About this letter 

In March, The Joint Commission announced that they were developing new requirements to address environmental sustainability for hospital accreditation programs, stating: “Hospitals need to take action to minimize their carbon footprints as they care for patients. Hospitals can begin decarbonization activities by measuring and reducing their greenhouse gas emissions.”

On April 27th, The Joint Commission's President & CEO announced that they would not implement the draft sustainability requirements due to the strong, immediate, negative feedback they received. Instead, they will promote these measures through a voluntary, “extra credit” approach. 

Health professionals have an important opportunity to let the Joint Commission know that mandatory measurement of health care greenhouse gas emissions is essential to achieve meaningful reductions. Please ask the Joint Commission to make the proposed requirements mandatory by signing the letter below.

This letter was drafted by Healthy Climate Wisconsin and Michigan Clinicians for Climate Action, with support from experts at Health Care Without Harm. 

Please sign on to the following letter by filling out the form below. Signatures will be gathered and delivered along with this letter to the Joint Commission by Wednesday, May 3.

Dear Dr. Jonathan Perlin, Dr. David Baker, Dr. Phavinee Thongkhong-Park, and members of the Joint Commission, 

As health professionals concerned about the health impacts of the climate crisis, we strongly encourage the Joint Commission to reconsider its recent decision to make the new environmental sustainability standards voluntary.

We thank the Joint Commission for initiating a conversation about the importance of addressing sustainability in hospitals and critical access hospitals. We share hospitals' core mission of protecting the health of our patients and the communities in which they live and believe that environmental sustainability can be achieved in a way that leaves hospitals financially and operationally healthier.

Decreasing greenhouse gas pollution is a major opportunity for health systems. Increasing efficiency and transitioning to clean energy saves health systems money, reducing health care costs. This effort is only more attractive with historic amounts of new federal financial support available through the Inflation Reduction Act. Pursuing climate-smart health care has also been shown to aid in recruiting and retaining care staff, a critical concern for hospitals. At the same time, these efforts can improve local air quality and boost local economies through local investments. Climate-smart health care can help hospitals become true anchor institutions.

We recognize that healthcare administrators may be resistant to accepting new mandated activities. However, as stated above, sustainability efforts broadly benefit hospitals and their communities. Furthermore, the climate crisis itself requires urgency. The current rate of voluntary emissions reduction efforts is insufficient. At a minimum, all hospitals should measure their emissions, make a plan to reduce them, assess progress toward those reductions, and name a staff role to coordinate that work.

As health professionals, our duty is to respond to the growing climate emergency not only by treating those made ill from the climate crisis and its causes, but also by encouraging the health sector to rapidly reduce its own emissions. The evidence is unequivocal; a global increase in temperature risks catastrophic harm to human health. Our health care systems are already experiencing the financial costs and health burden from increased spread of disease and more frequent extreme weather events, and we as health professionals are on the frontlines of this crisis. Higher temperatures cause increased cardiovascular and pulmonary morbidity and mortality, renal failure, infections, adverse mental health outcomes, and pregnancy complications among our patients. Climate change is also a significant health equity issue - with disproportionate impacts on the most vulnerable, including children, older adults, those from poorer communities, and ethnic and racially minoritized groups. 

Ironically, the health sector itself is responsible for 8.5% of total U.S. greenhouse gas emissions. In fact, pollution attributable to the U.S. health care sector has public health harms commensurate with those associated with preventable medical errors. From the womb to their last breath, our patients are harmed when the healthcare sector uses fossil fuels for energy. Air pollution from fossil fuels has been associated with stillbirths, preterm births, delayed cognitive development in children, asthma, heart and lung disease, many cancers, and dementia. With cheaper, cleaner energy technologies now available, we are obligated to minimize our sector’s climate footprint and fulfill our commitment to “do no harm.” Furthermore, the strong financial case for taking action removes any reasonable objection to doing so.

We believe these standards will produce a strong movement towards sustainability for health care systems and critical access hospitals, one which is directly beneficial not only to hospitals but to the communities they serve. Again, we thank you for your time and consideration in allowing us to share our ideas. We are in full support of the Joint Commission enacting each of these requirements as soon as possible.