Sustainability in healthcare in 9 steps

Before Article

ZiekenhuisParticularly at this time when the world is suffering from the coronavirus outbreak, the main focus is no longer on climate change. But especially in these times it is important to keep looking ahead. In the longer term, global warming will continue to demand our attention. Moreover, there are increasing indications that the energy transition will be one of the pillars on which the recovery of the economy will be based. In this article, Donald Huigen – healthcare advisor at CFP – explains what sustainability means for healthcare buildings and how sustainability can be achieved without major consequences for the healthcare process.

Healthcare roadmaps

In order to achieve all the objectives relating to sustainability, it has been agreed in the Netherlands that by 2020, each organisation will draw up a “roadmap portfolio” for each building it owns. This will indicate which short and long-term measures will be implemented. For this reason, sectoral roadmaps are being drawn up for care and cure. On this basis, the building owners in question can draw up their own roadmap.

Climate agreement


To combat global warming, the Paris Climate Change Conference COP21 on 15 December 2015 agreed to reduce global CO2 emissions. This can be achieved by using fewer fossil fuels and reducing overall energy consumption. All 197 countries that signed the agreement set their own climate targets. The Netherlands laid this down in the Dutch Climate Act of 2 July 2019.


ZiekenhuisGetting started with sustainability in healthcare

Optimal care remains of course the most important thing. It is therefore necessary to examine at what point which measures can be implemented, without major consequences for the care process and with an acceptable payback period. In order to make your building more sustainable, the following approach is self-evident:

1. Make an analysis of your building: surface area per type of use, energy usage, climate concept, age

An initial analysis can be made on the basis of a structured questionnaire. It is possible to perform this analysis online.

2. Take stock of the measures already taken

The first analysis of a building is based on the assumption that the construction method was founded on the regulations and state of the art at that time. Older buildings will certainly have been modified over time. It is necessary to establish which sustainable measures have been implemented. The CSR manager can provide assistance in this respect.

3. Check the measures taken against recognised healthcare measures

The Netherlands Enterprise Agency (RVO) has drawn up a list of energy-saving measures for the care sector. These will be used to assess the extent to which the institution in question has met its statutory obligations. For each individual measure, it should be established whether and to what extent it has been achieved.

4. Identify possible long-term measures in relation to regional plans

The Netherlands is divided into thirty energy regions. Each region has the task of drawing up a Regional Energy Strategy (RES). The RES is a document detailing the challenges for sustainable electricity generation and the challenges for the built environment (energy savings and heat) for 2030 and 2050. Within the regions, the municipalities, the province and the water board work together with stakeholders to arrive at an RES. In the long term, the energy supply of your building will have to fit within the infrastructure. The most important choices to be made are the future indoor climate concept and internal energy distribution.

5. Select possible measures based on figures and feasibility

It must be determined whether all possible sustainability measures contribute to improving the sustainability of the building. The measures must also be technically and financially feasible. You then determine for each measure what impact the implementation will have on the care process itself and the “healing environment”, which is largely determined by the indoor climate.

6. Determine the timing based on the disruption of the care process and synchronise natural times

The continuity of the care process is of primary importance. That is why it is often practical to implement sustainable measures at times when the care process needs to be disrupted in any event. Think, for example, of a renovation that has already been planned.

7. Create a roadmap portfolio

For every institution that consumes more than 50,000 kWh of electricity or 25,000 m³ of natural gas per year, reporting on the status and plans for energy-saving measures is mandatory. This is in fact a record of the previous steps.

8. Implement measures

As with any other project, a programme of requirements must be drawn up for each measure planned. The design must also be worked out, a contractor must be engaged and the execution and delivery must be monitored.

9. Report and assess periodically

On the basis of the roadmap drawn up in step 7, progress must be reported periodically. In addition, in some cases reporting will be required under the European Energy Efficiency Directive (EED).

Steps already completed

The different steps in this approach do not necessarily have to be carried out in that order. In many cases, these steps will already have been fully or partially taken. The current coronavirus outbreak will undoubtedly lead to adjustments being made to the buildings. On the one hand to better guarantee the isolation of groups of patients in future situations and on the other hand to be able to carry out other work without having to come into direct contact with one another (one-and-a-half metre society). Sustainability measures can often be taken at the same time as these adjustments.

written by: Donald Huigen, Healthcare advisor at CFP