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Examples of changes to practice

How hospitals are approaching sustainable healthcare

In this section Dr Rebecca Brinkler will describe some of things that that healthcare professionals are doing in New Zealand to reduce the carbon footprint of healthcare.

Rebecca competed her anaesthetic training in London. She now lives and works in Auckland, New Zealand and has interests in Obstetrics, Orthopaedics, Sustainable Practice and Anaesthesia in resource poor settings.

‘Healthcare’ is one of the biggest contributors to global warming worldwide. However, the carbon footprint of our entire health service seems like too mammoth a task for a single person to tackle.

In the following section we will discuss some of the initiatives which have been undertaken around the world, ranging from a whole hospital shake up to individual departmental changes. We can all make a difference and all the small differences add up and change culture.

Whole hospital shake up

The Southern District Heath Board in New Zealand provides primary, secondary and tertiary care to 319,000 people in the largest geographical DHB in the country.

Dr Matthew Jenks is a Consultant Anaesthetist at Southern DHB and he used his sabbatical to focus on his hospital’s carbon footprint.

  • He found that the Southern DHB carbon footprint was equivalent to 28,240 tonnes of CO2, with the main contributors being coal heating (59%), transportation (17%), medical gases (13%) and electricity (9%).
  • This was poor in comparison to other New Zealand hospitals.
  • His report was presented to the board, along with suggestions for improving the carbon footprint, aiming for an 80% reduction by 2030.

The suggestions focused on:

  • Improving staff engagement by developing learning packages, local sustainability champions and annual sustainability awards and changing the culture towards sustainable practice
  • Improving the sustainability of the current hospital buildings including switching from coal heating to wood biomass, and investigating the cause of unexpectedly high N2O use
  • Improving accountability with regards to sustainability practices by employing a sustainability manager, improving the greenhouse gas inventory, conducting annual carbon footprint audits and engaging with the Enviro-mark carbon footprinting programme
  • Reducing the carbon footprint involved in travel by aiming for a 50% electric vehicle fleet, reducing staff air travel and reviewing the use of aeromedical retrieval designing a climate smart new Dunedin hospital

The new Dunedin hospital is currently under construction and has taken these sustainability factors into consideration in the design:


  • Use of water efficient fixtures and fittings to minimize water wastage as well as metering and monitoring of water use
  • Rainwater collection and re-use
  • Capture of autopsy and radioactive water waste
  • Treatment of stormwater before discharge back to waterways


  • Energy efficient building design
  • Heat efficient building design
  • Metering and monitoring of energy usage
  • Primary energy source is city electrical grid (majority NZ electricity is from renewable sources).
  • Diesel backup generator
  • Air driven heat pumps
  • Significant glazing throughout building to optimize daylight
  • Refrigerant gas specified zero ozone depletion, low global warming potential


  • Building design incorporates space requirements for waste and recycling collection bins to reduce landfill
  • Future plan to include food macerators on site


  • Electric charging points for e-bikes and cars
  • Bus stops, scooter parking and bike parking provided
  • No vertical parking


  • Landscaping to include planting of productive food gardens
  • Procurement of locally produced food
  • Maintaining a healthy food policy
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How to Drive Sustainable Healthcare: Educate, Engage, and Empower

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