BY BROCK E.W. TURNER

Streamlining sustainability efforts across a health system can be a tall order. At Pittsburgh-based UPMC, doing so means coordinating work to reduce carbon footprints and boost environmentally friendly projects throughout its 40 hospitals—with plans to incorporate projects at its 800 doctors’ offices and outpatient sites.

Last year, the system took steps to formalize its green initiatives, starting in the C-suite: It created two executive roles focused on sustainability. It also launched a Center for Sustainability to serve as a five-person department and point of contact.

“We were doing quite a bit, but we were never really as organized [or] as coordinated as we are now,” said John Krolicki, who took on the role of chief administrative sustainability officer in September 2022. He also serves as vice president of facilities and support services at UPMC’s Presbyterian Shadyside and UPMC Children’s Hospital of Pittsburgh.

Along with recently appointed Chief Medical Sustainability Officer Dr. Michael Boninger, Krolicki oversees the UPMC Center for Sustainability and its newly hired senior director, Holly Vogt.

“I think it’s critical that not only do we have the administrative experience that [Krolicki] brings in the budget … we have the clinical experience and the management experience that I bring,” Boninger said.

Boninger, who is also president of UPMC Innovative Home Care Solutions, said a group of physicians at the system discouraged peers from using desflurane, a drug for general anesthesia that the American Society of Anesthesiologists has found to have disproportionately high climate impacts. Three UPMC hospitals have almost entirely stopped relying on the medicine, he said.

Meanwhile, Krolicki pointed to the importance of reducing food waste, using more solar power and finding other administrative ways to trim UPMC’s carbon footprint.

“Having the perspective from the clinical side of things, as well as the operations within each of the hospitals, facilities, clinics, doctors’ offices [and] things like that give a very different perspective,” said Vogt, who previously led sustainability initiatives for Beaver County, Pennsylvania.

Bringing sustainability efforts to the C-suite is a growing trend. According to a 2022 report from consultancy PricewaterhouseCoopers, the number of global chief sustainability officer roles more than tripled in 2021 compared with the prior year. The report noted the position requires an understanding of sector-relevant sustainability actions and strategic know-how, along with the ability to make organizational transformation.

Healthcare is behind the curve of some industries, according to the firm. A little more than half of pharmaceutical and health companies had sustainability officers who ranked below the C-level or who had limited influence on core business strategy. Nearly a quarter had no role specifically dedicated to environmental efforts.

“Emphasizing the upsides of the sustainability transformation from the very top is crucial to developing sustainable products and services. This also helps overcome the often long-held and deeply entrenched notion that sustainability is not core to business success and can pose a threat to profitability,” the report authors wrote.

Krolicki and Boninger say their institutional knowledge and organizational experience also give them the power to facilitate changes.

As part of its sustainability work, UPMC has several on-site hospital gardens. (Photo: UPMC Creative Services)

Several hospitals within UPMC have been working for years on various sustainability initiatives, such as recycling medical supplies, reducing dependence on diesel-powered employee shuttle buses, implementing storm water management techniques and instituting environmentally preferable purchasing practices for certain contracts. Around 400 care team members from all hospitals also formed a Clinicians for Climate Action group last year.

Many projects weren’t being documented, however, and accomplishments often weren’t communicated to the rest of the system.

“People didn’t think we were doing anything,” Krolicki said. Staff members “want to see UPMC being responsible. We were. We just didn’t advertise it well.”

The Center for Sustainability aims to gather standardized information on progress from hospitals and give separate facilities a central point of contact. It has also brought together a steering committee that will include representatives from each hospital.

“[The goal] is to bring all those teams together so that we’re learning from individual hospital experiences and spreading best practices,” Boninger said. “For those hospitals that don’t have a team up and running, we want to make sure we have a good process and we’re [growing] the right way.”

Some individual facilities can undertake relatively cost-effective initiatives, such as using federal funds for a solar energy project, on their own.

But other long-term projects, especially those requiring additional money, necessitate coordination between hospitals and among administrative and clinical staff.

“[Physicians] said, ‘We want to completely align with the health system,’ ” Boninger said. “[The physicians] recognize the importance of not trying to do this as a one-off, but do this internally.”

One such enterprise is a climate action plan. Last year, UPMC pledged to halve greenhouse gas emissions across the system by 2030. The goal is among the tenets of the White House/U.S. Department of Health and Human Services Health Sector Climate Pledge, which the organization signed in 2022.

Vogt said UPMC should be able to report select metrics on emissions and other key performance indicators from all 40 of its hospitals by the end of the year.

She said she is confident the organization-wide strategy will enable productive changes.

“A lot of times you can’t move things forward because there’s not enough momentum in the whole space,” Vogt said. “To be able to spread that [message] across the entire organization—this is why I see sustainability being extremely successful within UPMC.”

Correction: An earlier version of this story misstated how many UPMC facilities have almost entirely stopped relying on desflurane and the numeric goal for hospital representation on the Center for Sustainability steering committee.