Environmental Sustainability

Island Health is committed to making a positive contribution to environmental sustainability and supporting community preparedness and resiliency for climate emergencies.

Climate change is one of the greatest challenges to human health and our ability to provide excellent health and care for everyone, everywhere, every time. On Vancouver Island, climate-related events like wildfires, droughts, floods, and extreme heat highlight how closely health and the environment are connected. Meanwhile, the materials we use contribute to overflowing landfills and strain natural resources, showing the need for a more sustainable approach to healthcare. 

At Island Health, we’re taking action. We are cutting greenhouse gas (GHG) pollution, adopting sustainable practices, and improving efficiencies while striving to improve health and care. Our goals include cutting GHG emissions by 50 per cent from 2010 levels by 2030 and diverting 70 per cent of waste from landfills by the same year. We’re also adapting to new climate risks by strengthening emergency preparedness and building a more resilient health system. Together, we’re committed to creating a healthier future for people and the planet. 

Climate Change and Planetary Health Strategy

Island Health’s Climate Change and Planetary Health Strategy coordinates efforts across the health authority toward a shared purpose, vision, and goal for climate action. The strategy, released in September 2024, represents our commitment to take leadership on climate change and planetary health within our organization and within the communities we serve. 

Download the Climate Change and Planetary Health Strategy here.

Priorities include:  

1. Improving the climate resiliency, adaptability, and environmental sustainability of our health-care services 

2. Creating a culture of coordinated and effective climate action 

3. Building sustainable and climate-resilient healthcare infrastructure and operations 

4. Building a shared path with partners and communities toward climate resilience 

Planetary health means keeping both people and nature healthy, because they depend on each other. As a research field, planetary health studies how human-induced changes affect our natural systems, and shows us how the health of the planet and humans are closely connected. By focusing on planetary health, we can address climate change alongside the many other social and environmental factors that affect our health.  

Our targets and progress

Our climate commitments are reflected in the following Island Health outcome goals:

As a public sector organization in BC, Island Health publishes its emissions performance annually in our Climate Change Accountability Report.

Learn more about our goals

Greenhouse Gas Emissions

In accordance with the B.C. Climate Change Accountability Act and Carbon Neutral Government Regulation, Island Health measures and publicly reports its emissions from:

• Stationary sources – buildings, facilities, generators (owned or leased)
• Mobile sources – vehicles, off road equipment, marine vessels (owned or leased)
• Other sources – office paper consumption

View the latest Climate Change Accountability Report for 2023 here.

Previous reports are available here.

As a requirement of BC’s carbon neutral government legislation, Island Health is required to purchase and retire BC-based carbon offsets for our reported emissions. As a result, we have been carbon neutral on our reportable emissions categories since 2010.

To date, Island Health has reduced our publicly reportable emissions by 15.5 per cent since 2010, and done so while expanding our floor space by 22 per cent. Our goal is a 50 per cent reduction from 2010 levels by 2030.

Waste Diversion

Materials sent to landfill lead to land-use issues, water and soil contamination, and greenhouse gas emissions. Landfills also pose a threat to the health of local communities and surrounding ecosystems. 

Island Health is taking action to improve our waste diversion through:

• Reducing our overall waste volumes by eliminating unnecessary single-use items, and reusing materials and equipment safely and effectively.
• Diverting more waste from landfill through recycling, organics, and other waste streams. 

In the 2022-23 fiscal year, we achieved a 38.9 per cent waste diversion rate from landfill. Our goal is to reach a 70 per cent landfill diversion rate by 2030.

Community Preparedness and Resilience

Drought represents one of the top threats to health and health service delivery. Long-term decreases in summer rainfall, year-round warming, reduced snowpacks and increased evaporation, coupled with the current overexploitation of ground and surface water, has made Vancouver Island and the Gulf Islands particularly vulnerable to drought. Frequent droughts threaten drinking water quality and availability within the Island Health Region. Almost one-fifth of drinking water systems on the Island have already experienced water shortages (16 per cent according to a 2019 water purveyor survey).  

One of Island Health's key resilience goals focuses on enhancing community drought preparedness. This includes ensuring that 100 per cent of local water supply systems have Emergency Response and Contingency Plans (ERCPs) that include responses to depleted water levels. 

This work involves: 

• Developing a water quality and quantity assessment tool and related processes for all drinking water systems
• Climate resiliency education and engagement, highlighting improved health as an outcome of climate action
• Climate Resilience and Community Health Assessment 
• Developing implementation plan for provincial Environmental Health Information System (EHIS) implementation in 2025/26. 

 Visit Island Health’s Environmental Health page to learn more topics involving climate and your health.

How we're reducing our environmental impacts

Teams across Island Health are working to minimize our environmental footprint. Explore our priorities, projects, and progress.

Energy

Energy accounts for 95 per cent of Island Health's tracked greenhouse gas emissions. Since 2008, Island Health’s Energy Management Program has led projects to improve building energy efficiency, incorporate cleaner energy, and operate our buildings with smarter controls.  

We have reduced building emissions by 16.4 per cent since 2010, while expanding our floor space by 22 per cent. This means we're using energy much more efficiently. In fact, the amount of emissions per square meter of floor space has dropped significantly—from 0.065 tonnes of CO₂ equivalent per square meter in 2010 to 0.045 in 2023. 

In 2024, Island Health released its Low Carbon Resilience Roadmap, our capital infrastructure plan to reach a 50 per cent reduction in greenhouse gas emissions by 2030 and an 80 per cent reduction by 2050. The roadmap focuses on reducing fossil fuel use in our buildings by improving building systems, adding energy-saving upgrades, and using electric and renewable energy options. These upgrades will also enhance the experience for people in our buildings by improving indoor air quality and providing better cooling during the summer. Retrofits will also improve electrical capacity and reduce water consumption. 

We will use a variety of technologies and strategies to achieve our emissions targets. Our approaches include: 

• Control optimization and upgrades: This strategy involves working closely with our building operators to fine-tune systems to optimal settings – for example, adjusting air circulation rates to avoid wasting energy. This is our top priority because it delivers benefits without major costs. 
• HVAC and heat recovery upgrades: By capturing waste heat from building exhaust, medical imaging, or computers, we can reduce natural gas use and emissions. One important method, the thermal gradient header, allows us to redirect existing thermal energy and use existing equipment more effectively, saving us money. These upgrades are our top focus for retrofitting and for new construction projects. 
• Thermal energy storage: This allows us to store heating or cooling energy for use later, which can boost building capacity without increasing electrical demands. Options include geo-exchange and ice storage. 
• District energy systems:  District energy systems: A district energy system supplies energy to multiple buildings from a central plant, often in urban areas. This setup is efficient, climate-resilient, and can use low-carbon sources like biomass, electricity, and renewable natural gas (RNG) in B
• Fuel switching: Fuel switching involves replacing high-emission fuels (natural gas, diesel, oil) with cleaner options. Our main goal is to shift to electric energy since B.C.’s grid is mostly renewable hydroelectricity. Where electrification isn’t possible, we’ll consider renewable natural gas, and for remote sites, biomass where feasible.​ 

Read the full Low Carbon Resilience Roadmap report here.

Solar energy: West Coast General Hospital in Port Alberni has one of Vancouver Island's largest rooftop solar photovoltaic systems. The rooftop's 400 solar panels supplement the hospital's electricity, particularly on hot summer days when air conditioning is needed. Island Health also installed solar hot water systems at Victoria General, Saanich Peninsula Hospital, Aberdeen Hospital, and Cairnsmore Place in Duncan in 2011. The thermal systems reduce our use of natural gas.

BC Hydro and FortisBC continue to be strong partners in our journey to improve energy efficiency and reduce greenhouse gases.

Green Buildings

All new hospitals must be built with “Leadership in Energy and Environmental Design” (LEED) principals and meet LEED Gold certification.

Island Health currently has four LEED Gold facilities:

• North Island Hospital, Campbell River & District campus
• North Island Hospital, Comox Valley campus
• Patient Care Centre at Royal Jubilee Hospital in Victoria
• Emergency Department at Nanaimo Regional General Hospital

Island Health has one LEED Silver facility – the Oceanside Health Centre in Parksville.

The new Cowichan District Hospital (CDH), set to complete in 2027, is slated to be Canada's first carbon-zero hospital and British Columbia's first all-electric hospital. The new CDH will emit 75 per cent less greenhouse gas emissions than the existing hospital. 

Clinical Care

Frontline clinicians at Island Health are leading the way in integrating sustainability into healthcare, finding innovative solutions that improve both patient outcomes and environmental impact. From kidney care to inhaler use, these initiatives demonstrate how climate-conscious practices can enhance quality of care while reducing healthcare’s carbon footprint.

Environmentally Friendly Kidney Care: Kidney care has been identified as a key focus area due to the adverse environmental impact of treatments, including kidney replacement therapies, on climate change, which in turn impacts health outcomes and vulnerabilities for people living with kidney disease. Dr. Caroline Stigant of Island Health advocates for a patient-centred approach that simultaneously promotes climate mitigation and adaptation, and is involved in efforts provincially (BC Renal’s Planetary Health Working Group), nationally (the Canadian Society of Nephrology’s Sustainable Nephrology Action Planning committee), and internationally (the International Society of Nephrology’s Global Environmental Evolution in Nephrology and Kidney Care ‘GREEN-K’ initiative). GREEN-K endorses “sustainable kidney care for a healthy planet and healthy kidneys” through education, procurement, infrastructure and innovation, and sustainable clinical pathways. These initiatives have potential to produce significant health benefits for patients, as well as improve health quality and cost. 

Critical Air Project: The Critical Air Project is a quality improvement initiative led by Dr. Valeria Stoynova and Dr. Celia Culley that identifies opportunities to reduce inhaler related GHG emissions in the inpatient setting by combatting inhaler waste and loss. A three-pronged approach involving key interest holders across Island Health departments, in collaboration with CASCADES and Environment and Climate Change Canada, was adopted to understand the case for change before enacting a shift in policy (e.g., drug formulary listing, medication discharge procedure) and operations. The program is rolling out through an education campaign to interest holders responsible for delivering patient care. 

Materials and Waste

Materials and waste comprise a significant proportion of Island Health’s emissions and have an adverse impact on the environment. We are taking action to reduce unnecessary materials and waste across our sites. Initiatives include:

Furniture reuse: To promote a culture of circularity, Island Health’s Surplus Program at Royal Jubilee Hospital offers hundreds of lightly-used desks, chairs, office storage, televisions, and medical furniture – all free for staff. Island Health staff are encouraged to opt for used furniture and equipment through the surplus showroom when moving or updating their office spaces.

Waste container reuse: Island Health is working with our biohazardous waste collector, Daniels Health, to use reusable sharp containers rather than single use models, allowing for the reusable container to be emptied and sterilized before being returned to our sites for reuse.

Reusable bags: Island Health’s in-house laundry services transitioned from disposable plastic bags to reusable mesh bags, for the transportation of clean linens to our sites. Over 600 mesh bags are now shipped daily from Victoria Regional Laundry and 300 from Cumberland Regional Laundry. The change has eliminated over 100,000 single-use plastic bags per year. 

Soft plastic recycling: Efforts have been made to recycle the blue linen bags that are returned to the Victoria Regional Laundry, resulting in one million bags (75 tonnes) of soft plastics diverted from the landfill per year. This initiative is being expanded to include soft plastic food and linen cart covers, starting with Royal Jubilee Hospital. It is expected that an additional 42,000 cart covers will be diverted from the landfill annually from this site alone.

Paper: Island Health reports carbon emissions from office paper consumption as part of the Carbon Neutral Government Program. In addition to actively reducing our paper usage, Island Health uses Sugar Sheet, a tree-free paper made from the residue waste of sugar production. From 2022 to 2023, paper emissions decreased by 19 per cent, which is the largest single-year decrease in paper emissions since we began tracking this data in 2010. Today Island Health's greenhouse gas emissions from paper are 36.6 per cent lower than our 2010 baseline.

Water

Fresh water is a limited resource on Vancouver Island. Droughts and water use restrictions are now commonplace each summer. Island Health’s operations use significant volumes of water, and so we must improve our water use efficiency and reduce waste. Improved water management ensures the stability of our health-care system, protects community health, and preserves the local ecosystems on which clean, fresh water depends.

To reduce our water consumption, Island Health facilities are regularly upgraded and retrofitted with more water efficient appliances and fixtures. Existing water systems are maintained and optimized to a high standard. New facilities are designed to be more water efficient, in accordance with LEED Gold certification. Our organizational culture has also become increasingly mindful of environmental stewardship and the responsible use of water, with staff seeking opportunities to reduce our costs and impacts. 

Transportation

Delivering quality patient care requires significant transportation resources to move staff, patients, visitors, and materials to and from our facilities. We are taking action to mitigate our transportation-related climate and planetary health impacts.

Fleet electrification: Island Health is targeting emissions reduction by transitioning to low and zero-emission vehicles. The health authority is committed to the CleanBC provincial mandate by making 10 per cent of light-duty vehicle replacements zero-emission vehicles, where an available model meets operational needs. In 2021-22, Island Health utilized Carbon Neutral Capital Planning funding to procure two battery electric vehicles and two Level 2 charging stations to support fleet electrification in the North Island region. Additionally, Island Health introduced three plug-in hybrid electric vehicles (PHEVs), providing these multi-passenger vans to several outreach programs. 

Active and low carbon transportation: We encourage staff to choose green commuting options such as walking, cycling, transit and carpooling. Bicycle racks are conveniently located near most of our sites’ major entrances. NRGH, RJH, and VGH offer secured bicycle compounds and lockers for staff. Island Health also provides staff programs that reduce barriers to commuting by transit or carpool.

Telehealth: Patients can reduce travel time, costs, and emissions by participating in the Telehealth program, which virtually connects patients to health care services. Telehealth aims to create a similar experience to in-person consultation, where available.

Staff and Community Engagement

Building Community Resilience: Island Health’s Population and Public Health (PPH) teams help communities prepare for climate challenges and protect health through various efforts. They analyze local data, simplify climate health science for better decision-making, and work with municipalities to include climate health recommendations in community plans and policies. PPH staff also offer workshops and training on how climate change affects health and provide guidance for stronger climate adaptation. 

Climate Change & Planetary Health Conference: This September 2024 event brought together more than 200 staff, medical staff and leaders from across the organization to focus on our ambitious climate journey. Attendees gained valuable insights into ongoing sustainability work and Island Health's future direction. The conference also officially launched Island Health's Climate Change and Planetary Health Strategy​, which will shape our sustainability efforts for years to come. The event featured breakout sessions focused on creative healthcare waste solutions, water conservation, and adopting sustainable clinical care practices.  

Climate Change & Health Community Gathering in Nanaimo: Co-hosted by Snuneymuxw First Nation and Island Health, this January 2024 gathering brought together 170 intergenerational attendees from Indigenous communities, municipalities, and the health authority to share their stories, programs, projects, and experiences related to climate action. The focus of the event was the interconnectedness of climate change impacts on water and health. The event recognized the importance of intergenerational collaboration and insight by incorporating the traditional knowledge of Elders and involving youth as the next stewards of the land. The importance of connection to each other and to the land was a key theme for developing a shared path that embraces the value of Indigenous knowledge and Western science to foster climate change resilience. 

Environmental Sustainability Hub: This online hub on Island Health’s staff intranet is a resource for employees to access tools and guides to help make their workplaces more environmentally friendly. It celebrates the progress already made in climate action and supports staff in creating greener operations and care services. The hub provides easy-to-use resources that make it simple to start and grow climate-friendly improvements at local sites. 

Data and Analysis

Building Automation Systems: Island Health uses SkySpark, a digital application that allows us to analyze our energy and emissions data in real time. SkySpark collects, manages, and automatically performs analytics on our data from building automation systems, metering systems, lighting, weather and other smart devices. The tool is central to how our Energy Program monitors and manages energy demand and identifies savings opportunities.  

Emissions Database: Island Health has developed an internal Emissions Database to quantify additional sources of greenhouse gas emissions. The database collects and calculates the emissions associated with a wide range of activities, including solid waste, biomedical waste, anesthetic gases, metered dose inhalers, business travel, and more. The database helps Island Health staff reduce emissions that fall outside the scope of B.C.'s Carbon Neutral Government Program and will expand to include additional categories as data becomes available. 

How we're adapting to climate change

Climate change is already creating challenges for health care buildings and services. Extreme weather conditions can affect health systems in multiple ways from causing negative health impacts, infrastructure damage, patient care disruptions, new occupational health risks, and supply chain interruptions. However, we can greatly reduce these risks by planning and being ready for emergencies and for the changing climate. Along with cutting down on environmental harm, Island Health is working to prepare our facilities and operations for the effects of a changing climate. 

Climate Preparedness & Adaptation Strategy

B.C.’s Climate Preparedness & Adaptation Strategy (CPAS) provides the overall direction for this work, outlining key pathways to help us prepare for a changing climate.

The B.C. Ministry of Health has identified four priority action areas that outline the mandate for climate adaptation programs for B.C. health authorities: 

1. Cross-sectoral collaboration and engagement on innovative, evidence-based solutions grounded in cultural safety and health equity 
2. Public communications and awareness to support the public’s protection from climate-related health risks 
3. Build knowledge and capacity of health professionals and service providers, including dedicated staff to support CPAS actions and governance structures 
4. Assess climate risks to health and the health system, including assessments and information systems to inform health policy, programs, services, and adaptation plans 

Low Carbon Resilience Roadmap

In 2024, Island Health released its Low Carbon Resilience Roadmap (LCRR), our capital infrastructure plan to reach a 50 per cent reduction in greenhouse gas emissions by 2030 and an 80 per cent reduction by 2050. 

The roadmap not only lowers our carbon footprint, but also improves our buildings' resiliency to extreme heat, drought, and wildfire smoke. For example, planned capital improvements will:

• Add 3,600 tons of extra cooling capacity across our sites.
• Provide better air quality through upgraded filters and air recirculation systems - crucial as wildfires and smoke become more common.
• Reduce water, with equipment replacements following the best water-saving standards, including replacing or avoiding water-intensive equipment like cooling towers.

Major Capital & New Construction

Island Health’s Major Capital & New Construction division ensures our new facilities are designed, constructed, and begin operations with minimal emissions impacts.

The team advises our Facilities Design and Construction teams on optimal ways to build and reconfigure our hospitals and clinics for climate resilience. It also advises our Facilities Management Organization on cutting-edge building technologies and sustainable facility management practices. 

For example, the new Cowichan District Hospital (CDH), set to complete in 2027, is slated to be Canada's first carbon-zero hospital and British Columbia's first all-electric hospital. The new CDH will emit 75 per cent less greenhouse gas emissions than the existing hospital. 

Vulnerability Assessments

Island Health conducts a range of assessments across our building portfolio to identify climate change vulnerabilities and act on them. Nanaimo Regional General Hospital was recently the first hospital in Canada to complete a PIEVC Climate Change Vulnerability Assessment. We apply the following tools to enhance resilience at our facilities:

• Climate Resilience Guidelines for BC Health Facility Planning and Design
• Climate Change Extreme Event Screening Tool for Projects
• Contract Addendum: Designing for a Changing Climate

Our collective effort

Environmental sustainability is a team effort. Sustainability cuts across a wide range of departments and teams at Island Health, who all work in partnership to reduce our environmental impacts. We’re proud to have a growing community of health professionals who are advancing environmental sustainability in their practices, leading their peers through their research and advocacy, and working to protect our local communities from the damaging effects of climate change.

Island Health is also deepening its external partnerships to advance environmental sustainability action. Staff and medical staff participate in sustainable healthcare organizations and professional associations to share learnings and advance our collective goals.

Island Health also partners with First Nations and Indigenous organizations to strengthen land stewardship, climate resilience, and community health. We engage directly with supply chain partners to improve environmental performance & sustainable purchasing, and collaborate closely with our utility partners, BC Hydro and FortisBC, to implement cutting-edge emission reduction and resiliency-building projects. We also consult with all levels of government on a wide range of climate issues. 

Achieving a high-quality, environmentally sustainable healthcare system is only possible with collective action. We are committed to expanding and strengthening our internal and external relationships to take greater steps towards our goals.