A major Australian health provider has performed a complete audit of its carbon footprint as part of a strategy to reach zero greenhouse gas emissions by 2030.

Mercy Health says it is planning to move to 100% renewable energy and reduce its environmental impact across procurement, energy, transport, anaesthetic gases, food and capital works, all by the close of the decade.

But the first challenge is establishing an accurate baseline, something that had yet to be achieved by a healthcare organisation of its size in Australia, according to the authors of a new paper.

A Catholic provider with more than 10,000 staff, running hospitals and aged care homes across four states, it already had a “robust understanding” of its direct emissions – such as fuel and medical gases used on site – noted the team, as well as those resulting from its electricity consumption.

But everything else, from catering, to pharmaceuticals prescribed, to staff and patient travel, remained something of a mystery, the researchers said.

The audit, undertaken with ‘carbon accountants’ from consulting firm Arup, included all aspects of the organisation and calculated emissions for each area based on standards developed by the NHS and the federal government-accredited Climate Active scheme.

The results were somewhat surprising, wrote the Mercy executive leading the strategy, Sharon Desmond, and colleagues in Australian Health Review (link here).

Across the board, Mercy’s total carbon footprint for 2020-21 was 102.96k tonnes of carbon dioxide equivalent, but only 42% of this was generated by energy used for the service’s buildings.

Just over a third of all emissions were produced in the organisation’s supply chain, with food and catering accounting for 9% of emissions and pharmaceuticals and chemicals, medical equipment and non-medical equipment each contributing around 5% of the total.

Interestingly, personal travel was another significant contributor, with staff commute accounting for 6% of emissions, visitor travel 4% and patient travel 1%, the researchers found.

Medical gases and metered dose inhalers were responsible for 3% of the group’s carbon footprint.

But while electricity use accounted for only a minority of all emissions, the findings underscored the need to invest in more energy efficient buildings, including by increasing thermal insulation and upgrading heating, ventilation and air-conditioning units, the researchers said.

“Outside of electricity, decoupling from other fossil fuel energy sources requires investment,” they wrote.

“Natural gas accounted for 7.67% of emissions. New infrastructure will be 100% electric, and as gas powered infrastructure requires replacement, electrification will be preferred.”

Other potential improvements could be found by greening the organisation’s fleet with electric vehicles, implementing more virtual models of care to reduce the need for travel and conducting food waste audits at each facility, the authors suggested.

In addition, many health services had made positive gains in reducing the use of the anaesthetic gas desflurane in recent years, they noted.

“Emerging evidence from the UK and Australia demonstrates significant nitrous oxide waste via leaks from cylinders, pipework and values,” they added.

“An audit of nitrous oxide piped systems to determine leaks and remedial actions is planned.”

Beyond that, eliminating use of single-use items instruments and PPE and reducing demand and intensity of care via prevention, lean service delivery and lower carbon alternatives should all be on the table, according to the authors.

“This study has gathered evidence pertaining to Mercy Health’s baseline carbon emissions footprint. It is probable that anomalies will be discovered, and refinements made in subsequent inventories, which will facilitate time-series analyses,” they concluded.

“As detailed herein, this study, the first for a health and aged care provider, has important learnings for health and aged care services and funders regarding methodology, emissions imposts, composition intensity and evidence based interventions in Australia and beyond.”

“Benchmarking will be of interest, once other local carbon footprinting studies are available.”

Mercy says the work is informed by its Caring for People and Planet Strategy (2020-25), the organisation’s response to Pope Francis’ encyclical Laudato Si (2015), which calls for radical global change and unified action to protect the natural environment.