Quantifying hospital services by carbon footprint: A systematic literature review of patient care alternatives

Abstract Importance Reducing the carbon footprint of the healthcare sector can be achieved along with quality patient outcomes at lower environmental impact. Objective For the first time to categorize peer-reviewed articles that report quantitative improvement in greenhouse gas emissions related to medical devices and services, overview of trends, and identify some gaps for future research. Data sources Database searches resulted in 822 peer-reviewed articles (January 1, 2000 and December 31, 2016) on healthcare and environmental sustainability. Study selection A systematic review methodology identifies, critically evaluates, and integrates the findings. Articles reviewed 1) provided quantitative global warming potential (GWP) information, 2) were published in peer-reviewed journals, and 3) were related to one of the twelve hospital service categories. Results Patient care teams are substantially limited by a lack of data related to the environmental impact of their services. Of the one of three potential environmental scopes—travel-related energy, direct energy, and the procured goods and equipment embodied energy—only six articles covered all three scopes. Conclusions and relevance This research provides healthcare nurses, physicians, and administrators with the location of procedures, patient-based decisions, and other avenues to hospital sustainability improvements in twelve hospital service categories.