Congratulations on your new book Greening Health Care — How Hospitals Can Heal the Planet. What do you hope to accomplish with the book?

My hope is that the book will inform people about the impacts health care systems have on the environment, educate them on ways to reverse these negative impacts, and underscore the transformative power of embracing environmental stewardship as preventive medicine on a grand scale.

It seems that the health care systems that are the most sustainable, such as Kaiser Permanente and Gundersen Health, have top leadership that make it a major priority. Is it possible to become highly sustainable without a top-down-driven effort? If so, how can you accomplish that?

The most successful sustainability programs have both leadership support and a culture of innovation in which employees committed to sustainability are empowered to address waste and solve problems as they see them in their immediate lines of work.

There are many examples of great work being done at Kaiser Permanente that started on the front lines. Other decisions — purchasing, for example — that have a wider scope can require agreement from top leadership. So, both are necessary. But, in an organization that values innovation, where employees are encouraged to inspire change, a grassroots sustainability movement can be very effective.

You noted in your book that being green has evolved at Kaiser Permanente from a voluntary effort to a smart and healthy way of doing business that continues to progress even now. In addition to committed leadership, what does it take to maintain that level of dedication from a systemwide standpoint?

It takes three things to embed sustainability into the mainstream work of an organization: governance, aligned work plans and communication.

Governance ensures clarity about how goals are set, which strategies are prioritized, the allocation of resources and, most importantly, accountabilities for accomplishing the work.

Many environmental activities require the engagement of different disciplines. Aligned work plans help to keep everyone on track toward the shared goals.

Hospitals are complex organizations. Unless people are talking to each other and understand the ripple effects of certain business decisions, it is too easy for the sustainable choice to be overlooked.

The subtitle to your book is How Hospitals Can Heal the Planet. What do you mean by this?

Hospitals are symbols of health in their communities, but their missions to support health are challenged by their environmental footprint.

By broadening their perspective on health to include supporting healthy environments, hospitals can turn their significant buying power and community leadership into a national, even global, environmental sustainability movement for the health and well-being of the world’s people.

In your position as environmental stewardship officer, what are your chief responsibilities, and what does a typical workday involve? How has your job changed over time?

My main responsibilities include developing a strategic approach to reducing environmental contributors to disease, understanding Kaiser Permanente’s own impact on the environment and implementing programs to mitigate that impact.

A typical day has me interfacing with others with whom I share accountability for meeting goals and objectives, and partnering with others outside the organization to improve the environmental performance of the entire health care sector.

I support our nongovernmental organization partners in innovating and leveraging solutions. And I connect with other health care systems to learn from their accomplishments and to analyze failures.

When I began in this work, it was in addition to my “day job.” Today my role as environmental stewardship officer is an executive-level position with heightened authority and visibility. Many corporations have similar positions (also called chief sustainability officers), but they are not yet common in health care.

What are your strategic sustainability priorities for the organization and how were they set?

Our priorities are reducing fossil fuel use, minimizing waste, conserving water, promoting sustainable food, and procuring products and materials that contain safer chemicals.

We chose to focus on these areas because they have significant environmental and health impacts, and our actions have the potential to influence the entire health care sector and industries that intersect with health care.

How do you achieve compliance throughout such a large organization?

Compliance comes through building our work plan together, specifying accountabilities, tracking all of the work on a monthly basis, and quickly acting to realign work that may be getting derailed.

What organizational measures or dictates are in place to ensure that you achieve your mission?

Because of our history as an organization focused on prevention, it has never been a leap for Kaiser Permanente leadership to make the connection between environmental stewardship and our mission to provide affordable high-quality health care and improve the health of the communities we serve. All of our sustainability work is for the purpose of eliminating environmental contributors to disease.

Our work is endorsed by the organization’s board of directors and our chairman and CEO, Bernard J. Tyson. And we have adopted national policies on waste minimization, sustainable energy, requiring all major projects to attain LEED Gold status, and water conservation. These policies help to ensure that we achieve our goals.

What do you see as the future of sustainability in health care? At some point, will it become business as usual for all health care systems and, if so, how far down the road will that happen?

A thousand hospitals have joined the Healthier Hospitals Initiative. A recent Harris Poll survey shows that more than half of U.S. hospitals now make environmental sustainability a factor in purchasing decisions. And more than 80 percent of U.S. hospitals expect to engage in sustainable purchasing within two years. So, we are moving in the right direction.

I think the competitiveness of the current health care marketplace could further this momentum as the most creative and resourceful health care organizations rise to the top. The organizations leading the sustainability movement tend to be innovators in other areas of business as well. With the most innovative and committed among us leading the charge, this can only be good for the sustainability movement.

Jeff Ferenc is senior editor of Health Facilities Management.

The Gerwig file


• Vice president of employee safety, health and wellness, and environmental stewardship officer, Kaiser Permanente, Oakland

• Serves on boards of directors for Health Care Without Harm, Practice Greenhealth and the Center for Environmental Health


• Author of the book Greening Health Care — How Hospitals Can Heal the Planet, published by Oxford University Press

• Guiding Kaiser Permanente and its staff into becoming a world -class environmental stewardship organization

• Certified as Healthcare Risk Manager, Professional Environmental Auditor and Healthcare Environmental Manager

• Partners with nongovernmental organizations to achieve environmental successes throughout the U.S. health care sector, which has led to advances globally


• Pepperdine University, the George L. Graziadio School of Business and Management, master’s degree in business administration

• San Francisco State University, bachelor’s degree in geography and environmental studies