“Knowing the facility first” – Analysing environmentally relevant structures and processes in hospitals: A case study

Andrew Bonneau, Marzena Wilczynski, Julia Federer, Heiner Schanz


The operation of hospitals creates significant environmental burdens due to their large energy and material requirements, in addition to their production of hazardous wastes. Past research has predominantly focused on the role that medical technology and building design have on the environmental impact of hospital operations. In this paper, a holistic framework is developed to analyse hospital operation in order to better understand the processes, employee behaviours, and structures which contribute to the environmental impact of hospital operation. Specific focus is put on the derivation of a simple but effective method, which can also be applied by non-medical and non-specialized consultant personnel in general clinical contexts. Through the use of three empirical pathways, the employee perspective, patient perspective, and building perspective, data was gathered via a case study of the Children’s Hospital (CH), Medical Center, University of Freiburg, Germany. Results revealed linkages between specific employee processes and the consumption of energy and materials, as well as potential pathways for future sustainability relevant monitoring. Characteristics of the hospitals administrative organizational and operational characteristics highlight the difficulties in gathering pertinent data for a complete analysis. Insights, in particular regarding employee behaviours, provide avenues for future research to better understand the implementation of sustainability programs in hospitals.

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DOI: https://doi.org/10.5430/jha.v7n5p28


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Journal of Hospital Administration

ISSN 1927-6990(Print)   ISSN 1927-7008(Online)

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