Ways to Mitigate Climate Change by Implementing Zero Emission Hospitals – A Case Report

Main Article Content

Edda Weimann, MD, MPH Léa Elisa Weimann MArts, LLM

Abstract

If the global healthcare system would be a country, it would be the fifth largest emitter. Hence various health care systems worldwide have committed themselves to become carbon neutral. In Europe, Germany as an economy and the German healthcare system produces by far the most emissions. This has a significant impact on the health of the population in Germany, Europe and worldwide. It leads to Disability Adjusted Life Years (DALYs) as well as premature deaths. To reduce global climate change related damages, disasters and negative health outcomes, Germany has committed itself through various treaties to become carbon neutral and to transform the healthcare system towards net zero until 2030. The article highlights crucial steps for hospitals how this can be achieved. Important management tools are the SWOT analysis, the PDCA cycle, the DHOW model and the sustainable Balanced Score Card. Hospitals should establish Key Performance Indicators for Scope 1, 2, and 3 emissions and monitor them on a monthly basis. Important action areas are energy sources, insulation of buildings, waste, water consumption, nutrition, transportation, chemicals, pharmaceuticals, climate education and leadership. Leadership should be executed as a top-down as well as a bottom-up approach to involve all relevant stakeholders including staff and patients.

Keywords: Healthcare Systems, carbon neutral, transformation, C02 Emissions, Health

Article Details

How to Cite
WEIMANN, Edda; MARTS, Léa Elisa Weimann. Ways to Mitigate Climate Change by Implementing Zero Emission Hospitals – A Case Report. Medical Research Archives, [S.l.], v. 11, n. 1, jan. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3464>. Date accessed: 21 dec. 2024. doi: https://doi.org/10.18103/mra.v11i1.3464.
Section
Case Reports

References

1. The 2022 Global Report of the Lancet Countdown. https://www.lancetcountdown.org/2022-report/.
2. Carter A. 7 of Europe´s top 10 CO2 emitters are in Germany. I am expat. Published April 22, 2022. Accessed January 3, 2023. www.iamexpat.de/expat-info/german-expat-news/7-europes-top-10-co2-emitters-are-germany
3. Tiseo I. DIstribution of carbon dioxide emissions worldwide in 2021, by select country. Statista. Published November 23, 2022. Accessed January 4, 2023. https://www.statista.com/statistics/271748/the-largest-emitters-of-co2-in-the-world/
4. UNFCCC. Glasgow Climate Pact. https://unfccc.int/process-and-meetings/the-paris-agreement/the-glasgow-climate-pact-key-outcomes-from-cop26
5. Gießelmann K, Osterloh F. Klimaschutz im Gesundheitswesen: Klimaneutralität bis 2030. Dtsch Arztebl 2021 11845 -2088 B-1724.
6. Karliner J, Slotterback S. Health Care´s Climate Footprint. How the Health Care Contributes to the Global Climate Crisis and Opportunities for Action, Green Paper. Health Care without harm; 2019:1-43. www.hcwh.org
7. Hernandez AC. Reducing Healthcare´s Climate Footprint. Opportunities for European Hospitals & Health Systems.; 2016:11-13. www.hcwh.org
8. Dickhoff, A, Grah, C. Schulz, C, Weimann E. Rahmenwerk Klimagerechte Gesundheitseinrichtungen (2021). www.klimawandel-gesundheit.de/handlungsfelder-und-projekte/resiliente-gesundheitseinrichtungen/
9. Healthcareclimateaction. Race to zero. https://healthcareclimateaction.org/racetozero
10. Litke N, Szecenyi J, Wensing M, Weis A. Klimaschutz im Krankenhaus. Dtsch Ärztebl 2020 117 11 A544. 2020;117(11):A544.
11. Osterloh F. Klimawandel: Schutz vor der Hitze. Dtsch Arztebl. Published online 2022:A162-B141.
12. Osterloh F. Klimaschutz im Krankenhaus: Der Strukturwandel hat begonnen. Dtsch Arztebl. Published online 2021:A1299-B1073.
13. IPCC. Climate Change 2022: Impacts, Adaptation and Vulnerability. www.ipcc.ch/report/sixth-assessment-report-working-group-ii/
14. Weimann E. Die nachhaltige Balanced Score Card im Krankenhaus. Krankenh. 2022;7(114):559-563.
15. Weimann, E, Weimann, P, Weimann L E. High Performance Im Krankenhaus Management. 2nd Edition. Springer Publishing Company; 2022.
16. Hohnstein A. Klimaschutz im Klinikmanagement: „Wir verpassen immer mehr den Anschluss“. Kma - Klin Manag Aktuell. 2022;27(10):35-37. doi:10.1055/S-0042-1757845
17. Stancliffe R. 10 years to green the NHS and the health sector. Lancet Planet Health. 2020;4:e126−7.
18. Weimann E, Patel B. Tackling the climate targets set by the Paris Agreement (COP 21): Green leadership empowers public hospitals to overcome obstacles and challenges in a resource-constrained environment. S Afr Med J. 2017;107(1):34-38. doi:10.7196/SAMJ.2017.v107i1.12023
19. Berners-Lee M. The Is No Planet B. A Handbook for the Make or Brake Years. Cambridge University Press; 2019.
20. HEAL, Huscher J, Smith D. The Unpaid Health Bill: How Coal Power Plants Make Us Sick. Health and Environment Alliance; 2013. https://www.env-health.org/wp-content/uploads/2018/06/unpaid_health_bill_EN.pdf
21. Vittuari M et al. European project Fusions releases EU-28 estimates of food waste levels and a food waste quantification manual. Recommendations and guidelines for a common European food waste policy framework. EU Fusions Website. Published July 30, 2016. Accessed January 4, 2023. www.eu-fusions.org
22. DGE e. V. Vollwertig essen und trinken nach den 10 Regeln der DGE. Deutsche Gesellschaft für Ernährung e.V. Accessed January 4, 2023. https://www.dge.de/ernaehrungspraxis/vollwertige-ernaehrung/10-regeln-der-dge/#:~:text=Wie%20sich%20das%20umsetzen%20l%C3%A4sst%2C%20hat%20die%20Deutsche,Gem%C3%BCse%20und%20Obst%20%E2%80%93%20nimm%20%E2%80%9E5%20am%20Tag%E2%80%9C
23. EAT LC. The Planetary Health Diet. Eat Forum. Accessed January 4, 2023. https://eatforum.org/eat-lancet-commission/the-planetary-health-diet-and-you/
24. Medeiros G, Azevedo KPM, Mesquita GXB. Red meat consumption, risk of incidence of cardiovascular disease and cardiovascular mortality, and the dose-response effect: Protocol for a systematic review and meta-analysis of longitudinal cohort studies. Med Baltim. 2019;98(28):e17271.
25. Ruiz E. How healthcare can reduce unnecessary antimicrobial use in healthy animals. Published December 21, 2021. Accessed January 4, 2022. https://www.hcwh.org/articles/blog/europe/how-healthcare-can-reduce-unnecessary-antimicrobial-use-healthy-animals
26. Coffin S, Wyer H, Leapman JC. Addressing the environmental and health impacts of microplastics requires open collaboration between diverse sectors. PLOS Biol. 2021;19(3):e3000932. doi:10.1371/JOURNAL.PBIO.3000932
27. Yee MSL, Hii LW, Looi CK, et al. Impact of Microplastics and Nanoplastics on Human Health. Nanomater 2021 Vol 11 Page 496. 2021;11(2):496. doi:10.3390/NANO11020496
28. Leslie HA, Velzen MJM van, Brandsma SH, Vethaak AD, Garcia-Vallejo JJ, Lamoree MH. Discovery and quantification of plastic particle pollution in human blood. Environ Int. 2022;163:107199. doi:10.1016/J.ENVINT.2022.107199
29. Gallo F, Fossi C, Weber R, et al. Marine litter plastics and microplastics and their toxic chemicals components: the need for urgent preventive measures. Environ Sci Eur. 2018;30(1):1-14. doi:10.1186/S12302-018-0139-Z/FIGURES/1
30. Jeswani HK, Azapagic A. Life cycle environmental impacts of inhalers. J Clean Prod. 2019;237:117733. doi:10.1016/J.JCLEPRO.2019.117733
31. Conway N, A B, N G, G S, Schneider F. Die klimafreundliche Narkose. Dt Ärztebl. 2020;117(25):B 1064-52.
32. Weimann L, Weimann, E. On the Road to Net-Zero Health Care Systems: Governance for Sustainable Health Care in the United Kingdom and Germany. Int J Environ Res Public Health. Published online 2022. doi:10.3390/ijerph191912167
33. Hensher M, Canny B, Zimitat C, Campbell J, Palmer A. Health care, overconsumption and uneconomic growth: A conceptual framework. Soc Sci Med. 2020;260(2020). https://www.sciencedirect.com/science/article/pii/S0277953620306390