Facing industry pushback, Joint Commission plans to introduce proposed sustainability measures as optional

Editor's Note: This story was updated to include a statement from Health Care Without Harm.

After receiving industry feedback on new proposed standards on sustainability, the Joint Commission currently plans to roll them out as optional, Fierce Healthcare has learned. 

The accreditation standards, aimed at those participating in the hospital and critical access hospital accreditation programs, would require hospitals to designate a person responsible for overseeing the reduction of greenhouse gas emissions, measure specific data, develop goals and action plans to reduce those emissions and annually track progress.

In a virtual meeting on decarbonizing the sector hosted by the National Academy of Medicine on Thursday, the commission’s president and CEO Jonathan Perlin, M.D., Ph.D., presented the organization's plan. The proposal remains in an open comment period, which ends next week.

To date, overall feedback has been negative, Perlin said, mostly from senior administrators who say they are overwhelmed with workforce shortages, financial challenges and patient disposition concerns. 

At the same time, younger clinicians (45 years old and under) expressed their enthusiasm and support for the standards, Perlin said. Nevertheless, the organization’s “current plan” is to initially roll out the standard as “extra credit,” meaning it would not determine an accreditation decision. 

The organization has received more than 300 responses so far. The organization is considering implementing the standards either in January 2024 or July 2024.

“The Joint Commission sees environmental sustainability as a critical health and health equity priority,” Perlin said in a statement to Fierce Healthcare. “For maximum uptake among hospitals, we are continuing to evaluate how to best introduce the standard and its requirements, and are currently considering a voluntary, ‘extra-credit’ approach.”

Additionally, the organization is launching a virtual resource center to highlight the work of leading organizations “as they address environmental sustainability in the context of all of the shared challenges in healthcare today," he added.

On its website detailing the proposal, the commission wrote that healthcare organizations “can no longer ignore their contributions to greenhouse gas emissions.” It went on, “Hospitals need to take action to minimize their carbon footprints as they care for patients.” 

In response to the pending decision, nonprofit advocacy group Health Care Without Harm said in a statement: "We are deeply disappointed with the pre-emptive decision to make these requirements optional and urge the Joint Commission to reconsider. While voluntary programs play a useful role, mandatory measurement of greenhouse gas emissions is essential to achieve the meaningful reductions necessary at this critical moment." 

Climate change has been among the top priorities for this White House, which launched the Health Sector Climate Pledge in conjunction with the Department of Health and Human Services in 2022. So far, 116 organizations representing hundreds of hospitals have signed on to the pledge, including the Joint Commission.

“Decarbonization and sustainability are critical to a health agenda,” Perlin said at the time in a statement. “As the largest standards-setting and accrediting body in healthcare, it is vital that we take a leadership role and work with healthcare organizations nationally and internationally to reduce the carbon footprint.” 

Present on the Thursday call were a variety of stakeholders from across the healthcare and life sciences sectors including AstraZeneca, Philips, UnitedHealthGroup, Providence and the Center for Medicare and Medicaid Innovation.

A bullet point at the end of Perlin’s presentation slide contained a callout: “Appreciate your help in popularizing the moral obligation to ‘first, do no harm’ in healthcare.”