The increased frequency of extreme weather events due to climate change can cause casualties and put healthcare delivery at risk. Ironically, healthcare is a significant source of the very greenhouse gas emissions that lead to climate change. The Vancouver Island Health Authority case study shows the value of targets, energy management and innovation in new construction. Efforts have yielded great results to date with $2 million a year saved in utilities, and are nearing the target of reducing emissions by 33% below 2007 levels by 2020.