Written by Rodney J. Moore

Even as accountability impacts care delivery, other areas of hospital performance are beginning to come under increased scrutiny such as environmental impacts and community benefits.

Arlington-based Texas Health Resources, one of the largest faith-based, nonprofit health systems in the United States with 29 hospital locations, is the state’s first health system to produce an annual Community Responsibility and Sustainability Report in accordance with the Global Reporting Initiative framework. Established in 2000, the GRI framework is the first and most widely used sustainability reporting system applied to multiple industries from manufacturing to banking.

The GRI Standards are a set of 36 interrelated standards designed for flexibility to meet a range of sustainability reporting needs. The GRI Standards help organizations understand and communicate publicly the impact of business on the economy, environment and society.

Not-for-profit hospitals and health systems aren’t held to the same standards of reporting of their sustainability and environmental impacts as publicly traded hospitals. Nonprofit hospitals, which comprise over half of all U.S. hospitals, are required only to assess community health needs and report community benefit annually. But Texas Health is going beyond this requirement in an effort to be more transparent and accountable by reporting its sustainability goals and how it measures up with the community.

Joel Ballew
Joel Ballew

“Consumers are at the point where they're demanding this level of transparency and accountability from health care organizations,” said Joel Ballew, vice president, government and community affairs, Texas Health. “We wanted to report out to our community stakeholders and use a very well-developed and well-respected framework to do that, and GRI seemed to be the best fit since it’s being used across multiple industries throughout the world,” Ballew said.

A Five-Year Plan

Texas Health issued its first Community Responsibility and Sustainability Report in 2012. The report provides a high-level overview of Texas Health’s citizenship and sustainability programs, their commitments and goals and their progress on enhancing the workplace, their environment of care and improving the health of the community at large.

Terri Scannell
Terri Scannell

Now with its fifth report issued in August, it is still among only a handful of hospitals and health systems nationally to follow the GRI Sustainability Reporting Standards.

“It’s an extraordinary commitment (to follow the GRI standards) because you really are publicly making a commitment to measurement and then you’re going to have to come back the next year and reveal how you did,” said Terri Scannell, senior social responsibility director, Vizient, Inc, a health care performance improvement company serving a diverse membership base.

By 2014, Texas Health was the first hospital system in the state to publish a Quality & Safety Report to the Community, also making it one of only a few in the United States to publicly post quality, safety and patient satisfaction data.

Ballew said Texas Health initially turned to other national health care providers for comparison of reporting and sustainability practices, but also found several North Texas businesses as inspiration.

“We compared ourselves against other health care organizations,” Ballew said. We also researched other industry segments and key leaders in North Texas where we knew other organizations held in high regard as being great corporate citizens, such as Southwest Airlines and Texas Instruments.”

“We believe the (Community Responsibility and Sustainability) report builds trust by helping stakeholders understand how we operate and what we’re doing to meet community expectations,” said Jeffrey Canose, M.D., FACHE, chief operating officer and senior executive vice president Texas Health, and chair of the Texas Hospital Association board of trustees.

Health Care Plays Catch Up

According to KPMG’s Survey of Corporate Responsibility Reporting 2017, 93 percent of the world’s largest 250 corporations now report on their sustainability performance. Yet, of the more than 4,051 sustainability reports issued by U.S.-based organizations in the GRI Sustainability Disclosure Database, only 112 are from health care service-related organizations (including hospitals), which demonstrates that the industry hasn’t yet embraced the trend.

“One of the things we're hoping to do is share best practices, and show other organizations in the health care industry the benefits of doing this type of annual reporting using the GRI framework,” said Ballew.

Widely known as large consumers of resources and significant waste producers, hospitals have been saving resources by adopting sustainability measures for years, starting primarily with the supply chain. However, hospitals still consume 2.5 times more energy than other commercial buildings, spending more than $8.7 billion per year, according to the EPA Energy Star program.

Going Beyond Compliance

Proving that large health care systems can achieve sustainability targets, Texas Health saved $30.2 million in 2016 by reducing variation of supplies and their use, exceeding its goal of $28 million.

Alyson Genovese
Alyson Genovese

“Organizations are using the GRI Standards and our reporting process to get a better handle on their impacts and to start managing them more effectively,” said Alyson Genovese, North American head of regional hub, Global Reporting Initiative. “Increasingly, communities are asking hospitals and other organizations to demonstrate that they are contributing to the long-term health of the local economy and society. Sustainability is an excellent way to present this information in a consistent manner.”

While Scannell said it is too early to tell if there is a larger trend of hospitals being more transparent about their business practices related to sustainability, she does see hospitals moving beyond compliance in some areas. “What I’m seeing is hospitals making a greater commitment to sustainability programs because they are linked to the overall health of the communities they serve,” Scannell said. “We’re also seeing where hospitals are going beyond current regulations related to sustainability initiatives for recycling, waste reduction and reducing the use of environmentally harmful chemicals.”

In some ways, Texas Health could potentially be a pioneer in both achieving significant sustainability goals and increasing its transparency through initiatives such as issuing annual reports that require ongoing accountability.

“The reasons health care systems should report are the same as for other organizations,” Genovese said. “Stakeholders are asking for the information, it’s a way to manage operations better and increase efficiencies, and it’s a way to have smart dialogue with stakeholders about not only what the organization needs to do less of (such as using water or producing waste), but also what are they doing well that they can do more of (such as community outreach and increasing access to health care for underserved populations),” Genovese said.

Texas Health’s Ballew said the trend toward increased transparency and accountability in health care will likely continue and, as a leader, he would prefer to be proactive rather than reactive. “Why not be on the leading edge and championing these types of initiatives and efforts when it comes to transparency, because that train is coming, and I think everyone in the industry needs to acknowledge it,” Ballew said.

Texas health has achieved notable targets in its sustainability efforts:
$5.5 million invested in efficiency projects
Recycled 143,243 pounds of electric waste
Recycled 7.06 million pounds of paper
Invested in 44 projects to reduce energy use