Thursday, July 13, 2023
Put large devices such as PET CT scanners on power saving mode when not in use. Use reusable materials as default. These are some concrete recommendations of the ten master students who participated in the interdisciplinary thesis lab 'Sustainable Hospitals'. During a round table meeting, they presented their findings and shared their joint recommendations.
Over the past six months, the students have been investigating sustainability issues from healthcare practice. They were guided by participating in the thesis lab 'Sustainable Hospitals' of LDE Center of Sustainability and Medical Delta.
The research results are summarized in the posters at the bottom of this page. You can also download them here in PDF.
Tangible actions and recommendations
In addition to their individual studies, the students collectively identified five tangible actions that hospitals can take immediately:
- Make ‘reusable’ the standard. Reusable materials are almost always more sustainable, technically available and in many cases financially beneficial in the long term.
- Make energy-saving modes the default. For large devices such as scanners these are readily available and a quick win to reduce energy consumption and thus CO2 emissions. Contact manufacturers to see what is possible for any energy-consuming medical device.
- Prevent waste by automating supply chain management within hospitals. At the moment, hospitals do not have a system to keep track of all their inventory. Reuse and waste reduction can be improved by optimizing logistics operations, for example with a track-and-trace system for all medical instruments and materials – including pharmaceuticals. This would provide valuable insights into the hospital supply chain.
- Stop performing medical procedures in the OR that can also take place in day care. An operating room has an enormous environmental footprint. Take a critical look at what really needs the level of hygiene of the OR, instead of depending on what is convenient planning.
- Make a plant-based diet default in the hospital cafeteria.
More concrete actions can also be found here.
Medical Delta Café on how to make healthcare more sustainable
The completion of the thesis lab was also the reason for an online Medical Delta Café about making healthcare more sustainable. Experts from healthcare, industry and design discussed concrete actions to accelerate the greening of healthcare.
Watch the broadcast here:
Round Table ‘Circular Healthcare in the Delta’
In a round table setting, scientists, doctors, facility managers and students gathered on Wednesday 5 July to discuss how to make hospitals more sustainable. The participating students in the thesis lab presented their advice based on ten individual research projects. The inspiring talks about the ongoing research at the universities of Leiden, Delft and Rotterdam into the circularity of hospitals led to fruitful discussions. "Sometimes you just have to get started."
As storm Poly raged on, the undeniable presence of climate change was reaffirmed. "Action must be taken now," Prof. Dr. Frank Willem Jansen, chairman of Medical Delta, explained to those present. “As healthcare sector, we are facing a challenge to combat climate change. Healthcare contributes approximately 7% to the annual CO2 emissions in the Netherlands. It is clear that change is needed."
Debate
After the students presented their overall conclusions and recommendations, the attendees engaged in a debate, led by caseholders Sascha Verbruggen (pediatrician intensive care at Sophia Children's Hospital Rotterdam), Jan-Carel Diehl (professor Design for Inclusive Sustainable System Intervention at TU Delft) and Kim van Nieuwenhuizen (PhD candidate in gynecology and sustainability at the LUMC).
The points raised by the students were recognized as important steps. The discussion additionally identified economic factors and policies as major barriers to implementing more sustainable measures. The financial costs precede the benefits, a participant from the audience remarked, which makes hospitals hesitant to start. It was suggested that policy management students could look in next years' thesis lab at which stakeholders should be influenced to change this system, so that hospitals can make better choices more easily.
Circular care principles
The growing global hospital waste, attributed to population growth and the increased use of disposable items, has a significant environmental impact. Dr. Bart van Straten, researcher at TU Delft and co-founder of Greencycl, told this during his presentation on sustainability in the operating room. To tackle this problem, Van Straten advocated a circular healthcare economy. As an example, he showed how surgical packaging waste can be used for the production of medical products.
The promising results of the research indicate that it is only a matter of time and obtaining the necessary licenses before many hospitals can use it. At the same time, it was pointed out during the discussion that regulations such as the MDR (Medical Device Regulation) represent a huge barrier in both time and cost to bring innovative products to market.
Making diagnostic laboratories more green
The interdisciplinary character was underscored by a duo presentation by Michael van der Voorden – manager of the central diagnostic laboratory at Erasmus MC – and Cheyenne van der Waard – business administration student at Rotterdam University of Applied Sciences. The laboratory is responsible of both material and chemical waste streams. The hbo-students provided insight into these waste streams to the Green Team of the laboratory. Van der Voorden emphasized the importance of so-called 'relay projects'. New batches of students continuously build on the latest results.
Van der Waard was firm in her recommendations to healthcare professionals who want to use students for their research: "Know what you are getting into and allow enough time and space to supervise students." Communication is key.
Sustainability in the OR
The ongoing research and the practical implementations of the 'Green OR' initiative were presented by Dr. Ir. Anne van der Eijk, Manager OR Facilities & Central Sterilization at the LUMC. A notable example was the optimization of medical instrument trays using RFID techniques. By tracking instrument use, almost half of the items no longer needed to be used. This 'tray optimisation' not only reduces cleaning time, but also minimizes waste production, leading to a smaller CO2 footprint in the OR.
The separation and recycling of OR products was also mentioned. Various sustainable applications have been integrated into day-to-day operations, such as replacing disposable isolation gowns with reusable ones, no longer using plastic packaging for surgical suits, replacing bottled water with tap water, switching to reusable AMBU balloons instead of disposable balloons and reducing the use of inhalation anaesthetics. These sustainable measures contribute to the overall environmental sustainability of the operating room while ensuring efficient use of resources.
'Just do it'
During the final round table discussion, a number of open questions were raised, such as: who do we still need to convince of the use of more sustainable measures? And how do we increase acceptance and support for more sustainable alternatives? It was noted that hospital managements were absent: despite their decision-making power, sustainability is still 'not their problem'.
One of the participants responded to this with: "Sometimes you don't have to know everyone's opinion in advance and it is mainly a matter of 'just do it."
Read more about research into more sustainable healthcare and use our guides via this link.
Posters results per study
Thesis
Some thesis are published below:
Hospital Food Transition - A qualitative study on drivers and influences of stakeholder on healthy food policies in the Leiden University Medical Centre
- Thesis Annemarie Keller
Material logistics infrastructure in a circular hospital - Design science research in academic hospitals Erasmus Medisch Centrum (Erasmus MC) & Leids Universitair Medisch Centrum (LUMC)
- Thesis Mels Arnoldy
