Hospitals go green – helping patients and Mother Nature

Each day, a hospital consumes as much energy as a small city. Medical facilities work around the clock to provide excellent patient care. Environmental protection tends to play a secondary role in this setting as high safety and hygiene standards seem to be incompatible with optimized resource utilization – but is that really the case? Green Hospitals prove that environmental sustainability is possible.

The global healthcare industry is responsible for 4.4 percent of carbon dioxide emissions each year. That's higher than gas emissions from aviation and shipping. A German hospital uses 500 liters of water and generates several kilograms of partly hazardous waste per day and patient. Much of this consumption seems inevitable to adhere to hygiene guidelines and ensure patient safety. Plastic syringes, tubing, or needles may be contaminated with chemicals or biological materials after use, which is why they must be disposed of and cannot be recycled. Multiple life-saving devices are on standby power in case of an emergency. In times of accelerating climate change, single-use items and continuous, uninterrupted electricity to run equipment is technically inexcusable.

An institution that provides treatment to improve health should also consider those factors that have a negative impact on patients – namely ecological factors. Green Hospitals recognize the connection between human health and the environment.

"The Green Hospital should be sustainable wherever there is a use of resources," Anja Schönheit-Müller, Director of Nursing at the REGIOMED Klinikum Lichtenfels, defines the goal of Green Hospitals. A first step to follow in becoming a Green Hospital is striving to improve energy efficiency and switching to renewable energy like photovoltaic technology. Energy-conserving isolation and more efficient heating systems are another way to save power and energy. Even simple changes in the structure of a building can prompt a fast, major impact. Tackling water consumption is yet another important aspect of Green Hospitals. However, successful water use reduction primarily depends on all stakeholders changing their habits.

Hospital waste management is another, challenging aspect. The idea is to reduce waste – both hazardous waste and plastics -, and recycle or compost the generated waste whenever possible. For hospitals, this means striking a delicate balance between environmental protection and hygiene requirements.

Green Hospitals focus on creating successful long-term sustainable processes and approaches. This also includes logistics. Optimal delivery strategies including optimized schedules for ordering and deliveries and avoiding unnecessary transports help to implement this strategy. This enables hospitals to save material, avoid waste and reduce CO₂ emissions. Green Hospital measures also include the use of eco-friendly construction materials and reduced meat consumption by introducing a meatless day one day a week.

"It's not just about ecological, economic, and social sustainability," explains Schönheit-Müller of the Klinikum Lichtenfels. "In my view, the staff members, their knowledge and motivation continue to be the most valuable assets as their commitment drives health care quality. As with all other valuable resources, Green Hospital helps to relieve staff members and attracts, nurtures, and retains top talent."

The Lichtenfels Klinikum is considered an example of best practice in Germany. The clinic opened in the summer of 2018 after a nine-year planning and construction process. "We have optimized our building envelope with a triple-glazed window system, and the use of heat recovery, geothermal energy, solar heat, biogas, green electricity, and photovoltaics integration," says Schönheit-Müller. This translated into a 75 percent decrease in CO₂ emissions and a 60 percent reduction in energy use thanks to – among other measures – the introduction of OLED lighting. Total construction costs amounted to approximately 112 million euros.

The REGIOMED Klinikum Lichtenfels is the lighthouse project of the "Green Hospital Initiative Bayern (Bavarian Green Hospital Initiative), which provides a specific catalog of measures hospitals must take. If a Bavarian hospital satisfies the key criteria, it might be awarded the "Green Hospital Bavaria" seal of approval by the Bavarian State Ministry of Health and Care. According to the Initiative, these are stellar hospitals that set medical and environmental standards and are an example of exemplary sustainability performance. Facilities can also do a quick check on the homepage of the website. A questionnaire includes the key aspects of a green hospital, allowing interested parties to determine the current degree of environmental sustainability of the respective hospital and identify opportunities for improvement and potential savings.

The German Federation for the Environment and Nature Conservation (Bund für Umwelt und Naturschutz Deutschland e.V., BUND) participates in climate protection projects in hospitals across Germany and supports them in green hospital management. It awards the so-called "Energy-Saving Hospital" label. The Hubertus Protestant Hospital in Berlin was the first hospital in Germany to obtain this seal of approval. It reduced its energy consumption by 37 percent and decreased its CO₂ emissions by 2,600 tons. BUND is also the only German participant in the Health Care Climate Challenge of the global "Health Care without Harm" initiative, which aims to reduce the environmental footprint of hospitals.

Having said that, so far, these measures are still closer to a vision than final reality. Only few hospitals and clinics – a mere six percent in Germany – have developed a dedicated sustainability strategy. One reason is hospitals facing the pressure to increase quality and reduce costs. Measures that promote sustainability seem expensive at the outset, while their effects on patient care might not be immediately apparent. Centralized procurement is one of the biggest obstacles to success in this setting. Lower cost suppliers are given preference, even though a regional supplier would have been a more sustainable choice. Aside from that, hospitals and clinics must be open around the clock and can't easily close for renovations.

Innovative solutions and planning, financing, and implementation assistance are necessary to overcome these barriers. Yet the key prerequisites for sustainable changes are a mindset shift and a change of habits. There must always be continuous efforts to educate and raise awareness of the fact that Green Hospitals also have a positive impact and remarkable benefits on both the health and satisfaction of patients and employees. What's more, energy-smart improvements can reduce the CO₂ emissions footprint and keep energy costs lower – amounting to about 1,400 euros in cost savings per bed and year. This boosts both economic success and environmental sustainability. Apart from education and awareness, we also need formal legal commitments to achieve comprehensive implementation of sustainable strategies in healthcare settings.

Every little step counts. "It's a culture of continuous improvement," affirms Anja Schönheit-Müller.