Sustainable effort

Tuesday, 30 January, 2018

Sustainable effort

Many Australian healthcare organisations are determined to improve their environmental footprint, implementing projects to reduce their greenhouse gas emissions, energy usage and waste. The benefits aren’t just environmental — significant cost savings have been found, too. We look at five successful local case studies.




Case Study 1

Anaesthetic gases — greenhouse gas reductions

Western Health, Melbourne, Australia

About Western Health

Western Health, Melbourne, has approximately 700 beds and 18 operating rooms. It is a general hospital (no cardiac surgery, minimal neurosurgery) with a large maternity section.

Hospital goal

To reduce hospital greenhouse gas emissions by changing the type of anaesthetic gases used.

The issue

Like most hospitals, Western Health uses a variety of general anaesthetic gases, primarily sevoflurane, desflurane with some nitrous oxide (N2O). Desflurane and N2O have high global warming potentials compared with sevoflurane (or propofol). Moving away from desflurane and N2O can considerably reduce environmental footprint.

Sustainability strategy implemented

The majority of the Anaesthetic Department voluntarily reduced their desflurane and nitrous oxide use and attempted to use lower flows of gases in general. There was little appetite within the department to cease using desflurane and N2O completely.

Progress achieved
  • Financial benefits: approximately $28,900 per year.
  • Environmental benefit: 140 tonnes of CO²e emissions per year (equivalent to 36 return long-haul flights from Melbourne, Australia to London, UK).
  • Human health benefit: waste anaesthetic gases can be harmful to staff if not properly exhausted.

Western Health operating theatre in action. Image credit: ©Western Health

Anaesthetist Forbes McGain led the project. Image credit: ©Western Health

Case Study 2

Reducing waste from operating theatres

Royal Melbourne Hospital

About Royal Melbourne Hospital

Royal Melbourne Hospital is part of Melbourne Health, Victoria’s second-largest public health service, which also includes North Western Mental Health, North West Dialysis Service and Victorian Infectious Diseases Reference Laboratory. Employing over 8900 staff across our services, Melbourne Health manages over 1400 beds.

Hospital goal
  • Reduce waste to landfill.
  • Reduce carbon footprint.
The issue

Much of the equipment used in operating theatres is disposable for reasons of sterility, leading to a great deal of waste. Much of the waste was put into clinical waste bins costing 5.3 times more to dispose of.

Sustainability strategy implemented

Starting small, Kimguard (sterile wrap) bins were placed around the department. This was followed by introducing cardboard and paper recycling bins, co-mingled glass and plastic bins, aluminium bins, battery bins, PVC bins and bins for recycling sterile hand towels.

Other measures:
  • Clinical waste bags were not opened until the end of each operation to discourage people from putting general waste in clinical waste bins.
  • Staff re-educated on which items go into sharps disposal bins.
  • Polystyrene cups in the tearoom were replaced with paper cups.
  • Companies delivering items in polystyrene packaging asked to remove the packaging after delivery.
  • Contents of custom packs were changed to remove items regularly discarded.
  • Staff encouraged to shut down computers and turn off lights at the end of the day.
Progress achieved
  • Financial benefits: reduced clinical waste resulted in $230,000+ cost savings since 2013.
  • Environmental benefit: 187 tonnes of clinical waste eliminated.

Human health benefit: clinical waste is shredded, disinfected and then disposed of in prescribed landfill. By reducing clinical waste and increasing recycling a reduction in chemical use and landfill is achieved, reducing greenhouse gas emissions and pollution.

Some members of the Theatre Sustainability Committee. Image credit: ©Monika Page

Recycling bins in theatre. Image credit: ©Liana Horgan

Case Study 3

Community energy efficiency program

UnitingCare Community and Blue Care

About UnitingCare:

Uniting Care Community is the community services arm of Uniting Care Queensland, with 2400+ staff, 6000+ volunteers and over 280 services state-wide.

The issue

Energy is the most significant sustainability challenge for UnitingCare Community (UCC) and Blue Care (BC), with stationary energy comprising over 50% of the organisation’s carbon footprint. It is also the most significant financial consideration, with money spent on operating costs reducing the funding available for important community services.

The federal government’s Community Energy Efficiency Program (CEEP) provided a funding catalyst to enable UCC and BC to allocate highly prized capital funding towards energy efficiency, and to retrofit works that would not have otherwise been afforded.

Sustainability strategy implemented
  • Energy audits conducted, identifying energy saving opportunities. Energy efficiency activities were subsequently completed in 27 sites, including:
    • general electrical (lighting upgrades, lighting controls, de-lamping);
    • HVAC (split system air-conditioning upgrades, ceiling fans, ceiling insulation);
    • management controls (remote metering, chilled water timers, general appliance timers, time delay switches, zip boiler timers);
    • water systems (heat pump hot water system upgrades, efficient shower heads, pool pump timer).
  • Energy efficiency workshops for staff and volunteers.
  • Marketing and communications were distributed across UCC and BC’s state-wide network. Sparky the energy-saving icon was created as an identifying mascot to theme all communication resources.
Progress achieved
  • Total energy saving across all sites: 37%.
  • Cost savings: $99,000 in 2015 for UCC and BC. Average cost saving per site retrofitted is $3700 per year, with 13 sites producing savings greater than this.
  • Energy consumption savings: 124,069 kWh or 100 tonnes CO2. Average energy efficiency improvement (MJ/m2) of 39% per site.

Environmentally friendly cups. Image credit: ©Uniting Care Queensland

Members of the team learning about the new program. Image credit: ©Uniting Care Queensland

Case Study 4

SCC Marsfield energy efficiency works

Southern Cross Care (NSW & ACT)

About Southern Cross Care

Southern Cross Care NSW & ACT (SCC) is a not-for-profit quality aged-care service provider in 41 locations across New South Wales and the Australian Capital Territory, comprising home care services, retirement living and residential aged-care homes. SCC has over 1500 residential aged-care beds and 900 retirement living units.

Aged-care service goal
  • Reduce energy costs.
  • Reduce carbon dioxide emissions.
The issue

Following 12 months of monitoring electricity usage at its Southern Cross Marsfield Apartments, SCC commissioned an energy audit on the apartments, finding they used much more electricity than other aged-care facilities of a similar bed range in NSW and ACT (although gas usage was reasonable).

Sustainability strategy implemented

The audit found that SCC was being charged for double-metering, where the aged-care facility was being billed for both the electricity used by the facility and the independent living units. This earned SCC a significant refund of around $50,000 from its electricity service provider, Ausgrid.

Electricity saving measures were also implemented, including:

  • replacing fluorescent tubes and compact fluorescent lights with low-wattage LEDs;
  • installing movement sensors for the heat lamps in the ensuites, and for lights in store rooms;
  • amending the air-conditioners’ temperature set points to 22 degrees in winter and 24 degrees in summer;
  • staff engagement and education program implemented, including incentives to reward staff for the savings.
Progress achieved
  • Financial benefits: $21,400 per annum saved on electricity costs.
  • Environmental benefit: 230,000 kWh saved per annum and greenhouse gas emissions reduced approximately 150,000 kg of CO2 per annum.

New energy-efficient lighting rolled out across the centre. Image credits: ©Mark Garden

Case Study 5

Mater North Sydney room service

Mater Hospital


About Mater Hospital:

The Mater Hospital is a world-class facility operating 233 hospital beds, providing the highest level of care across core specialties including obstetrics; orthopaedics; heart, lung and vascular medicine; cancer care and surgery; ear, nose and throat surgery; urology; endocrine surgery and neurosurgery services. The Mater Hospital is part of St Vincent’s Health Australia (SVHA), the nation’s largest Catholic not-for-profit health and aged-care provider.

Hotel-style room service goals:
  • Reduce food wastage.
  • Improve the patient experience.
  • Provide a market differentiator.
  • Provide a sustainable economically viable food delivery model that could drive synergies through standardisation across SVHA private hospitals.
The issue:

The existing traditional trayline food service delivery models used across SVHA private hospitals was not sustainable due to high cost and high wastage. With national and international review of food service delivery models, room service was highlighted as aligning closest to the organisation’s strategy with regard to patient-centred care and sustainability.

Sustainability strategy implemented:

The hotel-style food delivery model provides flexibility for patients to order to appetite when it suits them. Meals can be ordered around physiotherapy sessions, sleep or visitors, are cooked fresh to order and are delivered within 45 minutes. In hospitals where patients experience a loss of control, this model empowers the patient — placing them in control of what, how much and when they want to eat, improving their intake and reducing waste.

Achievements to date include:
  • improved patient experience with Press Ganey meal quality up by 29%;
  • reduced food costs — 30% reduction in food purchases;
  • plate wastage reduced by 40%, resulting in 44,000 kg less waste in 3-month period;
  • waste removal cost savings of $41,000 per annum.

Examples of good food layout and quality meals provided by The Mater. Image credit: ©The Mater Hospital


Four of the organisations represented in these case studies are members of the Global Green and Healthy Hospitals network. The case studies serve to celebrate GGHH members’ work and document what they have achieved.

About Global Green and Healthy Hospitals

GGHH is an international network of hospitals, healthcare facilities, health systems and health organisations dedicated to reducing their environmental footprint and promoting public and environmental health.

The Global Green and Healthy Hospitals network is a free network which has more than 900 members in 49 countries on six continents who represent the interests of over 28,000 hospitals and health centres. Their members use innovation, ingenuity and investment to transform the health sector and foster a healthy, sustainable future.

GGHH is a project of Health Care Without Harm. The Climate and Health Alliance, as HCWH’s strategic partner, coordinates the GGHH network in Australia and New Zealand.

For more information about GGHH, contact or visit

About Health Care Without Harm

HCWH works to transform health care worldwide so that it reduces its environmental footprint, becomes a community anchor for sustainability and a leader in the global movement for environmental health and justice.

HCWH’s vision is that health care mobilises its ethical, economic and political influence to create an ecologically sustainable, equitable and healthy world.

For more information about HCWH, visit

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