The purpose of this study was to describe a new method to effectively improve the environmental impact of operating rooms through a systematic approach. A proven successful prospective risk... Show moreThe purpose of this study was to describe a new method to effectively improve the environmental impact of operating rooms through a systematic approach. A proven successful prospective risk analysis tool to improve the safety of complex healthcare processes (Healthcare Failure Mode and Effect Analysis) was adapted to reduce the environmental impact of surgical waste. For this novel method, named the Healthcare Sustainability Mode and Effect Analysis (HSMEA), a multidisciplinary team, using a structured step-by-step approach, systematically inventories surgical waste, quantifies its environmental impacts, identifies hotspots, and provides solutions for improvement. The five steps of the HSMEA are described (definition of the topic, team assembly, flowchart creation, hazard analysis, actions and outcome measures) and the surgical procedure of a caesarean section was used as a case study to assess the applicability of this method to improve its environmental impact. Applying the HSMEA to caesarean sections resulted in a 22% volume reduction and a 22% carbon footprint reduction in surgical waste. This was achieved by revising the disposable custom pack in order to reduce the overage that was present, and by intensifying waste stream segregation for plastic and paper recycling. The HSMEA is a practical work floor tool to aid in the reduction of the environmental impact of surgical waste that is applicable to all types of operations. It is reproducible, and because it identifies carbon hotspots, it enables an efficient approach to the issue of operating room pollution. Show less
Zhang, C.; Hu, M.; Laclau, B.; Garnesson, T.; Yang, X.; Li, C.; Tukker, A. 2020
Around 35% of the buildings in Europe are over 50 years old and almost 75% of the building stock is energy-inefficient. A European project VEEP is developing an innovative prefabricated concrete... Show moreAround 35% of the buildings in Europe are over 50 years old and almost 75% of the building stock is energy-inefficient. A European project VEEP is developing an innovative prefabricated concrete element (PCE) system to improve the thermal performance of new buildings (PCE1) and old buildings (PCE2). This study focused on retrofitting of old buildings via over-cladding of the building envelope with PCE2. This study aims to from a building owner/consumer’s perspective to explore the life cycle economic performance of the PCE2 system at an early stage and associated cost optimization strategies under the European context. This study tries to answer four questions: 1) whether the use of the PCE2 leads to an economic advantage over a specific life cycle of an existing building. 2) what is the biggest cost stressor in the life cycle of a PCE2? 3) the potential route for further cost optimization. and 4) how would the discount rate affect the life cycle costs, especially when Europe has entered a negative rate age? A typical apartment building in the Netherlands is selected as the case study for dynamic thermal simulation, in which the heating and cooling energy demands before and after refurbishment with PCE2 will be evaluated. By employing environmental life cycle costing (LCC), the life cycle costs over 40 years and associated strategy for cost optimization will be investigated. This research not only unveils meaningful financial implications on resource-efficient building energy retrofitting in Europe but also provides insight on methodological dilemmas within the application of LCC. Show less
