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It seems just a moment ago hospitals were struggling with pandemic-related problems, intensive care units were stretched to the limit, and organizational challenges on an unprecedented scale had to be overcome, not to mention doctors and nurses were at the edge of their physical and mental limits.

And now it is "post-covid symptoms" such as slow financial recovery, urgently needed digitization, the struggle for skilled workers and, last but not least, exorbitantly increased energy costs that are pushing the hospitals’ backs against the economic wall.

Is it really a "mandate" for our industry?

Yes, it’s precisely these times that make sustainable action urgently necessary. Because quite incidentally, our planet has long since reached the limit of its carrying capacity!

Within the Sustainability Development Goals defined by the United Nation 1), Healthcare, unlike any other industry, has sustainability at its very core. Everything healthcare does directly relates to goal 3 “Ensure healthy lives and promote well-being for all at all ages”. Additionally Healthcare has a dual responsibility as every healthcare facility is a place of healing, but at the same time healthcare contributes to the burden of diseases due to large share in climate change.

The health sector contributes more than 4 % to the global CO2 footprint 2), hospitals are major consumers of resources and major producers of waste. On average, about 6 kg. of waste is produced per patient per day in hospitals. Operating theatres are particularly emission- and waste-intensive units. In some hospitals, anesthetic gases cause up to one third of surgical procedure’s carbon footprint. Inhaled anesthetics account for 5% of acute Hospital CO2 equivalent emissions3). This isn’t surprising when one considers that, depending on the anesthetic gas used, one operating theatre hour is equivalent to a CO2 emission of up to 200-400km car journey 4).

Therefore, sustainability can no longer be considered a "nice to have". It is high time to make every effort to create transparency about the company's own CO2 footprint, to minimize waste and food waste, to critically assess purchasing strategies and supply chains with regard to the CO2 footprint, to reduce water consumption, to minimize waste water pollution, to make buildings climate-friendly, to use suitable areas for solar systems and to think about how patients, visitors and staff can get from home to the clinic and back in a climate-neutral way.

Last but not least, it’s also important to deal with the social aspects of sustainability, to ensure human rights and equality in the supply chains around the globe, and to establish a culture in one's own clinic to ensure the clinic's internal and external staff are treated fairly, irrespective of gender, origin, race, or religion,  and the risks of everyday clinical work are minimized. After all, health care workers are exposed to a variety of hazards in addition to the enormous workload, such as injuries from scalpels, risk of infections, exposure to chemicals and medicines, allergies and, unfortunately, violence by patients and relatives.

Of course, the issue of sustainability is not completely new. Hospitals have always had to deal with the disposal of hazardous, infectious, and radiological waste. And more than a decade ago the climate-damaging effect of anesthetic gases was already being addressed 5).

Legal requirements are forcing action

However, only now are further legal requirements being added that extend into the balance sheet and not only affect large hospitals, but must also be fulfilled by smaller hospitals. Sustainability-relevant key figures are finding their way into the legally prescribed reporting and so starting with 2024 data as the basis, the Corporate Sustainability Reporting Directive (CSRD) will be obligatory for almost all hospitals in the EU from 2025 onwards, except for very small hospitals.

In Germany, the Supply Chain Due Diligence Act has to be fulfilled by healthcare providers with more than 3000 employees since January 1, 2023, and will also be required from 2024 by hospitals with more than 1000 employees. Over 15 countries across Europe, Asia and North America have already instituted supply chain transparency legislation, and an EU Mandatory Due Diligence Directive is on the horizon.

SAP last year published the result of a first orienting pulse check 6) of healthcare providers. According to that survey, 46% of respondents say the increasing number of reporting requirements is urging them to improve insights across financial and non-financial data.

So, not least for legal reasons, transparency must be created and it’s necessary to address how key figures can be determined and whether the data basis is sufficient. Ideally, data can be obtained from current business processes and are available in digital form for further processing. The reality is that most hospitals are currently far from this goal.

What is SAP Doing to Help?

The first step is to know where you stand as a clinic. Based on this, the areas in which there is the greatest need for action are to be identified, be it conversion measures, process redesigns or organizational changes.

SAP offers a wide range of solutions for sustainability-related needs. These are divided into 4 major areas:

  • Holistic Steering and Reporting connects environmental, social and financial value in a holistic view

  • Climate Action with the goal of zero emissions

  • Circular Economy with the goal of zero waste

  • Social Responsibility with the goal of zero inequality.

Find the complete SAP solution portfolio here. And together with our partner ecosystem we serve an even wider range of healthcare-specific needs.


The topic of sustainability must be a core component of a healthcare provider's strategy, and it must be integrated into the core processes of a hospital, its supply chains, and networks. And it can’t wait for the next quarter, or the next fiscal year. First there is an obligation, means legal requirements, secondly there is a social aspect, means how much is a hospital willing to do, and thirdly there is a commercial aspect, means cost savings and also commercial benefits longterm.

There are already a number of hospitals and hospital chains around the world that have taken up the cause of sustainability and are leading the way. And fortunately, a process of learning from others is taking place. For example, the Global Green and Healthy Hospital Network, which promotes a healthy and sustainable future for the health sector, already has 1,650 members in more than 75 countries 7).

The time to act is now. Only if we start serious, continuous sustainability efforts from now on, we may still be able to save Patient Earth - even though she will most likely remain a chronic patient.


1) UN Sustainability Development Goals ||

2) World Economic Forum: Here’s how healthcare can reduce its carbon footprint ||

3) American Society of Anesthesiologists: Reduce Carbon Footprint form Inhaled Anesthesia with New Guidance Published ||

4) Royal College of Anaesthetists: Your anaesthetic and the environment ||

5) National Library of Medicine: Environmental Implications of Anesthetic Gases ||

6) SAP Puls-Check Sustainabiliy in Healthcare ||

7) Global Green and Healthy Hospitals ||
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