RSU doctoral student: The impact of climate-friendly hospitals on patients and the state

Writer: Olga Veilande, Acting Research Assistant, RSU Faculty of Social Sciences

The terms “sustainability” and “green transition” have been increasingly discussed in recent years, particularly in the context of the European Green Deal. These concepts will also have a significant impact on public hospitals, patients and their families, as well as hospital management and staff. But what does a sustainable management approach truly mean for climate-friendly, or ‘green,’ hospitals? What changes will it bring, and why are they necessary?

A green hospital is one that integrates environmentally friendly practices into its operations, infrastructure, and patient care processes. It minimises the negative environmental impact of its activities while creating conditions that promote health and well-being.

How can patients experience the benefits of a green hospital, and what would sustainable management in Latvian hospitals bring to the state and the environment?

A green healthcare facility makes more use of natural elements, creates health gardens and offers sustainable food. This improves patient comfort and facilitates faster recovery, while caring for the well-being of patients.

Natural lighting – such as that used in green hospitals – has been proven to reduce stress levels in hospital employees, improve working conditions and job satisfaction.

While the initial investment in green technologies and infrastructure can be high, in the long term, it will generate savings as energy-efficient systems reduce utility bills and waste management costs, while sustainable practices improve the hospital's operational efficiency.

By implementing carefully considered environmental practices in hospitals, the carbon footprint (amount of CO2 emissions) and damage to nature created during the hospital’s operations are significantly reduced.

The European Sustainability Reporting Standards require stakeholder feedback on hospitals’ sustainability goals – not only in terms of environmental management, but also in terms of social management. Thus, the dialogue with patients and their family members, staff, policy makers, and hospital providers will improve.

Hospitals are aware that their sustainable development depends on the well-being, safe environment, knowledge and skills of their staff, patients and their family members, so it is important to build respectful and ethical cooperation with stakeholders. For example, they can be involved in setting the hospital’s sustainability priorities and finding a shared understanding of values.

Seven practical tasks for green hospitals

The World Health Organization (WHO) has defined seven components for sustainable hospital operations (WHO, 2009):

1. energy efficiency: efficiency and conservation measures reduce the hospital’s energy consumption and costs;
2. green building design: the hospital must be built according to local climatic conditions and optimised for lower energy and resource consumption;
3. alternative energy generation: the hospital produces and/or consumes clean, renewable, local energy to ensure reliable and resilient operations;
4. transport: alternative fuels must be used in hospital vehicles, and staff, patients and the public are encouraged to use alternative mobility options such as walking, cycling or public transport;
5. food: sustainable local food must be available for staff and patients;
6. waste: the hospital must reduce, reuse, recycle, compost and use alternatives to incineration of waste;
7. water: the hospital should try to conserve water and avoid using bottled water if there are safe alternatives.

Sustainability in Latvia dates back 100 years

In Latvia, the principle of sustainable development has been enshrined in the Constitution of Latvia (preamble) for more than a century—since 1922, to be precise—stating that “everyone should take care of themselves, their family, and the common good of society, acting responsibly towards others, future generations, the environment, and nature.” At the global level, sustainable development was first defined in 1987 as “development that meets the needs of the present without compromising the ability of future generations to meet their own needs.”

The goal of sustainable development is to consider economic well-being (profit), social inclusion, and environmental protection equally. Ideally,

entrepreneurs should prioritise environmental and social issues as much as their profits.

It is well known that human activities affect nature by causing climate change or global warming (e.g. use of petroleum products, coal, industrial fluorinated gases). Observations over the past decade show that weather conditions have become extreme and unpredictable. For example, we are increasingly facing drought, rainfall, storms, and overall biodiversity decline. From the above we can conclude that climate change is already a reality, not the future, and a large part of Latvia’s population and businesses have already experienced severe damage due to climate change: roofs blown off homes, cars damaged, parks destroyed, road and rail traffic hampered by fallen trees, damage incurred by farmers.

To mitigate climate change and promote sustainable development, the United Nations (UN) General Assembly adopted a resolution in 2015 entitled ‘Transforming our World: The 2030 Agenda for Sustainable Development’. The resolution sets 17 Sustainable Development Goals and 169 sub-goals to reduce global poverty and make global development sustainable:

Figure. UN 17 Sustainable Development Goals (2015)

On 11 December 2019, the European Commission announced the European Green Deal (COM(2019) 640), outlining a sustainable and socially responsible growth strategy. One of the objectives of the European Green Deal is to achieve climate neutrality by 2050 – to ensure that net emissions of greenhouse gases (mainly CO2) are reduced to zero by 2050 compared to 1990 levels, thereby ensuring the elimination of the consequences of climate change.

Healthcare sector – the fifth-largest emitter globally

Studies show that the global healthcare sector is a major contributor to CO2 emissions, accounting for around 4.4% (2022) of global CO2 emissions. Its climate impact is equivalent to the annual greenhouse gas emissions of 514 coal-fired power plants. If the health sector were a country, it would be the fifth largest emitter on the planet.

On 5 January 2023, the Corporate Sustainability Reporting Directive (EU) 2022/2464 (CSRD) of the European Parliament and of the Council of 14 December 2022 entered into force, replacing the Non-Financial Reporting Directive (NFRD) No 2014/95/EU. The CSRD expands the range of companies that are obliged to report on their sustainability practices. The Directive applies to all large and listed companies, requiring them to disclose information on their social and environmental impacts, as well as governance.

In order to transpose the requirements stemming from the CSRD and in line with the European Union’s Green Deal, on 26.09.2024, the Saeima adopted the Sustainability Information Disclosure Law (hereinafter referred to as the Law), which entered into force on 17.10.2024. The Law provides, inter alia, for an obligation for a company to prepare a sustainability report and a consolidated sustainability report as part of the company’s annual report to be included in the management report; an obligation to prepare the sustainability report in accordance with the EU Sustainability Reporting Standards (European Commission Delegated Regulation (EU) 2023/2772 (ESRS)).

Sustainability issues cover environmental, social and governance areas.

Scholars have repeatedly studied sustainability management issues in the context of healthcare. For example, to clarify sustainability topics in healthcare, Indian scholars (Mehra & Sharma, 2021) at M.B.M. University studied academic literature and concluded from their analysis that for a hospital’s operations to be environmentally sustainable, i.e. climate-friendly, hospitals should:

1. use green energy (solar, wind, etc.);
2. reduce waste and adapt waste management;
3. improve air, water and soil pollution control;
4. take care to preserve natural resources (e.g. water);
5. improve energy efficiency;
6. replace fossil fuel vehicles with, for example, electric vehicles;
7. ensure that new building design is green or sustainable;
8. introduce circular economy (reuse, repair, refurbish, recycle) practices;
9. improve efficient use of materials;
10. introduce sustainable procurement policies.

For hospitals, the most typical social issues in the area of sustainability are patient and staff satisfaction, staff training, availability of free financial resources for residents, environmental accessibility, availability of health services (24/7), patient safety, convenience, sustainable health (prevention, lifestyle, etc.).

Brazilian scholars (Borges de Oliveira, K.; de Oliveira, O.J, 2022) have identified five key drivers for the establishment and development of sustainable management in hospitals:

1. circular economy;
2. sustainable (climate-friendly) buildings;
3. knowledge management and corporate culture;
4. organisational management;
5. technological innovations.

Each public hospital must choose the sustainability aspects that are relevant to its activities, set sustainability priorities and set measurable targets.

In order to assist public hospitals in the implementation of sustainable management practices and to study the inequalities created or reinforced by the European Green Deal in the health sector, on 01.01.2024, Rīga Stradiņš University launched fundamental-applied project Socially responsible green transition: strengthening governance solutions to empower Homo Climaticus in the healthcare sector (project No. lzp-2023/1-034, GreenCare project) funded by the Latvian Council of Science. During the project, a sustainable operations model, a roadmap for the implementation of a sustainable operations model in public hospitals, and recommendations for policy makers to promote a socially responsible green transition in healthcare will be developed.

The intended sustainable operations model will be adapted to the needs of Latvia, based on the environmental, social and governance dimensions of the European Corporate Sustainability Reporting Directive and the Law.

Source: Delfi.lv