How Can We Make Hospitals More Sustainable?

Jonathan Slutzman is an HMS assistant professor of emergency medicine, director of the Center for the Environment and Health, and medical director of environmental sustainability at Massachusetts General Hospital.

You’re an emergency medicine physician. How did you get into climate change?

I started out as an environmental engineer, and then I made the slightly inexplicable choice to go to medical school.

During my residency, one of my advisors said that at Mass General they had reusable suture kits for fixing lacerations but at Brigham and Women’s Hospital they had only disposable ones. I started looking into what the environmental difference was and realized I could be an environmental engineer focused on health care. I can speak both languages.

I enjoy taking care of patients — but what gets me up in the morning is asking how we can deliver the care people need without causing so much environmental harm.

How and why did the Center for the Environment and Health get started?

Six years ago, I identified a core group of three or four clinicians at Mass General who recognized that the climate is changing, that it’s hurting our patients, and that we in health care are contributing to it.

We asked Peter Slavin, [MD ’84], who was then the hospital’s president, to devote more resources toward environmental sustainability. He formed a sustainability committee made up of the leaders of nonclinical departments, individuals who control many of the processes that lead to clinical emissions. It turned out they were really enthusiastic about helping 

So we built on that. We got funding and created the center as a place to dedicate the time, energy, and people to coordinate on environmental sustainability across this big institution.

What are you proudest of that the center has helped accomplish?

On the energy side, 100 percent of the electricity at Mass General is now sourced from renewable generators. That’s a big deal. We’ve also reduced the unintentional release of greenhouse gases.

On the research front, we’ve produced studies on environmental repercussions, like our 2022 paper in the Journal of the American Society of Nephrology on the climate change effects of hemodialysis. We’ve done waste audits on inpatient medicine and, in our 2020 paper in the Western Journal of Emergency Medicine, wrote about waste generation and disposal practices in emergency departments. Our My Green Lab consult service is measuring potential improvements in a handful of labs. We also affected the design of a new building, the Ragon Building. A move toward greater energy efficiency for that building led to the elimination of a gas line in the design. When completed, 85 percent of the building’s energy needs will be from renewable sources and 15 percent will be met with steam produced by a nearby cogeneration plant, which has a plan to decarbonize as well.

We’ve designed an education module for faculty and are incorporating climate into our trainee curricula.

We’ve also instigated culture change. Our director of perioperative services recently got a request to try disposable bronchoscopes in our operating rooms, and his first reaction wasn’t, oh, that’s expensive. It was, that doesn’t sound very environmentally sustainable. He’s not an environmental engineer; he’s a nurse administrator. That’s the kind of thing we need to happen long term.

To what extent are carbon reduction solutions generic? Or do they need to be customized to institutions or departments? 

Most of it is not really custom. It takes some effort to come up with ideas, test them, and identify what works, but once we’ve done that, we can share them and others can implement them.

What do you say to health care professionals who feel overwhelmed by the problem?

We got into medicine because we see it as our mission to help sick people get better and keep people from getting sick to begin with. Environmental sustainability provides an avenue for doctors and nurses and pharmacists and everyone to do that.

Stephanie Dutchen is the manager of feature content and multimedia in the HMS Office of Communications and External Relations.

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