There is a growing movement to promote greener policies to achieve greater environmental sustainability in hospitals and other healthcare facilities. Yet without accurate, meaningful metrics to measure progress, advocates warn, such policies and practices are likely to be less effective.

In a new article published in the Lancet Planetary Health journal, Yale researcher Jodi Sherman and colleagues from Northeastern University and the Potsdam Institute for Climate Impact Research in Germany suggest four guiding principles to ensure metrics are fit for purpose in measuring healthcare sustainability. These are as follows:

• metrics should reflect the full scope of emissions caused by healthcare, both directly and indirectly;
• metrics should reflect not just greenhouse gas emissions but also other environmental pressures and their potential health impact;
• metrics should be linked to the core mission of health systems, from clinical outcomes of treatments reflecting quality performance of a healthcare organisation, to overall population health; and
• metrics should recognise the wide diversity of healthcare, from large, well-resourced hospitals to “a mobile clinician with a medical bag”.

Sherman is an associate professor of anaesthesiology at Yale School of Medicine and of epidemiology in environmental health sciences at Yale School of Public Health. She is co-leader of The Lancet Commission on Sustainable Healthcare and director of the Yale Program on Healthcare Environmental Sustainability.

The first author of the new article is Matthew Eckelman, associate professor at Northeastern and an adjunct associate professor at the Yale School of Public Health.