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62Hospitals drive emissions through energy use, supply chains, and waste incineration.Audit and optimise energy efficiency in facilities. Pursue carbon neutrality and cut waste such as transport.Carbon emissions affect marine biodiversity loss.Cut fossil fuel reliance.Support ocean-friendly supply chains.Anaesthetic gases may contribute to ozone-damaging emissions,similar to CFCs.Switch to low-impact alternatives. Train staff on gas capture systems. Phase out high-GWP gases through policy advocacy and R&D for eco-friendly anaesthetics.Pharmaceuticals and disinfectants pollute waterways, harming aquatic life.Investigate green chemistry, drug take-back programs and develop biodegradable alternatives and advanced wastewater treatment.High water use in cooling, sanitation, and laundry, especially applicable in water-scarce areas.Efficiency upgrades. Install low-flow fixtures and recycle grey-water. Integrate rainwater harvesting and advocate for conservation policies.Hospital expansions and waste landfills encroach on natural lands, fragmenting habitats.Reduce waste to improve existing capacity utilisation. Prioritise brownfield redevelopment. Conduct environmental impact assessments for new builds.Promote compact, vertical designs and urban greening initiatives.Fertiliser runoff from food farms and nitrogen-rich waste contributing to eutrophication. Food waste triggering more production.Evaluate menus and procurement practices to source cleaner options. Source from low-impact agriculture and treat wastewater to remove nitrates. Phosphate-free cleaners.Reduce food waste.Pharmaceutical waste contaminating ecosystems, and supply chains driving habitat destruction.Sourcing from cleaner supply chains and waste management. Proper categorisation and disposal of hazardous waste. Partner with suppliers for biodiversity-friendly practices and reduce single-use plastics.Hospital operations release particulate matter, nitrous oxide, and sulphur oxide from energy generation and vehicle fleets, exacerbating respiratory issues.Adopt clean energy and zero-emission transport and fleets. Install air filters and integrate green building standards to minimise on-site pollution.The Meaning Of SustainabilityThe learning journey of sustainable transformation begins with education. Climate change has dominated agendas, but sustainabilit y is a complex and evolving topic, that extends beyond the effects of greenhouse gas emissions. True sustainability is both a social and environmental challenge, and Kate Raworth’s Doughnut Model in figure 4 provides a holistic framework to envision the multidimensional transition. The model describes both the environmental limits to respect and the social essentials Figure 4: Healthcare environmental examples and the Doughnut Model (Adapted from Raworth, 2017 and Heathcote, 2023)