There likely has never been a more challenging time to be a hospital trustee. While technology allows us to operate in ways we never thought possible just a generation ago, we serve a population with rates of chronic disease that are dangerously rising. External pressure and conflicting internal priorities are forcing savvy leaders to step back and assess their organizations with a fresh set of eyes as they look to create value for what is often their community’s largest asset.

One place hospitals are finding answers to some of their most difficult questions is in sustainability. Progressive organizations have discovered that they can be environmentally responsible and fiscally prudent; in fact, to be the latter, they must be the former. These hospitals have determined that building a business case for sustainability is a requirement as a steward of the community, but also a value creator for the organization itself.

Among hospitals that integrated sustainability into their operations, four characteristics are common: balance, hardwiring, measurement and community benefit. By incorporating these areas throughout an organization, hospitals are creating more effective and more financially viable institutions that can weather the current external and internal pressures of our industry.

1. Balance: More than Green

Sustainability entails more than green health care. Organizations that define success by achieving financial targets, positively impacting the environment and improving the health status of their communities while fully engaging their employees already are integrating balance into culture and operations. Blending the science of environmentalism, the disciplines of hospital management and the principles of process improvement enables allows successful organizations to maintain their balance.

“Medical staff alignment and engagement have been a key element of Spectrum’s success throughout the years,” notes Harry Knopke, chairman of the board of Spectrum Health, Grand Rapids, Mich. Spectrum embraces the “triple bottom line” concept, which refers to assessing performance on three levels: financial, environmental and social. “Continuing that into the employed ranks across the system, as an effort to drive a balanced approach to the triple bottom line, is only natural.”

Balance also means addressing fiscal concerns in any overall sustainability effort. In fact, “future fiscal constraints will require every effort to remove fat from the organization. If the strategic elimination of waste reduces cost and improves health status, we must learn to lead that way today to be successful into the future,” says Patricia M. Szpakowski, board chair of Presence Saint Joseph Hospital in Elgin, Ill.

2. Hardwiring: Sustainability within Budget

Achieving balance will not occur without hardwiring sustainability into the cultural and operating fabric of the organization. This means achieving sustainability objectives without adding cost or overhead, all while engaging staff to become environmental stewards as part of their daily work.

With community stewardship a central tenet to hospitals’ mission and fiscal responsibility a requirement for survival, this means these two concepts — often seen as mutually exclusive — now must coexist. “Any activity shown to be best practice, even if it is environmentally driven, will ultimately help the bottom line,” Knopke says.

At Metro Health Hospital in Wyoming, Mich., “the sustainability report is an essential and standing part of the board building committee meetings,” says Jane Ross, vice chairwoman of the board.

Engaged staff can manage the financial and ecological give-and-take, so it is essential that sustainability be hardwired into the organization to weather changes in leadership, remain buoyant through the ebb and flow of financial trends, and survive changing community expectations.

"We do not need to superimpose sustainability on the organization,” Ross says. “It is ingrained in everything we do without additional cost. Sustainability is embedded in all of our decisions. We [no longer] classify sustainability as something different; it is seamless in the culture.”

3. Measurement: Achieving Success

The ability to track the effects of a sustainability strategy helps to provide ongoing support to the business case.

When Metro Health Hospital introduced microfiber mops and new vacuum cleaning techniques as an environmental initiative, the facility noticed benefits outside the traditional sustainability impact, including a reduced rate of shoulder injuries, fewer worker compensation claims and reduced injury days. In the environmental services department, workers’ compensation claims dropped to $10,000 from $350,000 in one year. “Knowing that these changes in procedure had a positive environmental impact as well as a visible improvement to our bottom line was important and intentional,” Ross says.

At Spectrum Health, Knopke believes that the right data are key to successful sustainability initiatives. “When managed and tracked appropriately, sustainability pays for itself,’ he says.

4. Community Benefit: Beyond Your Facility

While financial statements can communicate an organization’s fiscal strength, measurement systems also allow it to understand and then report its community benefit. For years, hospitals have been producing community benefit reports that typically emphasize spending. Recently, however, some organizations have begun tracking and reporting environmental impact. The community benefit of a sustainability strategy, aligned with improved community health status, may be most significant to those in the surrounding community. As Szpakowski notes, “As the largest employer in the community, [we] need to lead initiatives that foster long-term community health.”

Metro Health Hospital, for example, has committed significant resources to create a zero-discharge campus meaning there is no runoff into surrounding waterways or water tables — on its 170-acre site.

As hospitals work to transform care delivery, some may put sustainability on the back burner. But Ross believes that forward-thinking organizations should not abandon their efforts. “Regardless of these external pressures, we need to continue to focus on sustainability, because it is good for the organization and the community,” she says.

By balancing people, planet and profit, hardwiring sustainability into the organization’s culture, measuring outcomes and focusing on positive community benefit, sustainable health care organizations will thrive in the future.

Rick Ament ( is the president and CEO, SOS Partners, DePere, Wis.