The role of environmental impact assessments in hospital care: Healthcare professionals' views on research and implementation priorities.

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.