How Hospitals Can Foster Environmental Sustainability

When it comes to their environmental impact, hospitals present a challenge, yet can boost opportunities at the same time. They are an environmental burden due to a higher energy use resulting from frequently outdated technology. However, once they are modernized and switch to a sustainable concept, they can turn into a "green hospital".

In this MEDICA.de interview, Annegret Dickhoff explains how the so-called BUND Seal of Approval ("BUND-Gütesiegel") can motivate hospitals to embrace sustainability and become more environmentally friendly.

Ms. Dickhoff, what prompted the “Energy-Saving Hospital” project?

Annegret Dickhoff: The idea originated amid the Berlin Energy Week in 2000. During the conference, the former technical director of the Hubertus Protestant Hospital talked about an Energy Savings Partnership that was aimed at updating the power system. The renovation’s impact on climate, financial, and energy savings was remarkable. This inspired the German Federation for the Environment and Nature Conservation (BUND e. V.) to team up with the Berlin Energy Agency and the Hubertus Hospital to reward hospitals for their commitment to environmental sustainability. That is why we recognize best practices with the "Energy-Saving Hospital" label, which -among other things – also increases employee motivation.

What makes hospitals and rehabilitation clinics eligible for the Seal of Approval?

Dickhoff: Facilities have to implement energy-saving measures and meet the BUND e. V. criteria, which are based on the provisions outlined by the Kyoto Protocol. Targets on emissions of gases have already been set back in the 1990s, but very few companies and countries have implemented the objectives thus far. Facilities must meet at least two of the four criteria to be awarded the BUND Seal of Approval. A hospital can qualify by reducing its energy consumption by at least 25 percent over five years. Another way to qualify is by introducing energy controlling systems. This means taking a closer look at company management, data monitoring of technical installations and the implementation of strategies to reduce energy use in the building. By comparing the energy consumption indicators with the median reference values of the respective hospital category based on the hospital occupancy rates as outlined by the Energy Agency of the German State of North Rhine-Westphalia (NRW), you can calculate the percentage deviation of the actual values from the mean values. If the sum of both deviations is a negative value, applicants have met another criterion. The fourth criterion is used if the building is a new construction and already in operation. In this instance, the standard benchmark for heat or electricity must be met. The other specific indicator must not exceed the mean value.

Why is it so important for hospitals to implement climate-friendly measures?

Dickhoff: In Germany, hospitals are among the most resource-intensive consumers in the service, commercial and retail sectors. They use vast amounts of energy around the clock for electricity, heating, cooling and air pressure. The equipment is often outdated as well though this is an area where money could be saved. Yet the core competencies of hospitals does not pertain to energy supply. Hospitals and rehabilitation clinics are primarily required to provide medical treatment to patients to return them back to health. Meanwhile, hospitals are large contributors to carbon emissions. Hospital operations negatively affect the environment and the climate. Having said that, environmental protection equals health protection because humans can only survive in a healthy environment.

What are some easy improvements hospitals and clinics can implement?

Dickhoff: In the energy realm, it’s quite easy to optimize hospital operations. For example, ventilation optimization can drastically reduce energy consumption at hospitals if systems are adapted to work hours. Air-conditioning equipment often makes up 40 percent of energy consumption. Smart technology and controls can help in this setting. The same applies to the heating system. Heating only turns on if needed once it has been adjusted based on weather forecasts.

There are other efficient measures that improve hospital sectors. For example, smart food management is yet another simple measure that is both eco-friendly and relieves logistics. German clinics already implement effective waste management strategies, but consumer waste could still be further reduced. Educating staff members is yet another great tool to monitor the effectiveness of measures.

As part of the "KLIK- Klimamanager für Kliniken" project (climate action for clinical facilities), we created guidelines to address energy aspects. This includes energy-saving tips and examples of best practices with their financial impact.

What general measures would you recommend for hospitals and clinics?

Dickhoff: To be more sustainable, I believe it is critical for hospital management to acknowledge the importance of environmental protection. Hospitals should develop corresponding sustainability objectives. This entails a status quo analysis to subsequently set goals to reach the target state in individual steps. If you set long-term goals, you can continuously adopt sustainability and energy-efficient measures to achieve success and reap financial benefits. Environmental and economic aspects always go hand in hand and are mutually beneficial.

How invested and eager to get involved are hospitals and clinics at the moment?

Dickhoff: Hospitals are very interested in saving energy and strive to be "green hospitals". This concept doesn’t just pertain to energy consumption, but also includes respective measures in purchasing, IT, mobility and food procurement. Either way, healthcare facilities are very interested in getting the Seal of Approval. Once they have received this honor, they always strive to be awarded again after five years.

What are some other ways to improve environmental sustainability in hospitals?

Dickhoff: I see untapped potential not just in terms of the hospitals, but also as it pertains to production and healthcare supply chains. Neither area has fully explored sustainability at this point. I believe that environmental considerations should be integrated into all stages of the purchasing process of medical supplies and equipment. Hopefully, healthcare facilities will encourage suppliers to adopt more sustainable approaches in the future to achieve development goals. This requires sustainability standards that manufacturers and suppliers must comply with.