What Gets Measured Gets Managed: Sustainability in Healthcare Decision-Making

Sustainability has become a strategic priority for healthcare organizations worldwide. Yet despite growing commitments, many health systems continue to treat sustainability as a separate initiative rather than a core component of organizational performance.

A recent Lancet Commission on measuring sustainable healthcare transformation highlights a critical challenge. If sustainability remains separate from routine performance measurement, it risks remaining separate from decision-making (Singh et al., 2026).

The Commission argues that healthcare organizations should evaluate sustainability with the same rigour applied to quality, safety, patient experience, and financial stewardship. Doing so requires moving beyond a narrow focus on emissions and adopting a broader perspective that incorporates environmental, social, economic, and health outcomes.

This perspective aligns with work increasingly occurring across healthcare systems in Canada. As organizations undertake major infrastructure investments and service redesign initiatives, there is growing recognition that sustainability should be considered from the earliest stages of planning rather than retrospectively evaluated after implementation.

At Wilson&Wilbur, we have been exploring how sustainability principles can be embedded into the planning and redevelopment of critical healthcare services. Our experience suggests that sustainability is most effective when integrated alongside existing priorities such as patient outcomes, workforce well-being, operational efficiency, and financial stewardship.

Major redevelopment projects create a unique opportunity to establish sustainability as a decision-making framework rather than a standalone objective. When embedded early, organizations can better identify opportunities to improve resilience, reduce environmental impacts, strengthen workforce experiences, and create long-term value.

As healthcare systems face increasing pressures from climate-related events, workforce shortages, rising demand, and fiscal constraints, measurement may be one of the most powerful tools available for accelerating meaningful change.

The question is no longer whether sustainability matters. The question is whether healthcare organizations are measuring it in ways that meaningfully inform decisions.

Wilson&Wilbur looks forward to sharing insights from our recent work in this area in the coming months, including practical approaches for integrating sustainability into healthcare planning, implementation, and evaluation.

The W&W Team

Sources:

Singh, H., Weisz, U., Andrew, T., Blom, I.M., Kittipongvises, S., Nansai, K., Ouanhnon, S. ... Eckelman, M.J. (2026). The Lancet Commission on Sustainable Health Care Measurement Framework for Advancing Sustainable Health Care Transformation. The Lancet Planetary Health, 10(1). doi: 10.1016/j.lanplh.2025.101398