. Many organizations default to using time to trigger a re-evaluation of their plans, since it is easy to schedule an annual calendar reminder. 

A better way is to document the most important assumptions in the plan and track when updated information is available. While this method requires more active participation and awareness, it allows managers to let the changes in the market determine when to adjust the plan. 

Maintaining a healthy environment is a crucial responsibility of healthcare facilities managers. Sustainability and climate resilience are becoming higher priorities as the impacts of climate change escalate. Setting goals, integrating sustainability into facility operations and prioritizing capital initiatives to build toward long-term targets will be differentiators over the next few decades. Every facilities manager should be prepared to articulate the way their team is supporting this transition. 

Dan Scher is vice president of strategic planning and sustainability for Medxcel. He leads market and master facility planning and all aspects of the organization’s sustainability program. He has years of experience in strategy and analytics with a focus on the healthcare and utility industries. Dan served as a founding and steering committee member of the U.S. Department of Energy’s Hospital Energy Alliance from 2009 to 2012 and has participated on the Facility Guideline Institute’s health guidelines revision committee since 2015. 



December 28, 2022


Topic Area: Sustainable Operations


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