Using Life Cycle Assessments to Measure the Environmental Impact of Alternative Care Models in the Neonatal Intensive Care Unit

The healthcare sector is a major contributor to global greenhouse gas emissions. Little is known about the impact of individual clinical practices on overall emissions; more granular healthcare emissions data are needed to identify opportunities for resource stewardship. Our objective was to deploy an interdisciplinary team to perform Life Cycle Assessments (LCAs) comparing carbon emissions attributable to a novel home-care program for premature infants to those attributable to routine care in the Neonatal Intensive Care Unit (NICU). We used LCA methodology to compare the carbon footprint of two weeks of traditional care of infants in our NICU to that of those enrolled in an institutional alternative care program known as “Hope Grows at Home,” which transitions eligible infants requiring nasogastric feeds to the home setting with ongoing NICU team support. Our analysis showed that in-home care produces 77 kg of CO2 emissions (kgCO2e) per infant over a 14-day period, as compared to in-hospital care, which produced 338 kgCO2e. Transportation to a healthcare facility accounted for the majority of emissions in both groups (292 kgCO2e for NICU care and 58 kgCO2e for home care). This finding is likely impacted by our facility’s rural location. Home care reduced solid waste emissions by approximately 94% relative to NICU care (1.74 vs. 26.97 kgCO2e per term), reflecting the home setting’s reuse of feeding syringes and bottles that are routinely single-use in the hospital. Prospective data collection strategies for infants enrolled in home care will further refine our results. Exploring additional interdisciplinary collaborations may facilitate similar analyses, offering more insight into environmental stewardship opportunities within healthcare.