Physician-led sustainability efforts reduce anesthesia gas emissions at AdventHealth in North Carolina

ASHEVILLE AND COLUMBUS, N.C. - Clinical teams across AdventHealth are demonstrating how innovation, compassionate care and environmental stewardship can work together to support healthier communities and a more sustainable future.

Through physician-led sustainability efforts within the Department of Anesthesiology and Perioperative Medicine, AdventHealth Hendersonville and AdventHealth Polk have significantly reduced anesthesia-related greenhouse gas emissions while continuing to provide safe, high-quality care for patients across Western North Carolina.

Between January 2025 and January 2026, AdventHealth Hendersonville achieved a 63% reduction in total anesthesia gas emissions, including a 75% reduction in nitrous oxide emissions.

Similar improvements followed at AdventHealth Polk after sustainability-focused changes were implemented in 2025.

The initiative was led by Jacob J. Hansen, DO, MHI, department chair and medical director for the Department of Anesthesiology and Perioperative Medicine at AdventHealth Hendersonville, in partnership with Jeff Coston, DO, medical director for anesthesia at AdventHealth Polk. Together, they helped guide meaningful operational and clinical changes designed to reduce environmental impact without compromising patient outcomes.

Key interventions included eliminating routine use of desflurane, significantly reducing nitrous oxide use and reinforcing education around lower fresh gas flow techniques during anesthesia maintenance.

For Hansen and his colleagues, the work represented an opportunity to thoughtfully examine long-standing practices and identify evidence-based approaches that could improve sustainability while maintaining exceptional care experiences for patients.

"We've been able to show with evidence and research that these changes have not affected our anesthesia care or patient outcomes," Hansen said. "At the same time, we've demonstrated a dramatic improvement in our sustainability goals and environmental footprint."

One of the team's earliest successes came from reducing use of desflurane, an anesthesia gas associated with a high environmental impact.

The department also focused on reducing nitrous oxide waste by transitioning portions of its anesthesia delivery infrastructure away from centralized nitrous oxide systems and increasing provider education around lower-flow anesthesia practices.

Much of the initiative's success was driven by collaboration and communication among anesthesia providers, nurses and operational leaders.

Hansen said the team worked to create a culture where sustainability efforts were viewed not as a separate initiative, but as part of delivering responsible, patient-centered care.

The teams also introduced practical tools to support ongoing improvement, including pediatric anesthesia reference guides designed to help providers more closely match anesthesia gas flow to each patient's size and clinical needs.

As AdventHealth continues its mission of Extending the Healing Ministry of Christ, leaders say initiatives like this demonstrate how thoughtful innovation can support healthier patients, stronger communities and a more sustainable future. This work reflects the responsibility to care for their communities while also protecting the health and well-being of future generations.

As the teams continue building on these efforts, the work reflects a larger commitment to caring for the whole person and the communities AdventHealth serves.

By combining evidence-based medicine, thoughtful operational improvements and a culture of collaboration, AdventHealth Hendersonville and AdventHealth Polk are helping create a healthier future that supports patients today while strengthening environmental well-being for generations to come.