Environmental footprint of regular and intensive inpatient care in a large US hospital

Purnima Aishwarya Prasad,Cassandra Thiel,Joan Velletri,Dhruvi Joshi,Michael Collins,Robin Allen,Jenna Agins,Jennifer Lighter,Foohel Pena

doi:10.1007/s11367-021-01998-8

Abstract

PurposeEnvironmental sustainability is a growing concern to healthcare providers, given the health impacts of climate change and air pollution, and the sizable footprint of healthcare delivery itself. Though many studies have focused on environmental footprints of operating rooms, few have quantified emissions from inpatient stays. This study quantifies solid waste and greenhouse gas emissions (GHGs) per bed-day in a regular inpatient (low intensity) and intensive care unit (high intensity).MethodsThis study uses hybrid environmental life cycle assessment (LCA) to quantify average emissions associated with resource use in an acute inpatient unit with 49 beds and 14,427 hospitalization days and an intensive care unit (ICU) with 12 beds and 2536 hospitalization days. The units are located in a single tertiary, private hospital in Brooklyn, NY, USA.Results and discussionAn acute care unit generates 5.5 kg of solid waste and 45 kg CO2-e per hospitalization day. The ICU generates 7.1 kg of solid waste and 138 kg CO2-e per bed day. Most emissions originate from purchase of consumable goods, building energy consumption, purchase of capital equipment, food services, and staff travel.ConclusionsThe ICU generates more solid waste and GHGs per bed day than the acute care unit. With resource use and emission data, sustainability strategies can be effectively targeted and tested. Medical device and supply manufacturers should also aim to minimize direct solid waste generation.

Highlights

The cost of healthcare in the United States (US) is the highest in the world, while the US ranks lower than other developed countries for health outcomes (CMS 2017)
The acute care unit generated between 84 and 111 kg of solid waste daily. This results in about 6 kg of solid waste per bed day, or 79,685 kg of solid waste annually
The intensive care unit (ICU) generated between 25 and 81 kg of solid waste daily. This results in about 7 kg of solid waste per bed day, for an annual total of 18,098 kg of solid waste, or about 1% of the hospital’s total waste

Summary

Introduction

The cost of healthcare in the United States (US) is the highest in the world, while the US ranks lower than other developed countries for health outcomes (CMS 2017). Researchers have conducted LCAs for specific medical procedures such as childbirth (Campion et al 2012), hysterectomy (Thiel et al 2018, 2014; Power et al 2012), eye surgeries (Thiel et al 2017; Tauber et al 2019), plastic and other surgeries (Berner et al 2017; MacNeill et al 2017), dialysis (Piccoli and Mery 2017; Barraclough et al 2017; Chen et al 2016; Lim et al 2013; Connor et al 2011), radiology (Martin et al 2018; Chua et al 2021), and pathology (Gordon et al 2021) Studies at this level often report the largest share of emissions coming from single use and disposable supply production as well as energy use, though LCAs in low-resource setting often show more efficient resource utilization and variance in sources of emissions (Goel et al 2021; Steyn et al 2020). This study quantifies the resource-use, solid waste generation, and life cycle GHGs of inpatient stays in regular inpatient units/acute care (“low intensity”) units and intensive care units (ICU or “high intensity”) in a hospital in the northeastern US

Methods

Results

Conclusion