[GHI Series 1] What Is Required of Hospitals Under the Newly Introduced “GHI (Global Health Impact)” in JCI 8th Edition

Introduction

GHI Requires Healthcare Organizations Not Only to Have an Environmental Perspective, but to Build and Operate Systems That Contribute to Global Health

The GHI (Global Health Impact) chapter, newly introduced in the JCI 8th Edition (effective January 2025), elevates environmental responsibility from a “recommendation” to a formally evaluated standard. Beginning in January 2026, GHI became subject to survey review, and as of February 14, 2026, healthcare organizations have already begun undergoing GHI assessments.

With this in mind, we are launching a dedicated GHI Column Series (4 parts) to help you understand GHI and identify the practical actions required to apply it within your organization.

At its core, GHI asks whether the following elements are embedded into hospital management systems:

• Who holds responsibility? (Governance)

• How are all staff engaged? (Culture)

• What is measured, and how is it improved? (Metrics and PDCA)

• How is the organization prepared for climate-related risks? (Resilience)

GHI in the 8th Edition may be understood as a chapter that shifts environmental consideration from an act of goodwill to an organizational responsibility.

1. Why Should Healthcare Organizations Engage with GHI?

Its Significance and Responsibility

① From an Environmental Perspective: Hospitals Have Significant Social Impact

Hospitals consume large amounts of energy, water, and medical supplies, and they generate waste.

In other words, they are major players in regional decarbonization and resource circulation.

GHI requires organizations to measure, visualize, and explain this impact.

② Management Benefits: Changing Procurement Improves Operations

The supply chain significantly contributes to greenhouse gas emissions in healthcare organizations. By quantifying this impact, revising procurement standards, and managing them more effectively, organizations can achieve:

• Cost optimization

• Inventory reduction

• Waste reduction

In other words, operational efficiency improves.

GHI clearly requires the integration of environmental criteria into procurement guidelines. This not only enhances environmental responsibility but can also positively impact financial performance.

③ Protecting the Continuity of Healthcare

Floods, power outages, heat waves, infectious disease outbreaks.

Climate change is no longer something that happens “somewhere far away in the distant future.” It is already being experienced and remembered.

GHI requires organizations to incorporate climate risks into their risk register, develop adaptation plans, and conduct training. It calls for preparedness based on the assumption that such events may occur “nearby and in the near future.”

In this sense, GHI is directly connected to patient safety and Business Continuity Planning (BCP).

2. The Five Pillars of GHI: What Is Actually Required

GHI.01 Governance

• Appointment of a sustainability leader

• At least one annual review by the Board

• External visibility of progress

What matters most are the name of the responsible person and the Board meeting minutes. These processes must be institutionalized within your organization.

GHI.02 Education and Culture

• Annual education for all staff

• Integration into new employee orientation

• A proposal system from frontline staff

Education is evaluated not merely on whether it has been conducted, but whether it is ongoing.

If your organization does not yet have multiple years of implementation history, it is essential to build a sustainable system and implement it consistently.

For example:

• Education plan: Is annual implementation clearly documented? Has the first year been completed? Is there a plan for subsequent years?

• Institutionalization: Is GHI integrated into new employee orientation?

• Monitoring design: How will it be followed up (KPI)? Is the responsible department clearly defined?

We recommend reviewing these points carefully.

GHI.03 Measurement and Reduction

This is the core of GHI.

The requirements include:

• Measurement of energy, water, and waste consumption and emissions, and development of reduction plans

• Identification and reporting of renewable energy ratios

• Measurement of water-saving volumes

• Annual progress in at least one soft FM (Facility Management) area

• Evaluation of clinical practices (e.g., anesthetic gases)

The measurement component will be explained in detail in Part 2 of this GHI Column Series, where we will outline practical implementation steps.

An important perspective in this section is that GHI does not certify “low-impact hospitals,” but rather evaluates whether a hospital is managing its environmental impact.

We believe this design reflects a deliberate balance with healthcare quality — ensuring that environmental initiatives do not compromise patient safety or clinical standards.

GHI.04 Sustainable Procurement

• Procurement guidelines including environmental criteria

• Supplier evaluation

• Identification of unnecessary items (minimum three categories)

• Evaluation of transitioning from disposable to reusable items

GHI.05 Resilience

• Inclusion of climate risks in the risk register

• Adaptation planning based on information from the past three years

• Regional vulnerability assessment (every three years)

• Annual training

Conclusion (Part 1)

In this first installment of the GHI Column Series, we introduced what GHI is, the philosophy and purpose behind it, and what is required under the GHI chapter.

The next question is:

Where should your organization begin?

In Part 2, we will explain the seven concrete steps for implementing GHI.01 and GHI.03.

If you would like to receive immediate notification when Part 2 is released, please subscribe via the “Subscribe to Our Info” section at the bottom of the page.

Note: The content of this column is based on currently available information and emerging survey practices related to the newly introduced GHI chapter in JCI 8th Edition. As GHI is a newly established standard, interpretations and survey approaches may evolve over time. The content of this column may therefore be updated accordingly and should be used for reference purposes only.

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