A Review of the Applicability of Current Green Practices in Healthcare Facilities

Ana Luísa Ferreira Soares, Sandra C. Buttigieg, Bartosz Bak, Sonya McFadden, Ciara Hughes, Patricia McClure, Guilherme Couto, Isabel Bravo

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)
54 Downloads (Pure)


Background: Circular economy (CE) has raised great interest as a concept and as a development model worldwide. This concept aims to provide a substitute for the linear economic model, which was based on production and consumption, continuous growth, and resources depletion. CE allows a greener economy with sustainable development and promotes more balanced societies. The healthcare sector is a major contributor to the climate crisis, with a carbon footprint representing 4.4% of global net emissions. It is thus essential to rethink the applicability of CE in healthcare. Methods: We conducted a scoping review guided by the Arksey and O’Malley methodological framework and utilised PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist. A systematic search from MEDLINE complete, SCOPUS, and Web of Science databases published between 1992 and 2022. Results: Through database searching a total of 1018 records were identified and 475 duplicates were removed. From the total search, 543 articles were screened by title/abstract according to the inclusion and exclusion criteria. After screening, 38 full-text articles were selected and assessed for eligibility. Forty-seven additional records were also identified through other sources and screened for eligibility. Other sources included: 12 articles from snowballing of previous papers; 9 articles following peer-reviewers suggestions; 19 reports from relevant organisations in CE and healthcare; two webpage, and one book. Conclusion: Specific areas were identified where hospitals could reduce their greenhouse gas (GHG) emissions and consequently their negative environmental impact, namely through waste management, energy, water, transportation/travel, hospital design, food optimisation, green procurement, and behaviour. Also, lack of staff awareness and knowledge of the environmental impact of healthcare, and hospitals sustainability were identified as major contributors.
Original languageEnglish
Article number6947
Pages (from-to)1-15
Number of pages15
JournalInternational Journal of Health Policy and Management
Issue number1
Early online date6 Jun 2023
Publication statusPublished online - 6 Jun 2023

Bibliographical note

Publisher Copyright:
© 2023 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funding Information:
This work was co-funded by the SAFE EUROPE project under the Erasmus+ Sector Skill Alliances programme [grant agreement 2018e2993/001-001]. The European Commission support for the production of this publication does not constitute an endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.

Publisher Copyright:
© 2023, Kerman University of Medical Sciences. All rights reserved.


  • Circular Economy
  • Carbon Footprint
  • Healthcare Waste
  • Healthcare Management
  • Hospital Sustainability


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