Circular practices in hospitals as a response to climate change: a system dynamics approach

Background

Despite growing recognition of the healthcare sector’s impact on climate change, so-called ‘circular’ practices are difficult to adopt sustainably. In hospitals, this includes adopting reusable over single-use medical consumables where feasible. Such a shift requires various changes in practices, regulations, and behavior. While these changes are studied individually, few studies examine their dynamic interactions and system drivers. This is important as changes rarely happen in isolation.

Methods

To explore the interactions and drivers of the adoption of reusable medical consumables where suitable over time, we create a system dynamics model that integrates behavior change theory, Rogers’ innovation-decision approach, medical consumable supply chains, and procurement criteria. To inform the model structure and validate assumptions, we draw on literature and interviews with representatives in Dutch hospitals.

Results

Given the model structure, the emerging simulation results show an S-shaped pattern in the adoption of circular practices in hospitals across many futures, with adoption never reaching 100%. First, the perceived relevance drives the perceived need for change of hospital management, leading to raising resources for education and research on circularity. More education raises preference and procurement of circular medical consumables, and thus their use. The increasing use drives staff’s preference. Yet, the growing use also reduces the perceived need for change, lowering resources and speed of adoption. Especially low initial support hinders a lasting change.

Conclusions

Overall, exploring the adoption of sustainable practices using system dynamics helps identify drivers of the transition to circular practices in hospitals. The preliminary results indicate that the adoption depends on the initial state and the ability to mobilize resources. Systematic efforts in education and research may drive a lasting adoption of circular practices.

Key messages

• A systems perspective is valuable to explore the adoption of sustainable practices in hospitals over time, including its interactions and system drivers.

• Long-lasting efforts of hospital management toward education and research may increase the sustainable adoption of circular practices.