Short answer

Integrate comprehensive sustainability strategies, including renewable energy, water conservation, and waste management, into the design and operational plans of healthcare facilities, moving beyond sporadic implementation.

Field
Sustainability
Source
International Journal of Environmental Research and Public Health (2025)
Method
Mixed-method (scoping literature review followed by a structured survey)
Sample
18 healthcare facilities
Evidence
Moderate effect

Despite growing awareness of environmental issues, acute care hospitals in the Italian regional health system show significant gaps in the adoption of key sustainability practices, indicating a disconnect between discourse and implementation. This sustainability research insight is drawn from a 2025 study published in International Journal of Environmental Research and Public Health. Using Mixed-method (scoping literature review followed by a structured survey) with 18 healthcare facilities, researchers explored how this design variable affects real-world outcomes. The key design takeaway: Integrate comprehensive sustainability strategies, including renewable energy, water conservation, and waste management, into the design and operational plans of healthcare facilities, moving beyond sporadic implementation.

Study
SustainabilityNew This WeekModerate effect

Hospital Sustainability Practices Lag Behind Environmental Awareness

Despite growing awareness of environmental issues, acute care hospitals in the Italian regional health system show significant gaps in the adoption of key sustainability practices, indicating a disconnect between discourse and implementation.

International Journal of Environmental Research and Public Health · 2025

01

Key Findings

  • 01Eight core environmental sustainability dimensions were identified: energy efficiency, resource and waste management, transportation and mobility, materials and construction, environmental compliance, emissions, site sustainability, and design strategies.
  • 02Key sustainability measures such as on-site renewable energy capacity, water reuse systems, environmental certification, and heat island mitigation practices are sporadically adopted.
  • 03Many surveyed facilities exhibit consumption levels exceeding established benchmarks.
  • 04There is a notable misalignment between academic discourse on sustainability and actual practices in the Italian regional context.
02

Application

Design takeaway

Integrate comprehensive sustainability strategies, including renewable energy, water conservation, and waste management, into the design and operational plans of healthcare facilities, moving beyond sporadic implementation.

How to apply

When designing or retrofitting healthcare facilities, conduct a thorough assessment of current resource consumption and waste generation, and benchmark against best practices identified in the literature. Prioritize the adoption of proven sustainability measures and advocate for supportive policies.

Project actions

  • 01When researching a design problem, look for studies that assess the current state of practice in a specific industry.
  • 02Consider how to measure and compare the environmental performance of different design solutions.
  • 03Think about the barriers to adopting sustainable practices and how design can help overcome them.
03

Method & Evidence

AimTo assess the current state of environmental sustainability adoption and performance within acute care hospitals in an Italian regional health system.
MethodMixed-method (scoping literature review followed by a structured survey)
ProcedureA literature review identified key dimensions of hospital environmental sustainability. A survey was then administered to hospitals in the Lombardy region of Italy to gather data on their environmental performance and strategy adoption based on these dimensions.
Sample18 healthcare facilities
ContextAcute care hospitals within an Italian regional health system (Lombardy Region)

Variables

IV["Adoption of specific environmental sustainability measures (e.g., renewable energy, water reuse, certifications)","Environmental performance indicators (e.g., consumption levels)"]
DV["Level of environmental sustainability adoption","Environmental performance"]
CV["Type of healthcare facility (acute care hospital)","Geographic region (Lombardy, Italy)","Time of survey (May-June 2024)"]
04

Strengths & Limitations

Strengths

  • +Addresses a critical and under-researched area of hospital sustainability.
  • +Uses a mixed-method approach combining literature review with empirical data collection.

Limitations

The survey only captured a snapshot in time and from one region, so it might not reflect long-term trends or practices in other areas. The data relies on what the hospitals reported, which might not always be perfectly accurate.

Reliability & validity

The reliability of the survey data depends on the accuracy of self-reported information. Validity could be enhanced by cross-referencing survey data with objective performance metrics where possible. The scoping review provides a basis for the dimensions, enhancing content validity.

Think critically

To what extent do the identified sustainability dimensions and observed practices in Italian hospitals reflect global trends, and what specific regional or cultural factors might explain the observed misalignment?

05

Design Principles

"Proactive integration of sustainability principles throughout the entire lifecycle of healthcare facilities is essential for mitigating environmental impact."

This research highlights a critical area for improvement in the design, management, and operation of healthcare facilities. Designers and engineers can leverage these findings to advocate for and implement more robust sustainable strategies, addressing resource consumption, waste, and emissions more effectively.

06

What This Means for Your Design

Hospitals are not as green as they could be, even though people are talking about it. They are missing out on using things like solar power or recycling water, and using more energy and resources than they should.

How to use in your project

  • 1.Use this study to justify the importance of sustainability in your design project, especially if it involves large facilities or resource-intensive operations.
  • 2.Cite the identified sustainability dimensions as a framework for your own research or design considerations.
07

Add to My Project

08

Quick Cite

Paragraph starter

This research highlights a significant gap between the discourse surrounding environmental sustainability and its practical implementation within acute care hospitals. The study found that despite awareness, key sustainability measures such as renewable energy adoption and waste management strategies are sporadically implemented, with many facilities exceeding benchmark consumption levels. This underscores the need for designers to actively integrate robust sustainability strategies into facility design and operational planning, addressing the identified disconnect between environmental awareness and actual practice.

09

Source

International Journal of Environmental Research and Public Health

Assessing Environmental Sustainability in Acute Care Hospitals: A Survey-Based Snapshot from an Italian Regional Health System

journal · 2025

View source

Questions About This Research

What does the research say about hospital sustainability practices lag behind environmental awareness?
Integrate comprehensive sustainability strategies, including renewable energy, water conservation, and waste management, into the design and operational plans of healthcare facilities, moving beyond sporadic implementation. Evidence: International Journal of Environmental Research and Public Health (2025).
Why does "Hospital Sustainability Practices Lag Behind Environmental Awareness" matter for design?
This research highlights a critical area for improvement in the design, management, and operation of healthcare facilities. Designers and engineers can leverage these findings to advocate for and implement more robust sustainable strategies, addressing resource consumption, waste, and emissions more effectively.
How can designers apply this research?
Integrate comprehensive sustainability strategies, including renewable energy, water conservation, and waste management, into the design and operational plans of healthcare facilities, moving beyond sporadic implementation.
What were the main findings?
Eight core environmental sustainability dimensions were identified: energy efficiency, resource and waste management, transportation and mobility, materials and construction, environmental compliance, emissions, site sustainability, and design strategies.. Key sustainability measures such as on-site renewable energy capacity, water reuse systems, environmental certification, and heat island mitigation practices are sporadically adopted.. Many surveyed facilities exhibit consumption levels exceeding established benchmarks.. There is a notable misalignment between academic discourse on sustainability and actual practices in the Italian regional context.
What research method was used?
Mixed-method (scoping literature review followed by a structured survey) with 18 healthcare facilities.
How strong is the evidence?
Evidence strength is rated Moderate effect, based on a 2025 journal from International Journal of Environmental Research and Public Health.
What should I do differently in my next project?
When designing or retrofitting healthcare facilities, conduct a thorough assessment of current resource consumption and waste generation, and benchmark against best practices identified in the literature. Prioritize the adoption of proven sustainability measures and advocate for supportive policies.
What are the limitations?
The study is a snapshot of one regional health system in Italy, and findings may not be generalizable to all healthcare settings globally. The survey-based method relies on self-reported data.