On the way to becoming a climate-neutral hospital

More than two thirds of the CO₂ emissions in hospitals are so-called Scope 3 emissions, to which secondary processes in particular contribute. The latter include in particular logistics and supply services. With the project “KlinKe – Climate neutral secondary processes in hospitals”, Prof.  Dr. Silke Bustamante and her colleague Prof. Dr. Andrea Pelzeter at the HWR Berlin are researching which of these processes leave a particularly large carbon footprint – and how the processes can be made more climate neutral. 

Canteen deliveries, waste disposal, laundry operations, purchasing... The processes in a hospital are diverse and complex. This applies not only to internal but also to external processes. And like most companies and institutions, clinics also emit a lot of CO₂. “In Germany, the healthcare sector contributes around five percent to the entire German carbon footprint. It is particularly high in hospitals, which operate around the clock,” says Professor Dr. Silke Bustamante, Vice President for Sustainability, Student Services and University Communication at the Berlin School of Economics and Law (HWR Berlin). “However, the issue of environmental friendliness received little attention in the health sector until recently. Among other things, because the focus of the clinics has so far been primarily on medical core processes. That is slowly changing, because the topic of 'global health' is now being discussed worldwide.”

As part of lectures, the scientist had been dealing with the topic of sustainable procurement in the hospital sector for a long time. In conversation with her colleague Prof. Dr. Andrea Pelzeter, Head of Facility Management at the HWR Berlin, the idea of examining secondary processes in hospitals emerged with regard to their CO₂ emissions – and then deriving what measures need to be taken to make the processes climate-neutral. Both benefited from the fact that Andrea Pelzeter had previously developed an instrument with which the carbon footprint of facility services can be measured.

In September 2021, the project “KlinKe – Climate-neutral secondary processes in hospitals” funded by the Federal Ministry of Education and Research (BMBF) got underway. In a team with two research assistants, Silke Bustamante and Andrea Pelzeter have since been analysing in detail the processes in hospitals, for example building operations, hospital transport, hospital logistics or food supply. “According to the international Greenhouse Gas (GHG) Protocol, around 70 percent of the CO₂ emissions in the global healthcare sector are Scope 3 emissions that arise in such secondary processes,” explains Silke Bustamante, “but these have hardly been researched so far.”

In a first step, the KlinKe team systemised and structured the secondary processes in the processes of the project partners, including the Evangelical Hospital Hubertus in Berlin-Zehlendorf, Vivantes Service GmbH, the University Hospital Hamburg-Eppendorf (UKE) and the Charité CFM Facility Management GmbH. The clinics and service providers were selected based on their proximity, but also based on their openness and their level of development in relation to the research topic. Within the framework of a “materiality analysis”, Silke Bustamante and Andrea Pelzeter classified processes in terms of their carbon footprint, other ecological and social impacts and also in terms of their potential for change in the hospital. The “Hot processes” (A processes) include, for example, the cleaning service and waste disposal, while services such as the maintenance and repair of electrical or medical technology are assigned to the B processes. Services such as patient logistics, hygiene monitoring or processes of maintenance and repair of safety technology, in turn, were categorised as C-processes.

“An important point is that we conducted a bottom-up survey. This means that we have defined functional units such as square metres or beds for each secondary process. The carbon footprint for the total number of the respective units in the hospital could then be calculated from this,” explains Silke Bustamante and adds, “The primary purpose of the survey is to allow us to look at the process with our practice partners and, in a second step, jointly define what can be done in each case to reduce CO₂ emissions in the partner hospital.”

After around a year, the survey phase of the KlinKe project is almost complete. In 2023, the development of optimisation measures should then begin. And for the last phase of the project, the development of guidelines and recommendations for a change management process for hospitals is being considered. The project should be completed by the end of 2024.

“The special thing about the KlinKe project: We deal with value-added processes that are not exclusively controlled by one company or one clinic, but by many different players,” says Silke Bustamante. In order to be able to understand the complex processes in the hospital, the Klinke team exchanges information with the practice partners at regular workshops. When it comes to detailed questions, the scientists also call in consultants and experts from health associations, who are also partners in the project.

KlinKe is also a model example of knowledge transfer between science and practice. “It is only by means of close cooperation with our partners that what we develop can also be put into practice and necessary changes can be successfully initiated via change management. Cooperation with our partners is also very important for data collection.”

The team is also closely networked with initiatives in the health sector such as the NGO “Heath Care Without Harm” and research groups at the Heidelberg University Hospital or the Havelhöhe Community Hospital. Brain City Berlin offers the KlinKe project the important proximity to politics. Silke Bustamante: “Political support will certainly be needed to advance the issue of CO₂ reduction in hospitals. We are well located in Berlin to achieve that.” (vdo)

projekt-klinke.hwr-berlin.de (German only)