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What is environmental sustainability?

Sustainability is based on a simple principle: Everything that we need for our survival and well-being depends, either directly or indirectly, on our natural environment. To pursue sustainability is to create and maintain the conditions under which humans and nature can exist in productive harmony to support present and future generations.

U.S. Environmental Protection Agency (EPA)

Our commitment to sustainability

We are committed to making Boston Children’s a leader in operating sustainably, including through achieving net zero greenhouse gas emissions by 2050, and addressing and mitigating the effects of climate change and other environmental harms on the health of children.

We envision a world in which our patients, families, staff, and community can thrive because we, alongside others, have centered environmental health as a necessary condition for human health and wellbeing and acted accordingly.

Why environmental sustainability?

Environmental sustainability is key to our mission.

  • The negative consequences of climate change are already affecting Boston, the surrounding region, and the world. Children are uniquely vulnerable to the consequences of climate change. They have physiological differences from adults and are more likely than adults to live in poverty, which makes them more likely to incur impacts to their health and well-being. They will also be the most exposed to climate change and more frequent natural disasters, as their lifespan is in front of them.
  • Environmental justice is a key component of health equity. Here in Boston, as well as nationally and internationally, low-income communities and communities of color are disproportionately impacted by climate change. In Boston, these impacts include increasing heat island exposure, rising sea levels, and storm water flooding. Even if children and youth are not experiencing immediate, direct impacts of climate change on their day-to-day life, climate anxiety — distress about the potential effects of climate change — is increasing among our teens and young adults.

Our organization is both susceptible to the impacts of climate change and an active contributor to environmental harm. We must be part of the solution. This requires us to provide care that accounts for the impacts of climate change on our patients, to ensure our facilities and operations are resilient in the face of climate-related threats, and to reduce our contributions to climate change and other environmental damage.

How is Boston Children’s moving forward on sustainability?

In 2022, Boston Children’s signed onto the White House/Department of Health and Human Services (HHS) Health Sector Climate Pledge. The hospital made voluntary commitments to reduce its greenhouse gas emissions and work to increase resilience — our ability to plan for, manage, and recover from disruptions in order to keep operating — in the face of climate change.

One of these commitments is to develop a climate resilience plan, which addresses both the resilience of our facilities and operations in the face of climate-related emergencies and our plan for supporting community resilience. Another is to undertake “carbon accounting” for our supply chain and use this data to build on the existing work of our purchasing team to reduce the greenhouse gas impact of our purchasing decisions, and therefore make our supply chain more environmentally sustainable. This evaluation of our supply chain will reach to every part of the organization. Our final commitment under the pledge is to reduce greenhouse gas emissions (including from fossil fuel combustion, energy purchased to run our buildings, and anesthetic gases) 50 percent by 2030 and to “net zero” by 2050. This last commitment aligns with work we are doing at our Boston facilities to comply with the city’s Building Emissions Reduction and Disclosure Ordinance (BERDO).

Boston Children’s has convened a cross-disciplinary steering committee of senior leaders and a set of workgroups populated with internal experts from across the organization who are committed to building a culture of sustainability and organized around several key focal areas:

  • Facility decarbonization and resilience
  • Enterprise transportation and supply chain
  • Clinical practice and patient outcomes
  • Community, policy, and employee engagement

Current initiatives

Energy efficiency
  • Across our buildings, lights are being upgraded to LED fixtures to reduce energy use. Already, these lighting upgrade projects have created energy savings of more than 3,500,000 kilowatt-hours per year, the equivalent of 288 houses’ electricity for a year.1 An additional project underway in one of our research facilities is expected to save an additional 734,000 kilowatt-hours per year upon completion, the equivalent of another 60 houses’ electricity.
  • Hospital spaces such as operating rooms and intensive care units require heavy electricity use to ensure that airflow through these spaces meets requirements for infection prevention and control. Research laboratory spaces are similarly energy intensive. Boston Children’s has worked to ensure these systems meet all quality and safety standards while also eliminating excess air changes. New operating rooms, such as those in the recently opened Hale Family Building on the main campus, are designed to maximize energy efficiency from the day they were opened, while older clinical and research spaces have been upgraded through the work of our engineering team. Airflow reductions in research spaces alone have led to energy savings of 2,650,000 kilowatt hours per year.
  • Our research teams have dedicated themselves to maximizing the energy efficiency of freezers and fume hoods, two significant sources of electricity demand. Through participation in the International Freezer Challenge, Boston Children’s has been recognized as the top health care organization in the world, saving 843 kilowatt hours per day. As of September 2024, Boston Children’s is also the winner of the first Fume Hood Challenge to save energy through careful management of laboratory fume hoods.
Reducing vehicle emissions
  • Through ongoing support for virtual visits, Boston Children’s works to improve access to care and avoid vehicular emissions caused by travel to our sites. During one year of the COVID-19 pandemic, virtual visits led to a reduction in 620,231 gallons of fossil fuel use for travel by Massachusetts families to and from our sites. A paper on this work was published in the April 2024 volume of Academic Pediatrics.
Waste diversion
  • Boston Children’s participates in medical device reprocessing programs offered by device manufacturers, ensuring that eligible devices are diverted from the waste stream and can be refurbished by the manufacturer for future use.
  • The OR team in Waltham has worked to repurpose clean, single use items that are unneeded for patient cases and have potential future use in other settings. A paper based on this work will be published in the December 2024 volume of the American Journal of Surgery.
  • Laboratory plastics pose a recycling challenge for many health care and research organizations. Although these plastics can be recycled safely, many haulers refuse to accept them and they are sent to landfills as trash. Boston Children’s is piloting a partnership with a company that recycles lab plastics — including pipette tip boxes and lab media bottles — for processing and then produces new lab supplies from this reprocessed plastic. The first month of recycling alone diverted more than 185 pounds of plastic from landfills, and we are excited to share the ongoing impact of this program.
  • As spaces are updated to meet current standards, the facilities team works to divert materials including furniture, fixtures, art, and large equipment to organizations that can direct it to future users. We are launching an effort to standardize this process and solidify relationships with partner organizations.
Greening the OR
  • Perioperative and OR teams across Boston Children’s have engaged in projects to reduce the environmental impact of surgical services though projects aimed at reducing the use of blue wrap packaging for instruments and kits (in favor of rigid cases that can be sterilized) as well as shifting other products from single-use to reusable options.
  • The anesthesia team is engaged in work pioneered at Seattle Children’s Hospital and University of Washington, known as Project SPRUCE, to measure the use of inhaled anesthetic agents and shift practice patterns to reduce the greenhouse gas impact of anesthesia practice, including by substituting the most polluting agents with environmentally preferable, therapeutically comparable alternatives.
Climate-informed care
  • The Boston Children’s Pediatric Environmental Health Center cares for patients with a range of environmental exposures, and consults with families and providers about environmental health concerns. As the Environmental Protection Agency (EPA) Region 1 Pediatric Environmental Health Specialty Unit, it serves as a resource for patients, families, and providers across New England. Additionally, it offers a wealth of resources for providers and families seeking to understand the impacts of climate change on the health of children and families through its Climate Rx resources. Available in English, Spanish, and Portuguese, these resources include pediatric-focused toolkits for dealing with a range of issues.
Community and public policy engagement
  • Through the Office of Community Health’s Collaboration for Community Health, we have funded youth led projects to understand and address the mental health impacts of climate change. These projects are organized through Boston Chinatown Neighborhood Center, The City School, and Madison Park Development Corporation.
  • Boston Children’s is a participant in the Boston Green Ribbon Commission, an organization formed to accelerate the city’s response to the challenges of climate adaptation and mitigation, including the Green Ribbon Commission’s climate justice workgroup. In one example of this work, Boston Children’s hosted a heat sensor in summer 2024 at Martha Eliot Health Center, as part of a pilot project to explore feasibility of real-time heat mapping across the city.

Additional resources

Resources on climate and health

Helping youth cope with climate anxiety

Health care organization resilience