Sustainability: Hospitals can achieve a trifecta


Humans leave large ecological footprints on the planet. Nevertheless, sustainability - that being resource-conserving and environmentally oriented action - is still far from being a concern everywhere. The public sector, in particular, has a difficult time with this because sustainability requires initial funding to renew and adapt processes and technology. This applies especially to hospitals.

Image: Aerial shot of a large hospital in a city; Copyright:

University medical centers, like Erasmus in Rotterdam, are a city within the city. They are a gigantic system of employees, visitors, organized structures and processes. They have a respective impact on the environment; © kruwt

"A university medical center is like a small town," says Frank Dzukowski, CEO of the KFE Clinic Facility Management Eppendorf. KFE is a subsidiary of the University Medical Center Hamburg-Eppendorf (UKE) which is in charge of supply and maintenance for the clinic. The UKE has more than 10,000 employees and treated more than 386,000 patients in 2015. "We work with significant budgets in the double-digit million range when it comes to energy supply. For this reason alone, a hospital like ours has a big incentive to act as sustainably as possible," explains Dzukowski.

Focused on the quest to run hospitals in an environmentally friendly, resource-conserving and sustainable manner, the Green, Green+ and Blue Hospital concepts have been established over the past few years. Johannes Dehm of the VDE, the Association for Electrical, Electronic & Information Technologies (Verband der Elektrotechnik Elektronik Informationstechnik e. V.) explains the differences in an interview with "A Green Hospital predominately aims to save energy. Green+ adds to this approach with business processes and medical technology that make further energy and material savings possible. Blue Hospital calls for savings in all areas which is achieved by optimizing operating procedures."

Image: A lockable trash can for used disposable products in the hospital; Copyright:

Not only the regular garbage from employees and patients is a challenge for hospitals, also the medical garbage: It needs to be disposed and destroyed especially safe; © angellodeco

Healthy humans in a healthy environment

Technically speaking, hospitals are huge energy hogs thanks to lighting, heating and device intensive areas such as operating rooms and intensive care units. They also have high water consumption and produce a lot of waste - due to a large number of disposable medical one-time use products that need to be disposed or destroyed separately and the regular trash produced by employees and patients. All this costs a lot of money on the one hand, while it pollutes the environment on the other. It also indirectly has a negative effect on the hospital's image. In this day and age, a large corporation cannot afford to neglect environmental issues because climate change and pollution are constantly in the media. At this point, the Anthropocene period denotes the current geological age named after the impact our human activity has on Planet Earth.

That is why sustainability in hospitals is actually not a new issue. "Since 2011, a task force at the UKE has focused on the subject of sustainability. We have already been active in this manner long before then, but this marked the starting point for a structured, interdisciplinary project," says Dzukowski. One of the results of this work - among other things - is the launch of our own combined heat and power unit that considerably adds to reducing energy consumption and thus CO2 emissions. "The combined heat and power unit has been specifically developed and built for the requirements of the Medical Center and not only supplies UKE's energy but also provides magnetic resonance tomographs with cooling energy and the central sterile services department with steam," said Dzukowski during the unit's launch in 2013. The UKE was able to already achieve its self-imposed goal of reducing its CO2 emissions by 20 percent in 2014 instead of in 2020 as originally planned.

Image: Employees of a hospital work in the storage; Copyright: Olson

Not only economical behavior, but also the right organization and logistics make a hospital work more ecologically, because efficient processes use less ressources; © Tyler Olson

Sustainability means more than saving

That is why sustainability is not only manifested in the use of resources and environmental orientation; hospital logistics can also contribute to making a hospital greener. "Sustainability is a trifecta of ecology, economy, and social factors. This pertains to the structure itself on the one hand, but notably also the processes inside of the hospital," as D. Eng. Sebastian Wibbeling of the Fraunhofer Institute for Material Flow and Logistics IML explains in an interview with This also includes the organization of the OR and the individual wards for instance since "environmental processes are more efficient, that is to say, it all goes along with savings in the area of resources. These can be physical resources such as raw materials but also resources like personnel or its workload," Wibbeling continues.

This shows that employees are not just contributing to sustainability in hospitals by turning down the heat and turning off the light. The management level also needs to make a contribution for them and be considerate of their workload and ability to work under pressure to implement efficient processes. To this effect, a green concept also includes people and their needs. The UKE was able to achieve its savings for instance by also directly addressing its employees and sensitizing them for resource-conserving behavior.

Sustainability - for all?

Operating hospitals sustainably seems to, therefore, be good for everyone - the patients, employees, the operators, health and care insurance providers and last but not least the environment. So why then are not all hospitals sustainable? Sebastian Wibbeling describes the subject’s current status: "Sustainability is presently not deemed particularly important by hospitals; especially environmental subjects have to yield to economic matters. There is more likely a question of how much social pressure is being exerted."

An ecologically compatible presence is most strongly noticeable to the public and can be utilized in terms of good hospital marketing and to improve an image. Large industrial enterprises have discovered this tool for themselves some time ago. That said, they can frequently also afford to invest in sustainability. Before the average hospital is able to follow in these footsteps, it needs to invest a considerable amount to set the process in motion. However, sustainability can subsequently pay off again for the entire medical small town - inside and out.

Image: Man with glasses and beard - Timo Roth; Copyright: B. Frommann

© B. Frommann

The interview was conducted by Timo Roth and translated from German by Elena O'Meara.