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Green Hospitals: Environmental Impact Assessment, Resource Efficiency, and Hands-on Applications

English title Green Hospitals: Environmental Impact Assessment, Resource Efficiency, and Hands-on Applications
Applicant Stucki Matthias
Number 172453
Funding scheme NRP 73 Sustainable Economy
Research institution Zürcher Hochschule Institute of Natural Resource Sciences Zurich University of Applied Sciences
Institution of higher education Zurich University of Applied Sciences - ZHAW
Main discipline Other disciplines of Environmental Sciences
Start/End 01.09.2017 - 31.08.2021
Approved amount 599'848.00
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All Disciplines (3)

Discipline
Other disciplines of Environmental Sciences
Other disciplines of Engineering Sciences
Economics

Keywords (9)

Environmental; Health sector; Resource efficiency; Environmental management; Process optimization; Infrastructure; Life Cycle Assessment; Sustainability; Hospitals

Lay Summary (German)

Lead
Um die Spitallandschaft nachhaltiger zu gestalten, analysieren wir in Partnerschaft mit Schweizer Spitälern den Ressourcenverbrauch von Spitalprozessen. Dazu werden wir konkrete Vorschläge zur Prozessoptimierung ausarbeiten und testen.
Lay summary

Hintergrund
Obwohl der Gesundheitsbereich aus Umweltsicht nach Ernährung, Mobilität und Wohnen der viertwichtigste Konsumbereich ist, gibt es dazu kaum umfassende Umweltbewertungen. Dadurch ist nicht klar, wo die grössten Hebel für mögliche Verbesserungen sind und wie diese konkret umgesetzt werden könnten. Ausserdem gibt es bisher noch keine Effizienzanalysen im Spitalbereich, welche neben den Kosten auch Umweltbelastungen miteinbeziehen.

Ziel
Mit den folgenden vier Projektzielen sollen die genannten Forschungslücken geschlossen werden:

  1. Umfassendes Wissen über den Ressourcenbedarf und dessen Effizienz im Schweizer Spitalsektor erarbeiten
  2. Ausschlaggebende Faktoren der Umweltbelastung und der Ressourceneffizienz von Spitälern im gesamten Lebenszyklus bestimmen
  3. Eine Liste von umweltfreundlicheren Abläufen ausarbeiten und deren Umsetzbarkeit untersuchen
  4. Praktische Anwendungen von umweltfreundlichen Prozessen im Spitalkontext testen


Bedeutung

Die Lebenszyklusanalyse trägt zu einer umfassenden ökologischen Nachhaltigkeitsperspektive bei, wodurch insbesondere die folgenden Ziele für nachhaltigen Entwicklung der Agenda 2030 gestützt werden: 9 (Industrie, Innovation und Infrastruktur), 12 (verantwortungsvoller Konsum und Produktion) und 13 (Massnahmen zum Klimaschutz). Zusätzlich wird das Ziel 3 (Gesundheit und Wohlergehen) gefördert, indem Spitalabläufe optimiert und die Effizienz der Spitäler erhöht wird.

Direct link to Lay Summary Last update: 01.03.2018

Lay Summary (French)

Lead
Afin d’orienter le paysage hospitalier suisse vers un modèle plus durable, nous analysons, en partenariat avec des hôpitaux suisses, l’utilisation des ressources dans les processus hospitaliers. Pour ce faire, nous élaborons et testons des propositions concrètes visant à optimiser les processus.
Lay summary

Contexte
Bien que la santé soit le quatrième domaine de consommation ayant le plus fort impact sur l’environnement (après la nutrition, la mobilité et l’habitat), il n’existe presque aucune évaluation environnementale complète. Il n’est donc pas évident de savoir où se trouvent les principaux leviers qui permettraient d’améliorer la situation et la façon dont ils pourraient être mis en place en pratique. De plus, il n’existe encore à ce jour aucune analyse de l’efficacité dans le secteur hospitalier incluant non seulement les coûts mais aussi les impacts environnementaux.

Objectifs
Les quatre objectifs suivants serviront à combler ces lacunes de recherche:

  1. développer des connaissances approfondies sur les besoins en ressources et leur efficacité dans le secteur hospitalier suisse,
  2. déterminer les facteurs clés de l’impact environnemental et de l’utilisation efficace des ressources dans les hôpitaux tout au long de leur cycle de vie,
  3. établir une liste de processus plus respectueux de l’environnement et étudier leur applicabilité,
  4. tester des applications pratiques de processus respectueux de l’environnement dans le contexte hospitalier.


Importance

Une analyse dans l’optique du cycle de vie contribue à une perspective globale de durabilité écologique, ce qui soutient en particulier les objectifs de développement durable des Nations Unies nos 9 (industrie, innovation et infrastructure), 12 (consommation et production responsables), 13 (mesures relatives à la lutte contre les changements climatiques), 14 (vie aquatique) et 15 (vie terrestre). Enfin, le projet soutient également l’objectif n° 3 (bonne santé et bien-être), en optimisant les processus hospitaliers et en améliorant l’efficacité des hôpitaux.

Direct link to Lay Summary Last update: 01.03.2018

Lay Summary (English)

Lead
To make the Swiss hospital environment more sustainable we are analysing the consumption of resources by hospital processes in partnership with Swiss hospitals. In addition, we will develop and test specific proposals for process optimisation.
Lay summary

Background
Although healthcare is the fourth most important consumer sector from an environmental perspective (after food, mobility and housing), there are hardly any comprehensive environmental assessments. Thus, it is not clear where the greatest levers for possible improvements are, and how these can be implemented. Furthermore, no efficiency analyses have been conducted in the hospital sector to date that include not only costs, but also environmental impacts.

Aims
The cited research gaps are to be closed as follows:

  1. By developing comprehensive insights into the resource requirements and their efficiency in the Swiss hospital sector.
  2. By determining key environmental impact factors and resource efficiency within hospitals’ lifecycles.
  3. By preparing a list of environmentally friendly processes and verifying their feasibility.
  4. By testing practical applications of environmentally friendly processes in the hospitals context.


Importance

The life cycle analysis will contribute towards a comprehensive ecological sustainability perspective, which will in particular support Sustainable Development Goals nos. 9 (industry, innovation and infrastructure), 12 (responsible consumption and production), 13 (climate action), 14 (life below water), 15 (life on land). In addition, goal no. 3 (good health and well-being) will be supported by optimising hospital processes and increasing the efficiency of hospitals.

Direct link to Lay Summary Last update: 01.03.2018

Responsible applicant and co-applicants

Employees

Publications

Publication
Environmental Efficiency Analysis of Swiss Acute Care Hospitals
Roth Florian, Merki Manuela, Keller Regula (2021), Environmental Efficiency Analysis of Swiss Acute Care Hospitals, 3939627.
From bandages to buildings: Identifying the environmental hotspots of hospitals
Keller Regula Lisa, Muir Karen, Roth Florian, Jattke Marleen, Stucki Matthias (2021), From bandages to buildings: Identifying the environmental hotspots of hospitals, in Journal of Cleaner Production, 319, 128479-128479.
How life cycle–based science and practice support the transition towards a sustainable economy
Stucki Matthias, Jattke Marleen, Berr Marcus, Desing Harald, Green Ashley, Hellweg Stefanie, Laurenti Rafael, Meglin Ronny, Muir Karen, Pedolin Dario, Shinde Rhythima, Welz Tobias, Keller Regula Lisa (2021), How life cycle–based science and practice support the transition towards a sustainable economy, in The International Journal of Life Cycle Assessment, 26(5), 1062-1069.

Datasets

Environmental efficiency estimates for 127 Swiss acute care hospitals

Author Roth, Florian; Merki, Manuela; Keller, Regula
Publication date 11.10.2021
Persistent Identifier (PID) https://doi.org/10.5281/zenodo.5562372
Repository Zenodo.org
Abstract
These are the estimates from our enviromental efficiency estimates using frontier analysis (Stochastic Frontier Analysis and Data Envelopment Analysis) for 127 Swiss acute care hospital in 2018.For further details please see our working paper: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3939627

Collaboration

Group / person Country
Types of collaboration
Hôpitaux universitaires de Genève Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration
Christian Abshagen, Universitätsspital Basel Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Marcel Coray, Kantonsspital Graubünden Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
GZO Spital Wetzikon Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Hirslanden Gruppe Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Insel Gruppe AG Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Industry/business/other use-inspired collaboration

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
NFP 73: 3. SNF Programmkonferenz Poster Green Hospital: Primary Results 13.02.2021 Murten, Switzerland Stucki Matthias;
Swiss Green Economy Symposium Talk given at a conference Auf dem Weg zum Green Hospital 03.09.2019 Winterthur, Switzerland Muir Karen;
Life Cycle Management 2019 Talk given at a conference The environmental impact of hospitals 01.09.2019 Poznan, Poland Keller Regula; Stucki Matthias; Muir Karen;
1st Life Cycle Innovation Conference Talk given at a conference Resource Efficiency and Life Cycle Innovation in the Healthcare Sector 29.08.2018 Berlin, Germany Raida Andrea; Keller Regula; Dragon Dominika; Stucki Matthias; Muir Karen;
1st Life Cycle Innovation Conference Talk given at a conference Green Hospital: Bringing Life Cycle Innovation into the Healthcare Sector 29.08.2018 Berlin, Germany Stucki Matthias; Muir Karen; Keller Regula;
NFP 73: 1. SNF Programmkonferenz Poster Green Hospital: Environmental Impact Assessment, Resource Efficiency & HandsꟷOn Applications 22.01.2018 Nottwil, Switzerland Stucki Matthias;


Self-organised

Title Date Place

Knowledge transfer events

Active participation

Title Type of contribution Date Place Persons involved
9th World Sustainability Forum Talk 13.09.2021 online, Switzerland Keller Regula;
Green Hospital Netzwerktreffen Workshop 24.06.2021 online, Switzerland Moll Beate; Roth Florian; Stucki Matthias; Raida Andrea; Keller Regula;
Symposium « Pour des services de santé respectueux de l’environnement », organisiert von Unisanté, Talk 05.05.2021 Lausanne, Switzerland Keller Regula;
Nachhaltigkeitswoche Bern - Klimawandel und Gesundheit: Wo wir stehen und was wir tun können Talk 11.03.2021 Bern, Switzerland Keller Regula;
Best Practice in Spitälern Workshop 04.02.2021 online, Switzerland Moll Beate; Stucki Matthias; Keller Regula;
Zukunftskongress Logistik Talk 17.09.2019 Dortmund, Germany Raida Andrea;
Med Logistica Workshop 05.06.2019 Leipzig, Germany Raida Andrea; Dragon Dominika; Keller Regula;
FM-Perspektiven: FM-Innovationen im HC digital Poster 05.04.2019 Wädenswil, Switzerland Keller Regula;


Self-organised

Title Date Place
Green Hospital Kick-Off-Meeting 24.01.2018 Berne, Switzerland

Communication with the public

Communication Title Media Place Year
Media relations: print media, online media 50% der Spitäler könnten ihren Umwelt-Fussabdruck halbieren Schweizerische Ärztezeitung German-speaking Switzerland Western Switzerland 2021
Media relations: print media, online media Auf dem Weg zu mehr Umwelteffizienz Competence German-speaking Switzerland 2021
New media (web, blogs, podcasts, news feeds etc.) Best Practice Workshop Linked-in (Forschungsgruppe Ökobilanzierung) International 2021
Media relations: print media, online media Die Klimabilanz von Spitälern - Wo sind die Hebel? Oekoskop - Die Fachzeitschrift der Ärztinnen und Ärzte für Umweltschutz 2/21 German-speaking Switzerland 2021
Media relations: print media, online media Environmental Efficiency Analysis of Swiss Acute Care Hospitals Environmental Economics eJournal International 2021
Media relations: print media, online media Fraunhofer IML Wie Krankenhäuser ihre Emissionen reduzieren German-speaking Switzerland 2021
Media relations: print media, online media Green Hospital: Wie können der ökologische Fussabdruck und der CO2-Bedarf im Berner Gesundheitswesen Interpellation Kanton Bern German-speaking Switzerland 2021
New media (web, blogs, podcasts, news feeds etc.) Projektpost Twitter (Fraunhofer IML) German-speaking Switzerland 2021
Media relations: print media, online media So steht es um die Ökobilanz der Schweizer Spitäler NZZ am Sonntag German-speaking Switzerland 2021
Media relations: print media, online media Versorgung mit Speisen: Verbesserung der Nachhaltigkeit bei der Speisenanforderung im Krankenhaus Klinik Einkauf German-speaking Switzerland 2021
Media relations: print media, online media Green Hospital - Prozessorientierte Analyse der Nachhaltigkeit im Krankenhaus KU-Gesundheitsmanagement German-speaking Switzerland 2020
Media relations: print media, online media Hoher Ressourcenverbrauch - großes Einsparpotenzial Health & Care Management German-speaking Switzerland 2020
Media relations: print media, online media Klimaschutz braucht ein Commitment von oben NOVAcura German-speaking Switzerland 2020
Media relations: print media, online media Krankenhauslogistik und Nachhaltigkeit - Potentiale der Speisenversorgung Newsletter-HCL German-speaking Switzerland 2020
Media relations: print media, online media Ressourcen- und Energiebedarf im Krankenhaus und in Pflegeeinrichtungen NOVAcura German-speaking Switzerland 2020
Media relations: print media, online media Spitäler im Umwelt-Benchmarking IUNR Magazin des Instituts für Umwelt und Natürliche Ressourcen, 01/20 German-speaking Switzerland 2020
Media relations: print media, online media Auf dem Weg zum grünen Spital Transfer German-speaking Switzerland 2019
Media relations: print media, online media Die nächsten Schritte zum »Grünen Spital« - Ökobilanzierung und Potentialanalyse Heime und Spitäler German-speaking Switzerland 2019
Media relations: print media, online media Gemeinsam in Richtung «Grünes Spital» Competence German-speaking Switzerland 2019
Media relations: print media, online media Green Hospital – Nachhaltigkeit im Krankenhaus Kleine Kniffe International 2019
Media relations: print media, online media Grünere Spitäler Transfer German-speaking Switzerland 2019
Media relations: print media, online media Ökologie und Ökonomie im Gleichgewicht KTM - Krankenhaus, Technik, Management German-speaking Switzerland 2019
New media (web, blogs, podcasts, news feeds etc.) 5 Fragen, 1 Projekt: Die ZHAW erforscht die Ressourceneffizienz von Spitälern ZHAW Blog für Forschung und Entwicklung German-speaking Switzerland International 2018
Media relations: print media, online media Das nachhaltige Wirtschaften erreicht Schweizer Spitäler News contribution to Research Group webpage German-speaking Switzerland International 2018
Media relations: print media, online media Ineffizienter Ressourceneinsatz ade! Heime & Spitäler Fachzeitschrift German-speaking Switzerland International 2018
New media (web, blogs, podcasts, news feeds etc.) Kick-Off Sitzung mit den Spitälern Facebook (ZHAW Ökobilanzierung) International 2018
New media (web, blogs, podcasts, news feeds etc.) Green Hospital Web page German-speaking Switzerland International 2017
Media relations: print media, online media Ressourceneffizienz in Schweizer Spitälern NRP 73 Western Switzerland German-speaking Switzerland International 2017
Media relations: print media, online media Transdisziplinäres SNF Projekt zu «Green Hospital» News contribtion on Research Group webpage International German-speaking Switzerland 2017

Associated projects

Number Title Start Funding scheme
185630 Lifesaving: A multi-perspective approach for extending the service life of mobile internet-enabled devices to reach a resource light economy 01.06.2019 NRP 73 Sustainable Economy
178679 The Art of Living the Good Life: A Personalized Exhibition Presenting the Impact of Individual Lifestyles on the Environment 01.04.2018 Agora

Abstract

'Health' is one of the four areas of private consumption in Switzerland with the highest impact on the environment after 'food', 'mobility', and 'housing'. The health sector has shown continuously high growth rates over the recent years and is expected to further increase its environmental impact. The new inpatient financing scheme, which is based on diagnosis-related groups, and the free choice of health service providers have triggered competition amongst Swiss hospitals. Curbing costs and increasing economic profitability by means of efficient processes and resource savings is of high interest for hospitals and health service providers. Also, a commendable environmental management is a potential competitive advantage. Some Swiss hospitals have already adopted resource management initiatives and have their environmental management certified, showing the increasing interest in this topic. Nevertheless, there is still a large resource reduction potential in the health sector, which is not yet exploited. In this study, we set out to provide a comprehensive overview of environmentally relevant processes in Swiss hospitals. Specifically, this project aims to (1) develop consistent and comprehensive knowledge concerning resource consumption end efficiency in the Swiss hospitals sector, (2) analyse determinants of life cycle environmental impacts in the health sector and of hospital resource efficiency, (3) work out a list of environmental best practices and investigate the currently realizable options, and (4) test hands-on applications for environmentally optimized processes.Environmentally-extended input-output analysis shows that within the Swiss health-care sector, the main inputs are from the food provision (17%), installation of infrastructure (7%) and energy and water consumption (6%). Medical and optical instruments (8%) and disposal (4%) are also among the inputs with the highest impact. In order to quantify the environmental impacts of hospital activity, we thus include building and equipment, waste management, food and non-food supplies, energy and water use, reprocessing and reuse of equipment as well as general procurement. The structural infrastructure is an interesting area, since hospitals are expected to invest heavily in their infrastructure over the next decades. Consequently, the sector faces the unique opportunity to increase efficiency and decrease the environmental impact on the basis of concrete projects.Our interdisciplinary project team consists of three main partners with complementing competences: The academic lead will be held by the ZHAW Institute for Natural Resource Sciences, who will coordinate the project and implement the environmental life cycle assessment methodology in the hospital context. IWSB will provide health economic input over the complete course of the project and are the administrative leaders of the project. The Fraunhofer-Institute for Material Flow and Logistics (IML), department Health Care Logistics, provide their expertise in optimizing hospital processes. Finally, selected inpatient providers ('partner hospitals') such as from the Insel Hospital Group and Geneva University Hospitals will provide process information in the initiation phase and implement best practices in the implementation phase.The proposed research will provide a cutting-edge overview of the total environmental impact of Swiss hospitals, thus closing the knowledge gap of the environmental impacts and resource efficiency in the health sector. Due to our hands-on applications, we expect our findings to sustainably improve resource efficiency and the environmental awareness in the hospital sector, in Switzerland and abroad. This way, our multidisciplinary and comprehensive study helps to establish a more resource efficient and sustainable health-care sector.
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