Executive leadership in action: Embedding sustainability as a core investment

Published: July 16, 2026

Our new CleanMed Insights Series transforms select sessions into short-form articles that dig into practical lessons, emerging trends, and resources you can act on all year long.

Healthcare organizations increasingly recognize that sustainability affects everything from operational resilience and financial performance to quality, workforce well-being, and community health. Yet one question continues to surface across the sector:

How do organizations move sustainability from a passionate initiative led by a few individuals to a strategic priority embedded across the enterprise?

This question was at the center of CleanMed 2026's opening plenary, where executive leaders from leading health systems explored how leadership, governance, accountability, and culture influence progress.

The discussion reinforced a lesson many sustainability leaders already know: meaningful progress rarely happens through projects alone. It happens when sustainability becomes part of how organizations make decisions.

1. Leadership is a force multiplier

One of the strongest themes from the session was the role leadership plays in accelerating progress.

Drawing on research with health system CEOs across the country, Gene Washington, chancellor emeritus of Duke University, emphasized that executive leadership is often the deciding factor in whether sustainability efforts take root and endure. Leaders are most effective when they align sustainability with organizational strategy, hold teams accountable for results, and integrate climate goals into existing priorities such as quality and safety.

By the numbers: Leadership drives results

Preliminary analysis* of 2026 Environmental Excellence Awards data suggests leadership is a critical factor in sustainability progress. Our findings suggest that organizations are significantly more likely to achieve sustainability goals when leadership moves beyond endorsement and actively invests in organizational structures, accountability, and cross-functional ownership.

The biggest drivers of deep Scope 1 and 2 greenhouse gas reductions (25%+ cuts from baseline) are:

Having a dedicated sustainability lead (at minimum 70% more likely to achieve 25%+ reductions, often much more) and
Embedding sustainability into non-sustainability job descriptions (21%+ boost in an organization’s likelihood of reducing emissions).

The biggest drivers of cost savings in the OR are the same actions:

Hiring a dedicated lead (2-24x more likely to hit the savings threshold) and embedding sustainability in everyday job descriptions (1.7x minimum increase in likelihood).
The savings threshold was the 75th percentile of 2026 applicant performance, which was $339K in savings over one year.

Confidence level: Results use 95% confidence intervals, so the minimums are reliable floors, not averages.

*Preliminary findings shared during the CleanMed 2026 opening plenary. Full analysis forthcoming.

2. Accountability moves sustainability beyond good intentions

The conversation repeatedly returned to the difference between supporting sustainability and operationalizing it.

Panelists David Entwistle, president and CEO of Stanford Health Care, Carol Gomes, CEO and COO of Stony Brook University Hospital, and Gene Washington, chancellor emeritus of Duke University, emphasized that sustainability gains momentum when it becomes part of existing management systems. They described integrating sustainability into strategic plans, board discussions, operational scorecards, executive goals, and performance metrics rather than treating it as a standalone initiative.

Leaders also discussed how sustainability responsibilities are increasingly shared across departments including operations, facilities, procurement, quality, and workforce teams.

Audience engagement echoed this theme. One of the highest-rated audience questions focused on whether sustainability metrics should be incorporated into executive performance and incentive structures, reflecting growing interest in how organizations create accountability for long-term progress.

From board commitment to frontline metric

Stanford Health Care has developed a proprietary Environmental Citizen Composite Score to comprehensively measure, benchmark, and monitor its sustainability progress across its facilities. This custom metric is part of a broader sustainability management strategy championed by the Stanford Health Care Sustainability Program Office.

This score represents an innovative way to take the health system board’s sustainability commitment statement and embed it in the annual operational plan as a frontline metric that is measured and reviewed the same as any other system-wide goal for the year. The system structures its environmental targets around core pillars:

Energy and emissions: Tracking reductions against the goal to cut energy usage in buildings by 25% by 2030.
Waste reduction: Pursuing zero-waste operations by targeting a 90% waste diversion rate through composting, recycling, and reusables.
Sustainable procurement: Managing upstream environmental and chemical impacts through structured utilization management.

For its achievements, Stanford Health Care was among the first systems in the country to earn the Sustainable Healthcare Certification from The Joint Commission.

3. The business case is bigger than cost savings

For many sustainability professionals, securing leadership support often depends on demonstrating financial value.

Panelists challenged the common perception that sustainability is primarily a cost center. Instead, they described sustainability as a value-creation strategy that can strengthen operational resilience, improve quality outcomes, reduce waste, and generate financial returns over time.

Examples shared during the plenary illustrated how organizations are reducing waste, improving operational efficiency, lowering costs, and strengthening resilience simultaneously. Leaders encouraged organizations to evaluate sustainability investments through a broader lens that includes avoided risk, operational continuity, workforce impacts, quality outcomes, and total cost of ownership, not simply short-term payback periods.

As one audience member noted during the discussion, the challenge is usually not whether savings exist, but how to communicate their value in ways that resonate with executive and financial leaders.

4. Leaders must prepare organizations for what's next

While the plenary focused on governance and strategy, audience questions pointed toward emerging issues healthcare leaders are actively addressing.

Artificial intelligence generated the greatest audience interest, with participants asking both how organizations are leveraging AI to advance sustainability goals and how leaders are addressing the technology's environmental and social impacts.

Together, these questions reinforce an important reality: sustainability leadership must continue to evolve and be nimble in order to address emergent challenges and opportunities. Leadership must navigate increasingly complex decisions while staying rooted in a health system's core mission and values.

Take action: Use these takeaways to build executive support

If you're working to build executive support for sustainability, share this article and the plenary recording with leaders across your organization, and consider asking these opening discussion questions:

How is sustainability reflected in our organization's strategic priorities?
Where do we have clear accountability for sustainability outcomes?
How are sustainability efforts connected to quality, resilience, and financial performance?
What barriers are preventing us from making faster progress?

What’s next?

Leadership in action: Many attendees asked how to build executive support, create accountability, and make the business case for sustainability. We're exploring additional resources or peer learning opportunities on these topics. Tell us what questions you'd like addressed.
Next in the CleanMed Insights Series: Explore key takeaways from AI opportunities in healthcare sustainability, including where AI may accelerate sustainability efforts, and the environmental and equity considerations leaders should be evaluating.
Share your experience: Have a leadership, governance, or sustainability success story to share? Watch for the CleanMed 2027 Call for Proposals and consider contributing your lessons learned.

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