L H J A Kouwenberg, A M Wijnhoven, E S Cohen, W J K Hehenkamp, N H Sperna Weiland, D S Kringos
{"title":"The role of environmental impact assessments in hospital care: Healthcare professionals' views on research and implementation priorities.","authors":"L H J A Kouwenberg, A M Wijnhoven, E S Cohen, W J K Hehenkamp, N H Sperna Weiland, D S Kringos","doi":"10.1186/s12961-025-01386-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The crossing of planetary boundaries, such as climate change and biosphere integrity, threatens human health, while healthcare systems paradoxically contribute substantially to these environmental challenges. Although research on the environmental impact of care activities and pathways is expanding, it remains unclear how this information is used in clinical practice. This study explores healthcare professionals' views on the environmental impact of hospital care, the role of environmental impact data and research and implementation priorities to support sustainability in clinical practice.</p><p><strong>Methods: </strong>Semi-structured focus groups and interviews were conducted between April and July 2024 with 31 Dutch healthcare professionals working across 12 medical (hospital) specialities with the highest care volumes and expenditures. Participants were selected on the basis of their involvement or interest in green healthcare initiatives. Focus groups and interviews were transcribed verbatim and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Participants have a general sense of environmentally impactful care activities, including surgical procedures, medication and outpatient visits. However, they reported a lack of quantitative environmental impact data at the clinical level, limiting their ability to make informed, sustainable choices. While participants recognized multiple uses for environmental impact data and supported integrating sustainability considerations into healthcare decision-making, they emphasized the need to balance these factors with other priorities, such as clinical effectiveness, patient safety and costs. Several research gaps were identified, including the need for comparative pathway analyses and standardized metrics. Additionally, implementation priorities, such as focusing on high-volume care, leveraging healthcare co-benefits and driving systemic changes to overcome barriers in the sustainability transition, were defined.</p><p><strong>Conclusions: </strong>Healthcare professionals lack the quantitative data needed for sustainable healthcare decision-making. Targeted research and implementation efforts should focus on high-impact, modifiable care. These findings may support better alignment between environmental research and clinical priorities, thereby informing evidence-based sustainability efforts in hospital care.</p>","PeriodicalId":12870,"journal":{"name":"Health Research Policy and Systems","volume":"23 1","pages":"116"},"PeriodicalIF":3.2000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465600/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Research Policy and Systems","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12961-025-01386-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The crossing of planetary boundaries, such as climate change and biosphere integrity, threatens human health, while healthcare systems paradoxically contribute substantially to these environmental challenges. Although research on the environmental impact of care activities and pathways is expanding, it remains unclear how this information is used in clinical practice. This study explores healthcare professionals' views on the environmental impact of hospital care, the role of environmental impact data and research and implementation priorities to support sustainability in clinical practice.
Methods: Semi-structured focus groups and interviews were conducted between April and July 2024 with 31 Dutch healthcare professionals working across 12 medical (hospital) specialities with the highest care volumes and expenditures. Participants were selected on the basis of their involvement or interest in green healthcare initiatives. Focus groups and interviews were transcribed verbatim and analysed using reflexive thematic analysis.
Results: Participants have a general sense of environmentally impactful care activities, including surgical procedures, medication and outpatient visits. However, they reported a lack of quantitative environmental impact data at the clinical level, limiting their ability to make informed, sustainable choices. While participants recognized multiple uses for environmental impact data and supported integrating sustainability considerations into healthcare decision-making, they emphasized the need to balance these factors with other priorities, such as clinical effectiveness, patient safety and costs. Several research gaps were identified, including the need for comparative pathway analyses and standardized metrics. Additionally, implementation priorities, such as focusing on high-volume care, leveraging healthcare co-benefits and driving systemic changes to overcome barriers in the sustainability transition, were defined.
Conclusions: Healthcare professionals lack the quantitative data needed for sustainable healthcare decision-making. Targeted research and implementation efforts should focus on high-impact, modifiable care. These findings may support better alignment between environmental research and clinical priorities, thereby informing evidence-based sustainability efforts in hospital care.
期刊介绍：
Health Research Policy and Systems is an Open Access, peer-reviewed, online journal that aims to provide a platform for the global research community to share their views, findings, insights and successes. Health Research Policy and Systems considers manuscripts that investigate the role of evidence-based health policy and health research systems in ensuring the efficient utilization and application of knowledge to improve health and health equity, especially in developing countries. Research is the foundation for improvements in public health. The problem is that people involved in different areas of research, together with managers and administrators in charge of research entities, do not communicate sufficiently with each other.
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