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October 21, 2025Frontiers in Health Services0 citationsOpen Access

Greenhouse gas emissions of a large, academic outpatient orthopedic center in the United States

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AJAnna M. JettVKVenkat KothandaramanEBEsther Bobbin

Key Points

  • Total greenhouse gas emissions were 11,049 metric tons of carbon dioxide equivalent (MTCO2e), indicating significant pollution.
  • Scope 3 emissions accounted for 81% of total emissions, primarily from patient transportation, emphasizing the need for targeted strategies.
  • LEED Silver certified outpatient orthopedic center utilized the Greenhouse Gas Protocol to categorize emissions for fiscal year 2023.
  • Identifying the high proportion of patient travel emissions highlights unique challenges for outpatient facilities in healthcare assessments.

Abstract

Introduction Hospitals and health systems create pollution as a byproduct of their work improving people's personal health. Pollution can harm human health. As part of a broad effort to comprehensively quantify a health system's pollution, we started with one group of pollutants, greenhouse gases, at a freestanding outpatient orthopedic center (OC). Methods OC has clinic rooms, imaging, administrative offices, and a small ambulatory surgery center. It was newly constructed and received LEED Silver certification in 2022. The Greenhouse Gas Protocol was used to categorize emissions into Scope 1 (direct), Scope 2 (indirect from purchased energy), and Scope 3 (supply and value chain) emissions for fiscal year 2023. Results OC's total annual emissions were 11,049 metric tons of carbon dioxide equivalent (MTCO2e), with 2% from Scope 1, 17% from Scope 2, and 81% from Scope 3. Most Scope 3 emissions came from just three categories: patient transportation (52% of Scope 3 emissions), purchased goods and services (20%), and employee commuting (12%). Discussion This initial study highlights the significant contribution of Scope 3 emissions to an outpatient center's greenhouse gas footprint. It specifically identifies patient travel as a major contributor to emissions; this is particularly important since patient travel is not always included in Greenhouse Gas Protocol healthcare assessments and patient travel can be mitigated in some circumstances by utilizing telemedicine. The emissions distribution across scopes is similar to other international hospitals, indicating generalizability, though the high proportion of patient travel emissions is unique to this outpatient-focused facility.

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Cite This Study

Jett et al. (2025) studied this question.

synapsesocial.com/papers/68f74e597f21f73e19e5b30dhttps://doi.org/10.3389/frhs.2025.1675827
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