Organizational bottom-up LCA of a maximum-care university hospital in Germany

Main Presenter:    Lukas Messmann 

Co-Authors:   Sandra Köhler     Felix Assies      Alex Cimprich      Steven B. Young      Renate Linné      Andrea Thorenz      Axel Tuma            

The healthcare sector is responsible for 4.4% of global greenhouse gas emissions. Hospitals face the challenge of sustainable transformation and must measure, monitor, and report on their sustainability performance. In contrast to top-down approaches, Life Cycle Assessment (LCA) promises higher accuracy of results and can shed light on impacts other than global warming. While most LCAs are carried out on a product level, organizational LCAs (O-LCA) covering the operations of an entire organization are rare. This study thus aims to assess the annual environmental impacts of a 1700-bed maximum-care university hospital in Germany in 2021, 2022, and 2023. The system boundaries encompass the inputs to and outputs from the hospital’s operations, including energy and water consumption, direct emissions from fuel combustion and medical gases, transportation of goods and patients, waste and wastewater, as well as purchases of, e.g., food, pharmaceuticals, office and medical supplies, or
cleaning agents. The Life Cycle Inventory (LCI) is based on primary (foreground) data and supplemented with background data from LCI databases (ecoinvent 3.10 and AGRIBALYSE 3.1.1). Since the detailed modeling of every purchased item is infeasible, we apply the statistical sampling approach analogous to the hospital O-LCA study by Cimprich & Young (2023). Impacts are assessed with different LCIA methods (e.g., EF3.1), and compared to the results of the studies of Cimprich & Young (2023) and Keller et al. (2021). In addition to the overall environmental impacts of the hospital, the results reveal environmental hotspots, both among the on-site processes and along upstream supply chains. This in-depth analysis of environmental impacts can be used for internal and external reporting and is a starting point for reduction paths in hospitals. From the comparison with similar studies, insights on the influencing factors on environmental impacts as well as methodological best-practices for
hospital O-LCAs are derived. In addition, this study contributes to improving the coverage and quality of LCA data in the healthcare sector, as well as opportunities for benchmarking among hospitals.

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