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LIFE Project Number
LIFE12 ENV/ES/000124
FINAL Report Covering the project activities from 01/07/2013 to 30/06/2016
Reporting Date
30/09/2016
LIFE+ PROJECT NAME or Acronym
BOHEALTH
Project Data
Project location Spain
Project start date: 01/07/2013
Project end date: 30/06/2016 Extension date: n/a
Total Project duration
(in months) 36 months (including Extension of 0 months)
Total budget 1,017,355 €
Total eligible budget 1,017,355 €
EU contribution: 488,942 €
(%) of total costs 48 %
(%) of eligible costs 48 %
Beneficiary Data
Name Beneficiary FUNDACIO HOSPITAL SANT PAU I SANTA TECLA
Contact person Mr. Jordi Cañellas
Postal address Joan Maragall, 1, ES, 43003, Tarragona
Visit address Joan Maragall, 1, ES, 43003, Tarragona
Telephone +34 977 248536
Fax: +34 977 248537
E-mail [email protected]
Project Website www.bohealth.eu
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 2 of 89
1. List of contents
1. List of contents ................................................................................................................... 2
Lists of key-words and abbreviations ......................................................................................... 4 Lists of Tables ............................................................................................................................ 4 List of Figures ............................................................................................................................ 4 2. Executive Summary ........................................................................................................... 6
2.1. Project Objectives ........................................................................................................ 6
2.2. Key Deliverables and Outputs ..................................................................................... 7 2.3. Report Chapters ........................................................................................................... 9
3. Introduction ...................................................................................................................... 11
3.1. Description of background, problem and objectives ................................................. 11 3.2. Expected long term results ........................................................................................ 11
4. Administrative part ........................................................................................................... 12 4.1. Description of the management system ..................................................................... 12
4.1.1. Description and schematic presentation of working method ............................. 12
4.1.2. Presentation of the coordinating beneficiary, associated beneficiaries and project
organisation ...................................................................................................................... 13 4.1.3. Description of changes due to amendments to the Grant Agreement ................ 16 4.1.4. Submission of the Partnership Agreement ......................................................... 16
4.2. Evaluation of the management system ...................................................................... 16 4.2.1. Project management process .............................................................................. 16
4.2.2. Communication with the Commission and Monitoring team ............................ 16 5. Technical part ................................................................................................................... 17
5.1. Technical progress, per task ...................................................................................... 17 5.1.1. Action A.1.- Definition of the most appropriated “KEPIs" ............................... 18 5.1.2. Action A.2.- Review of BATs and best practices .............................................. 21
5.1.3. Action B.1.- Tailored decision making process for Healthcare centres ............. 23 5.1.4. Action B.2.- Integrated web-based application to support the decision process 29
5.1.5. Action B.3.- Approach & web application implementation in two centres ....... 36 5.1.6. Action B.4.- Definition and implementation of “Environmental Action Plans” 41 5.1.7. Action C.1.- Monitoring of project impact after Action Plans implementation 46 5.1.8. Action C.2.- Assessment of the socio-economic impact of the project ............. 51
5.1.9. Action E.2.- Networking with other projects ..................................................... 55 5.1.10. Action E.3.- After-LIFE Communication Plan .............................................. 59
5.1.11. Action E.4.- Audit .......................................................................................... 61 5.2. Dissemination actions ................................................................................................ 62
5.2.1. Objectives ........................................................................................................... 62 5.2.2. Dissemination: overview per activity ................................................................. 62 5.2.3. Action D.1.- Project website, including web 2.0 communication channels ....... 62
5.2.4. Action D.2.- LIFE+ information boards and other printed material .................. 66 5.2.5. Action D.3.- Layman’s report ............................................................................ 69 5.2.6. Action D.4.- Workshops with other Healthcare institutions and employees ..... 70 5.2.7. Action D.5. - Papers and oral presentations ....................................................... 75
5.3. Evaluation of Project Implemention .......................................................................... 78 5.3.1. Methodology ...................................................................................................... 78 5.3.2. Results ................................................................................................................ 78
5.3.3. Project amendment ............................................................................................. 82 5.3.4. Effectiveness of the dissemination ..................................................................... 83
5.4. Analysis of long-term benefits .................................................................................. 83
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 3 of 89
5.4.1. Environmental benefits ...................................................................................... 83 5.4.2. Long-term benefits and sustainability ................................................................ 85 5.4.3. Replicability, demonstration, transferability, cooperation: ................................ 87 5.4.4. Best Practice lessons: ......................................................................................... 88
5.4.5. Innovation and demonstration value: ................................................................. 88 5.4.6. Long term indicators of the project success: ...................................................... 89
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 4 of 89
Lists of key-words and abbreviations
BAT Best Available Techniques
EC European Commission
EMAS Environmental Management and Audit Scheme
FHSPST Fundació Hospital Sant Pau i Santa Tecla
ICT Information and Communication Technologies
HVAC Heat Ventilation Air Conditioning
KEPI Key Environmental Performance Indicator
LCA Life Cycle Assessment
LCC Life Cycle Costing
LEITAT Leitat Technological Centre
PDCA Plan-Do-Check-Act
Xarxa Xarxa Sanitaria i Social Santa Tecla, AIE
Lists of Tables Table 1.- List of Actions, responsible and Status ....................................................................... 7 Table 2.- List of Deliverables and Status ................................................................................... 8 Table 3.- List of Milestones and Status ...................................................................................... 8
Table 4.- List of Reports and Status ........................................................................................... 9 Table 5.- List of partners and main roles ................................................................................. 13
Table 6.- List of meetings ........................................................................................................ 14 Table 7.- List of Actions and planning ..................................................................................... 17
Table 8.- List of meetings held with healthcare centres and organisations .............................. 24 Table 9.- List of selected health care centres for the implementation ...................................... 36
Table 10.- List of Action Plans for each Centre ....................................................................... 43 Table 11.- Estimations and results for the extrapolation of the case studies ........................... 48 Table 12.-Global economic impact of BOHEALTH at Hospital del Vendrell ........................ 52
Table 13.-Total eco-costs avoided at Hospital del Vendrell .................................................... 52 Table 14.-Global economic impact of BOHEALTH implementation at Centre de Llevant .... 52 Table 15.-Total eco-costs avoided at Centre de Llevant .......................................................... 53
Table 16.-Stakeholder of BOHEALTH project and the impacts ............................................. 53
Table 17.- Most relevant contacts for Networking .................................................................. 56
Table 18.- Summary of common activities during Networking ............................................... 57 Table 19.- Summary of BOHEALTH publications ................................................................. 77
Table 20.- Assessment of the results against the Objectives .................................................... 81 Table 21.- Indication of visibility of the results achieved until date ........................................ 82 Table 22.- Indication of visibility of the results achieved until date ........................................ 83
List of Figures Figure 1.- Gantt Diagram of the project ................................................................................... 12
Figure 2.- Organisation Chart of the project ............................................................................ 14 Figure 3.- Contribution of each item considered to the environmental impact (CML 2001) .. 19 Figure 4.- Contribution of the energy consumption to the environmental impact ................... 19 Figure 5.- Example of descriptive sheets for selected BATs ................................................... 22
Figure 6.- Decision-making process scheme ............................................................................ 23 Figure 7.- Results of the survey related on relevant environmental aspects for each service .. 25
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 5 of 89
Figure 8.- Scheme for the allocation of environmental aspects to each section ...................... 26 Figure 9.- Example of criteria for environmental aspects prioritisation .................................. 27 Figure 10.- Diagram flow of the web-based application .......................................................... 30 Figure 11.- Screenshot of the entry page of the web-based application .................................. 30
Figure 12.- Screenshot of the assessment module of the web-based application .................... 31 Figure 13.- Screenshot of the environmental aspects prioritisation ......................................... 32 Figure 14.- Screenshots of the results presentation .................................................................. 32 Figure 15.- Screenshot of the module Action Plan definition and monitoring ........................ 33 Figure 16.- Screenshot of the "Comparison" module ............................................................... 33
Figure 17.- Example of pdf report generated by the tool ......................................................... 34 Figure 18.- Global Results. Assessment of Centre de Llevant (electricity) ............................. 38
Figure 19.- Prioritisation of environmental aspects (Centre de Llevant) ................................. 38 Figure 20.- Prioritisation of best practices (Centre de Llevant) ............................................... 39 Figure 21.- Example of implemented action (Hospital de Vendrell) ....................................... 44 Figure 22.- Example of action monitoring (Hospital del Vendrell) ......................................... 47 Figure 23.-Quantity of CO2 eq. avoided at Hospital del Vendrell ............................................. 48
Figure 24.-Quantity of CO2 eq. avoided at Centre de Llevant ................................................... 49 Figure 25.- Screenshots of the projects with Networking activities......................................... 57 Figure 26.-Structure of the private area in the website ............................................................ 63 Figure 27.- Number of visits and users of the project website ................................................. 63
Figure 28.- Printed material. Information board an 1st Leaflet ............................................... 67 Figure 29.- BOHEALTH Layman's report ............................................................................... 69
Figure 30.- BOHEALTH Final Conference ............................................................................. 72
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 6 of 89
2. Executive Summary
2.1. Project Objectives
The main objective of the project has been to reduce the environmental impact associated
to the health sector (e.g. to hospitals activity) by facilitating the decision making process
of the management when decides, implements and monitors "Environmental Improvement
Action Plans".
The second objective has been to support this decision-making process by developing an
easy-to-use tool, tailored for the Health sector, which includes all the needed information
and calculation methods to support this process (e.g. questionnaires, etc.). This web-based
tool has been optimised to reduce as much as possible the time and resources needed to
obtain clear and useful results.
The third objective has been to demonstrate the usefulness of the proposed approach by
implementing it in two health care centres. This implementation allows the organisation to
progressively reduce their environmental impacts, in a continuous improvement process
(following the main objective of the project).
The proposed approach has been able to achieve these objectives,:
Analyse and quantify the environmental and economic impact of different inputs
and outputs associated to the organisation (i.e. environmental aspects), prioritising
these aspects according to their relevance.
Identify the “key environmental performance indicators” (KEPIs) and “functional
units” which best fit with Health sector characteristics, in order to monitor and
control these environmental aspects.
Identify the Best Available Techniques (BATs) that can be applied to reduce these
environmental aspects (including technical, environmental and economic
perspective), and prioritise them following environmental and economic criteria.
Support the definition and monitoring of “Sustainable Action Plans” to be applied
to each centre, taking into account the previous information.
Allow a clear and quantitative comparison between the initial and improved
situation (i.e. after action plan implementation), from an economic and
environmental view point.
The environmental aspects considered include resource consumption (i.e. water); energy
consumption (i.e. electricity and fuels) and waste generation (i.e. hazardous and non-
hazardous).
To achieve these objectives, the following actions have been developed (see Table 1 that
summarises the actions and their status):
Action Leader Status
A.1.- Definition of the most appropriated “KPIS” LEITAT Done
A.2.- Review of BATs and best practices LEITAT Done
B.1.- Tailored decision making process for Healthcare centres SIMPPLE Done
B.2.- Integrated web-based application to support decision process SIMPPLE Done
B.3.- Process and web application implementation in two healthcare
centres
FHSPST Done
B.4.- Definition and implementation of “Environmental Action Plans” FHSPST Done
C.1.- Monitoring of the project impact after Enviro. Action Plans
implementation
FHSPST Done
C.2.- Assessment of the socio-economic impact of the project LEITAT Done
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 7 of 89
Action Leader Status
D.1.- Project website, including web 2.0 communication channels LEITAT Done
D.2.- LIFE+ information boards and other printed material (e.g. flyers) LEITAT Done
D.3.- Layman's report LEITAT Done
D.4.- Workshops with other Healthcare institutions and employees FHSPST Done
D.5.- Papers and oral presentations SIMPPLE Done
E.1.- Project Management and monitoring (Overall project operation) FHSPST
Xarxa
Done
E.2.- Networking with other projects SIMPPLE Done
E.3.- After-LIFE Communication Plan LEITAT Done
E.4.- Audit Xarxa Done
Table 1.- List of Actions, responsible and Status
2.2. Key Deliverables and Outputs
The main results of the project have been the following:
Practical and tailored methodology to facilitate the decision-making process when
defining the most appropriated “Sustainable Action Plans” in each hospital or
healthcare centre, taking into account its specific characteristics.
This methodology is based on three main pillars:
o Allocation of the general environmental aspects (e.g. total energy consumption,
etc.) to each service or section (e.g. operating theatres, etc.) and use (e.g. lighting,
heating, etc.). In order to carry out this allocation, specific algorithms,
simplifications and default data have been developed and included in the
methodology (see more detail in the Technical part).
o Prioritisation of the identified environmental aspects based on ISO 14.001 or
EMAS (i.e. definition of criteria for magnitude, significance, etc.).
o Prioritisation of the best practices to be applied based on economic and
environmental criteria.
A web-based tool, which includes the needed modules to implement this
methodology in healthcare organisations with different profiles (e.g. different size,
offered services, etc.). This web-based tool has been designed to facilitate its use and
understanding by users with different level of experience on environmental
management.
Direct contacts with stakeholders (e.g. other healthcare organisations,
administration, etc.) to involve them in the development of the methodology and web-
based tool and obtain their feedback and recommendations
Practical application of the proposed approach and the web-based tool in two
healthcare centres to test their viability and monitoring of the real savings that can be
achieved if the selected Sustainable Actions are implemented.
Some stakeholders have also tested the web-based tool in some of their centres.
The list of project deliverables and their status are summarised in the Table 2.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 8 of 89
Name of the Deliverable Action Deadline Responsible Status
D1.- Project website (with Internal
Area)
D1 01/10/2013 LEITAT Done (to be
updated after
project ending)
D2.- Dissemination printed
material
D2 01/10/2013 LEITAT Done
D3.- Report on proposed KEPIs
and functional units
A1 01/01/2014 LEITAT Done
D4.- Report on BATs and best
practices
A2 01/02/2014 LEITAT Done
D5.- Report on proposed decision-
making process
B1 01/06/2014 SIMPPLE Done
D6.- Demo version of the web-
based application
B2 01/06/2015 SIMPPLE Done
D7.- Report on action plans
implementation
B4 01/09/2015 FHSPST Done
D8.- Report on project impact
monitoring
C1/
C2
01/06/2016 FHSPST
LEITAT
Done
D9.- Layman's Report D3 15/06/2016 LEITAT Done
D10.- After-LIFE Communication
Plan
E3 15/06/2016 LEITAT Done
D11.- Audit Report E4 30/09/2016 FHSPST Done
D12.- Communication Plan1 Dn 01/04/2014 LEITAT Done (updated at
the end of the
project)
Table 2.- List of Deliverables and Status
The list of project milestones and their status are summarised in the Table 3.
Name of the Milestone Action Deadline Responsible Status
M1.- Consortium Agreement E1 01/10/2013 FHSPST Done
M2.- Proposal for KEPIs and functional
units
A1 01/12/2013 LEITAT Done
M3.- BATs and best practices
identification
A2 01/01/2014 LEITAT Done
M4.- Decision-making process definition B1 01/05/2014 SIMPPLE Done
M5.- Alpha version of the web application B2 01/08/2014 SIMPPLE Done
M6.- Beta version of the web application B2 01/01/2015 SIMPPLE Done
M7.- Final & Demo version of the web
application
B2 01/06/2015 SIMPPLE Done
M8.- Action Plans definition and
implementation
B4 01/08/2015 FHSPST Done
M9.- Assessment of the project impact C2 01/05/2016 LEITAT Done
M10.- Final Conference at National level D4 01/06/2016
(24/05/2016)
LEITAT Done
Table 3.- List of Milestones and Status
The list of project reports and their status are summarised in the Table 4.
1 Note: This report was not included in the original proposal. However, it is considered that it would be very
useful to update and summarize in a document all the dissemination activities developed during project duration
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 9 of 89
Type of Report Deadline Status
Inception Report 01/04/2014 Submitted on time
Midterm Report 01/03/2015
(1/05/2015)
Some delay due to Technical
coordinator illness
Final Report 30/09/2016 This document
Table 4.- List of Reports and Status
2.3. Report Chapters
This Final Report, covering the overall period from 1/07/2013 to 30/06/2016 (36 months),
is divided in the following chapters:
Chapter 1.- List of contents.
Chapter 2.- Executive Summary.- It describes the project objectives, results and
deliverables. In summary the project has achieved their objectives by developing a
methodology and web-based tool to support environmental decision-making process in
the healthcare sector, and by implementing, testing and validating them in two
healthcare centres. Also the real and potential benefits that can be achieved by the
implementation of the proposed action plans have been defined, monitored and
quantified.
Chapter 3.- Introduction.- It describes the Environmental problem addressed (i.e. the
high use of resources, energy and waste generated in healthcare centres) and the
proposed solution: i.e. a methodology and web-tool to assess the environmental
performance of the centre, to prioritise the identified environmental aspects and the
best available techniques to reduce these aspects. These results support the definition
and monitoring of the environmental action plans to be implemented in the centre. The
expected results in short term are the implementation of the methodology/web-based
tool in two healthcare centres (belonging to FHSPST) and their test in other centres
belonging to stakeholders. In longer term it is expected the implementation in other
centres (belonging to FHSPST and stakeholders) and the sale of the web-tool to other
healthcare centres in Spain and Europe. These centres will achieve a significant
reduction of their environmental burdens, if the adequate action plans are defined and
implemented. This will contribute to EU policies in resource and energy efficiency.
Chapter 4.- Administrative Part.- It describes the management system which, in
general, has worked well during the project development. The communication
between partners has been fluent and each partner has correctly developed the
assigned roles and responsibilities in the project. It was needed an amendment to the
Grant Agreement, at the beginning of the project, in order to include Xarxa AIE as
partner (following EC recommendation). In comparison with the planned actions, not
major deviations have occurred during the project.
Chapter 5.- Technical Part.- It describes the technical progress, per task. All planned
actions have been successfully finished with the release of the associated deliverables
(see Table 2). However, it is needed to mention that unfortunately, not all the proposed
action plans have been finally implemented in the two centres (Action B4), due to
internal budget restrictions of the leading beneficiary (i.e. FHSPST). These actions are
self financed, and were not included as cost in the initial budget. This issue was
described as a potential risk in the project proposal, and the corrective action taken has
been to simulate the impact of the non-implemented actions, estimating their potential
impact.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 10 of 89
This chapter also describes the dissemination actions, focused on the project web-site
(7423 visits), Social Networks (i.e. LinkedIn and Twitter), printed material (i.e. 12
information boards and 1000 leaflets), Workshops with healthcare organisations (i.e. 7
workshops), papers/articles (i.e. 6 general articles, 5 technical communications, 2
poster and 30 internet-articles) and congresses (i.e. attendance to 4 Congresses and
organisation of a project final conference).
It covers also the Evaluation of Project Implementation, using quantitative
indicators, which show that most of the targets have been achieved. The Analysis of
long-term benefits describes the expected savings and environmental/social benefits
of using the proposed approach (i.e. energy saving, waste reduction, etc.) and the
potential long-term benefits and sustainability. It describes the potential replicability at
EU level and the potential transferability to other sectors (i.e. hotels).
Comments on the financial report.- It gives an overview of the costs incurred,
information about the accounting system and relevant issues from the partnership
agreements and allocation of the costs per action. At the end of the project, it has been
spent a 95% of the proposed budget. The main cost incurred is associated to personnel
(90% of total). Travel costs, consumables and external assistance are lower than
expected. The distribution of costs per action is similar to the initially proposed, with
minor deviations. Some budget transfers have been done between partners and cost
categories, but without exceeding the limit of more than 10 % and € 30 000 in one or
more categories of expenditure.
An Audit has been carried out by an external auditor, who has declared that the
Financial Report is in compliance with LIFE+ Programme Common Provisions, the
national legislation and accounting rules (see attached Audit Report)
Annexes.- Including Administrative (1 Annex), Technical (7 Annexes) and
Dissemination Annexes (11 Annexes). Also it includes the Final table of indicators as
annex.
Financial Report and Annexes.- Separated documents (9 Annexes), which include the
required financial information (Payment request, Financial Statements, Supporting
Documents & Auditor Report).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 11 of 89
3. Introduction
3.1. Description of background, problem and objectives
Healthcare centres are complex systems involving different types of activities, not only
healthcare but also inpatients hospitality, laundry, cooking, laboratory, etc. and very different
equipments, from sophisticated medical equipment to dishwashers. Healthcare activities use
very different products and generate very different types of wastes. For an adequate
operation of these activities, different utilities are needed: industrial heating, ventilation and
air conditioning (HVAC) systems, different levels of lighting or ventilation for each section,
Information and Communication Technologies (ICTs) systems, etc., with the consequent
consumption of significant amounts of resources (energy, water and others). In general,
these consumptions are monitored using single general meters for the entire centre, without
specific information for each section (e.g. operating theatres, etc.). Then, the question is how
to decide the best improvement actions for each section?
The hypothesis to be verified by the project is that a well informed "decision-maker" will be
able to better decide the most adequate environmental improvement actions for its healthcare
centre. The fact of focusing the improvement actions on the most relevant aspects, with higher
impact, will optimise the implementation costs and it will produce higher reductions on the
environmental impacts associated to the centre.
The proposed solution is a methodology and web-based tool that are based on the fact that
better informed management will take better decisions. In the case of environmental actions, it
is crucial to know where the environmental aspects are located, their magnitude, their
relevance and the best practices that could reduce them. A life cycle thinking approach is
needed in this assessment. Once the actions to be developed are decided, it will be crucial to
monitor their evolution, using the correct Key Performance Indicators (that could be specific
for each section).
The expected results are a tested and validated methodology and web-based tool, customised
for the healthcare sector, which have been successfully implemented in two healthcare
centres, with the definition of Sustainable Action Plans. These plans have lead to significant
savings on energy, and potentially on water or waste. The impact assessment shows an
average impact reduction of 5.9% in the Hospital del Vendrell and a reduction of 6.9 % in
Centre de Llevant (average of 9 environmental impact indicators used in LCA analysis).
3.2. Expected long term results
The project is in line with the Sustainable Consumption and Production & Sustainable
Industrial Policy Action Plan of the European Union, which maximises the potential for
business to transform environmental challenges into economic opportunities, improving the
environmental performance of organisations. Long term results are based on the use of the
web-based tool in other healthcare centres, belonging to the coordinator beneficiary or to
other stakeholders contacted during the project or afterwards. A full operative free demo
version will be available through the project website (at least five years after project ending).
A commercial version of the web-based tool will be developed after the end of the project, for
those organisations that need to customise the tool for their specific needs, and consultancy
services will be offered to the interested organisations.
The proposed approach and web-based tool is applicable at European level because they take
into account the specific characteristics of each centre (e.g. climatic conditions, building
characteristics, equipment, etc.). The free web-tool is available in Spanish and English.
The proposed concept and approach is replicable to other type of buildings that include
different services and equipment (e.g. hotels, etc.), with the needed adaptation to their specific
characteristics (different type of equipment, etc.).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 12 of 89
4. Administrative part
4.1. Description of the management system
4.1.1. Description and schematic presentation of working method
The working method followed in the project is based on the definition of Actions (and
subtasks) and the assignment of a responsible for the development of these tasks.
The proposed phases are: A) Preparatory Actions, B) Implementation actions, C) Monitoring
of the impact of the project actions, D) Communication and dissemination actions and E)
Project management and monitoring of the project results. The Actions D & E were carried
out during all the project development. The Figure 1 shows the Gantt Diagram of the project
and its final situation (proposed vs actual development).
1T 2T 3T 4T 1T 2T 3T 4T 1T 2T 3T 4T 1T 2T 3T 4T
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
Proposed
Actual
B.2.- Integrated web-based application to
support the decision process
B.3.- Process and web application
implementation in two healthcare centres
B.4.- Definition and implementation of
“Environmental Action Plans”
E.4.- Audit
C.1.- Monitoring of the project impact
after Enviro.Action Plans
implementation
C.2.- Assessment of the socio-economic
impact of the project
D.1.- Project website, including web 2.0
communication channels
D.2.- LIFE+ information boards and other
printed material (e.g. flyers)
D.3.- Layman's report
D.4.- Workshops with other Healthcare
institutions and employees
D.5.- Papers and oral presentations
E.1.- Project Management and
monitoring (Overall project operation)
E.2.- Networking with other projects
E.3.- After-LIFE Communication Plan
A.2.- Review of BATs and best practices
B.1.- Tailored decision making process
for Healthcare centres
Tasks/
Activities
Overall project schedule
2015 20162013 2014
A.1.- Definition of the most appropriated
“Key Performance Indicators”
Inception ReportProject Start Midterm Report FinalReport
Figure 1.- Gantt Diagram of the project
As it can be seen in Figure 1, some minor delays have occurred during project development,
for example 1 month delay in the development of the web-based tool due to the inclusion of
new comments from stakeholders, which produced a delay in the start of action B3. Also to
mention that Action B4 has been prolonged in order to include as much as implementing
actions as possible, which are limited by internal budget and resource availability (i.e. actions
own-financing by FHSPST not included in the budget). Other small deviations are associated
to the release of printed leaflets (i.e. adapted to when the results are obtained), to the
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 13 of 89
workshops with healthcare organisations (i.e. adapted to organisations' availability), and
prolongation in the release of this Final Report (initially proposed on 1/09/2016).
4.1.2. Presentation of the coordinating beneficiary, associated beneficiaries and
project organisation
The consortium that developed the project includes the following partners:
Coordinating Beneficiary: Fundació Hospital Sant Pau i Santa Tecla (FHSPST).
This private non-commercial Foundation has its origins in the XII century and its
objective is to provide healthcare and social attention to the community. Nowadays it is
integrated in the XHUP (Network of Public use Hospitals in Catalonia). It is part of the
Xarxa Santa Tecla, a network of hospitals with offer services to nearly 158,000 people
and a staff of about 2,200 professionals.
Associated Beneficiary: SIMPPLE SLU.
This R+D+i company is a spin out of the Universitat Rovira i Virgili (URV) of Tarragona
(Spain), and it was founded in the middle of 2004. In January 2011, Fundació Hospital de
Sant Pau i Santa Tecla bought the 100 % of SIMPPLE shares. SIMPPLE has experience
on software and web-based applications development and its Eco-innovation department
has experience on Ecodesign, environmental management and LCA methodologies. It has
participated in several EU projects, some of them as coordinator.
Associated Beneficiary: ACONDICIONAMIENTO TERRASENSE -LEITAT-.
LEITAT, founded in 1906, is a technological centre aiming to offer services to the
companies of the industrial sector by adding technology value both to products and
processes. It is focused on Research, Development and Innovation (R&D&I) and its
services are clearly aimed at the adaptation to the constant changes of the market. The
centre has been involved in research projects at a regional, national and European level,
concretely involving waste recycling and revalorization technologies.
Associated Beneficiary: Xarxa Sanitaria i Social Santa Tecla, AIE (Xarxa AIE)
Xarxa Sanitaria i Social Santa Tecla, AIE (in short Xarxa AIE) was founded in 2001 as
Economic Interest Grouping (EIG) by three non-profit Foundations, one of them was the
Fundacio Hospital de Sant Pau i Santa Tecla. The aim of this Economic Interest Grouping
(EIG) is to group the general services such as management, administration, finances,
maintenance, human resources, etc., in order to supply these services to these
Foundations. As it is reflected in its constitution statutes, Xarxa AIE only can supply
these services to the centres associated to the Foundations that constitute the EIG.
The main roles of the partners are indicated in the Table 5.
PARTNER Main ROLES
FHSPST
Xarxa AIE
• General Coordination of the project
• Official Communication with EC
• Alignment with sector needs
• Leading Case Studies
• Implementation and monitoring of the Action Plans
SIMPPLE
• Technical Coordination of the project
• Development of the decision making methodology
• Development of the web application
• Support to the Cases Studies
LEITAT
• Definition of best available techniques
• Development of the LCA/LCC studies
• Communication and dissemination
Table 5.- List of partners and main roles
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 14 of 89
The General coordinator of the project is Jordi Cañellas on behalf of FHSPST. He coordinates
all the administrative aspects of the project and the official communication with the EC. The
technical aspects, such as meetings organisation, project monitoring, etc. are coordinated by
Juan Carlos Alonso from SIMPPLE. Both are supported by the administrative personnel of
their organisations, and they have a fluent and direct communication.
The communication between the partners was guaranteed by a direct contact via e-mail and
phone calls. Additionally, some activities have been developed, such as periodically
scheduled teleconferences via Skype (19), General Assemblies (7), Technical meetings (2)
and an internal area in the project website for document sharing, etc. Meeting minutes have
been drawn up for these team meetings and most relevant teleconferences. The list of
meetings is detailed in Table 6.
General Assemblies Date Location Monitoring Team
1st Technical Meeting 1/08/2013 SIMPPLE. Tarragona no
Kick-off Meeting 30/09/2013 FHSPST. Tarragona yes
2nd General Assembly 06/03/2014 LEITAT. Terrassa no
3rd General Assembly 14/10/2014 SIMPPLE. Tarragona yes
2nd Technical Meeting 01/12/2014 LEITAT. Terrassa no
4th General Assembly 13/04/2015 FHSPST. Tarragona no
5th General Assembly 08/10/2015 LEITAT. Terrassa yes
6th General Assembly 08/03/2016 SIMPPLE. Tarragona no
7th General Assembly (Final) 22/06/2016 FHSPST. Tarragona no
Table 6.- List of meetings
The Figure 2 shows the organization chart of the project.
Project Management Organisation Chart
General Project Management
(Jordi Cañellas)
Technical Project Management
(Juan Carlos Alonso)
Project Financial
administration
Project EC
relationsProject Reports &
Deliverables
Project Contractual
administration
Project Quality and
Technical Monitoring
Technical Issues Administrative IssuesEC Relations
Decision Process (General Meetings and Teleconferences)
FHSPST &
XarxaSIMPPLE LEITAT Advisory Board
Figure 2.- Organisation Chart of the project
The list of the people involved in the project, per each beneficiary, is attached hereafter (see
more detail in the Financial Statements and Annex 28).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 15 of 89
Person Actions involved
FHSPST
Xavier Oliach (Manager Hospital Santa Tecla) A1, B1, B2, B3, B4, C1, C2, D4
& E2
Maria Arenas (Manager Hospital de Vendrell) B1, B2, B3 & C1
Lourdes Gort (Manager Centre de Llevant) B1, B2, B3 & C1
Amparo Maeso (Administrative) B3, B4 & C1
Susana Regadera (Administrative) B3, B4 & C1
LEITAT
Olga Bonastre (Technical/ environmental expert) A1, A2, B2, B3, C1, C2,
Gertri Ferrer (Technical/ environmental expert) A1, A2, B1, B2, B3, B4, C1,
C2, D1, D2, D3, D4, D5, E2
Marc Torrentelle (Technical/ environmental expert) A1, A2, B1, B2, B3, B4, C1,
C2, D4, D5
Carme Hidalgo (Technical/ environmental expert) A1, A2, B1, B2, B3, C1, D4, D5
Raquel Villalba (Technical/ environmental expert) B2,B3, C1, E2
Natalia Fuentes (Technical/ environmental expert) A1, A2, B1, B2, B3, C1
Marta Escamilla (Senior Expert) A1, A2, B1, C1, C2, D1, D4, E2
Marta Morera (Communication Expert) A1, A2, D1, D2, D4, D5, E2
Helia Romero (Web Expert) B1, D1, D2
Émilie Mespoulhes (Financial & Administrative manager) D1, D2, D4, D5, E1
Silvia Roser Perez (Financial & Administrative manager) B1, D1, D2, E1, E2
Rosario Ramon (Financial & Administrative manager) D1, D4, D5, E1, E2
Max Viallon (dissemination manager) D1, D2, D3, D4
Laia Puigmal (Technical/environmental expert) D4, C1, C2
Lara Valentin (Financial & Administrative manager) E1, E2
SIMPPLE
Juan Carlos Alonso (Project manager) B1, B2, B3, B4, C1, D2, D3,
D4, D5, E1, E2
Julio Rodrigo (Project manager) A1, A2, B1, D1, D2, D5
Noemí Cañellas (Senior technician) B2, B3, C1, C2, D5
Xavier Guardiola (Project manager) B2
Eduard Pauné (Senior developer) B2
Medir Alcañiz (Junior developer) B2
David Escuer (Junior developer) B2
Xarxa AIE
Jordi Cañellas (general manager) E1, B1, B2, D4, D5, E2
Xavier Isern (General Services responsible) A2, B1, B3, B4
Eduard Roig (Financial manager) E1, E4
Montse Masdeu (administrative) E1
The consortium has nominated an Advisory Board that has been involved in the project
during its development. The nominated members are:
o Ms. Maria Passalacqua (Director of the Club EMAS.- Association of EMAS registered
organisations in Catalonia. It includes a working group of certified Healthcare Centers)
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 16 of 89
o Dr. Francesc Castells (Professor of the Rovira i Virgili University, with a large
experience on environmental activities (e.g. LCA and LCC)
o Mr. Josep Maria Masip (Member of the DG of Environmental Quality of the Catalonia
Government, with large expertise on environmental management and certification).
o Dr. Xavier Singla (Director of Operational Planning and Management Control. Xarxa
Sanitaria i Social de Santa Tecla. Expert on Healthcare management)
4.1.3. Description of changes due to amendments to the Grant Agreement
It was proposed an amendment to the Grant Agreement in order to include Xarxa AIE as new
partner because some of the activities to be developed by FHSPST will be actually developed
by personnel assigned to Xarxa AIE. This issue was alerted in the kick of meeting held in
Tarragona on September 30th 2013 and the European Commission recommended this
amendment (letter on October 28th 2013). The paper version of the proposed amendment was
ready by the end of November 2013, but some problems in the electronic eproposal system
delayed its actual submission until March 2014 and it was officially approved and signed by
the Commission in June 2014.
This amendment only distributes the tasks originally assigned to FHSPST between FHSPST
and Xarxa AIE. It does not affect the proposed tasks, deliverables, planning or total budget of
the project.
4.1.4. Submission of the Partnership Agreement
Due to the delay in the acceptance of the proposed amendment of the Grant Agreement, the
Partnership agreement was also delayed, to avoid the signature of an agreement that will be
modified after the acceptance of the amendment. Eventually, the signed version of the
Partnership Agreement was submitted in July 2014, in a separate letter to the monitoring team
and the European Commission. This letter included a hard copy and an electronic version of
the Partnership Agreement.
4.2. Evaluation of the management system
4.2.1. Project management process
The project management process has worked well during the whole project, and there are not
significant deviations from the arrangements contained in the partnership agreement. The
beneficiaries have supplied the required information on time, and with the required quality, to
the Coordinating beneficiary or to the task leader responsible for the development of each
task. As result, not significant delays have occurred in the release or submission of technical
and financial reports.
4.2.2. Communication with the Commission and Monitoring team
It was maintained a fluent communication with the external monitoring team, via e-mail and
phone calls. The advice received from them where very useful during the project
development, especially during the amendment process and reports submissions.
The external monitoring team attended several General Assemblies (3 in total). Copies of the
meeting minutes and presentations were sent to them after each meeting.
The communication with the Commission was via official letters. In total, the coordinator has
received 14 official letters from the Commission, including the review of the three monitoring
visits, Mid-Term and Inception Reports review, amendment of the Grant Agreement etc.
Additionally, the Technical and Financial Desk Officers of the Commission visited the project
on April 12th, 2016.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 17 of 89
5. Technical part
5.1. Technical progress, per task
The following sections describes what and how has been done in each action developed in the
project, except for "project management" (Action E1) which is dealt with in the
administrative part (section 4) and "dissemination" (Actions D1, D2, D3, D4 and D5), which
is dealt with in section 5.2.
The Table 7 shows the proposed actions, the responsible partner and the proposed planning of
each action.
Action Leader Starts Ends
(month)
A) PREPARATORY ACTIONS
A.1.- Definition of the most appropriated “Key Performance
Indicators” LEITAT 1 6
A.2.- Review of BATs and best practices LEITAT 2 7
B) IMPLEMENTATION ACTIONS
B.1.- Tailored decision making process for Healthcare centres SIMPPLE 4 11
B.2.- Integrated web-based application to support the decision
process SIMPPLE 8 24
B.3.- Process and web application implementation in two
healthcare centres FHSPST 18 24
B.4.- Definition and implementation of “Environmental Action
Plans” FHSPST 20 26 (34)
C) MONITORING OF THE IMPACT OF THE PROJECT
C.1.- Monitoring of the project impact after Environmental
Action Plans implementation FHSPST 22 34
C.2.- Assessment of the socio-economic impact of the project LEITAT 31 35
D) COMMUNICATION AND DISSEMINATION
D.1.- Project website, including web 2.0 communication
channels LEITAT 1 36
D.2.- LIFE+ information boards and other printed material (e.g.
flyers) LEITAT 1 36
D.3.- Layman's report LEITAT 35 36
D.4.- Workshops with other Healthcare institutions and
employees FHSPST 11 36
D.5.- Papers and oral presentations SIMPPLE 11 36
E) PROJECT MANAGEMENT
E.1.- Project Management and monitoring (Overall project
operation)
FHSPST
Xarxa 1 36
E.2.- Networking with other projects SIMPPLE 1 36
E.3.- After-LIFE Communication Plan LEITAT 33 36
E.4.- Audit Xarxa 36 38
Table 7.- List of Actions and planning
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 18 of 89
5.1.1. Action A.1.- Definition of the most appropriated “KEPIs"
Main Objectives
The objective of this Action has been to identify the most appropriated Key Environmental
Performance Indicators (KEPIs) for the Healthcare sector. To obtain these indicators, firstly a
holistic approach, including Life Cycle Assessment Methodology (LCA) and Life Cycle
Costing (LCC) had been done in order to identify the environmental and economical impacts
of a "representantive" healthcare centre.
The results of this action identify the key aspects that are needed to be considered in the “case
studies” (demonstration actions of BOHEALTH project). In particular, the environmental and
economical approach identifies:
Where and when it is needed more data collection effort to obtain an accurate
environmental and economical profile of a health-care centre.
Where the needed data is located or how it can be gathered
Which environmental data is more relevant and need more quality
Activities/Progress/Modifications
Type Preparatory Action Status Finished
Duration month 1 to 6 Schedule On time
Leader LEITAT Modifications No
Collaborate SIMPPLE, FHSPST Objectives Achieved
Deliverables Deliverable D3 “Report on proposed KEPIs and functional units”
The details of the tasks carried out in this Action are presented hereafter:
Task A1.1.- Bibliographic research on existing LCA/LCC studies in the Health sector.
Responsible: SIMPPLE. Status: Finished.
This was the first step to develop the action. This action was important in order to define
the representative hospital. The bibliographic research specially focuses on the
environmental statement documents of the EMAS registered healthcare centres, which
were reviewed in order to extract the relevant information. Twenty two cases have been
analyzed and classified depending on their activity. Another bibliographic references,
websites and journals have been checked to obtain data about the environmental
performance of healthcare centres.
Also, the onsite visits to some hospitals, done in the task B1.1, provided useful information
for this action.
Task A1.2.- Environmental an economic assessment of a representative hospital using
LCA and LCC. Responsible: LEITAT. Status: Finished.
According to the data previously collected, a representative hospital was described.
Considering that the 70% of the hospitals in Spain have less than 200 beds, it was
established that average to select representative cases. The environmental analysis done
was based on the Life Cycle Assessment and economic parameters were included. The
scope of the analysis was in accordance with the defined study goals. And according to
this, the impacts generated in the hospital's activity, from obtaining of raw materials to
waste disposal, were taken into account.
Each aspect was accurately analyzed to quantify the environmental and economical
impacts. The inputs and outputs considered were: the energy consumption, the water
consumption, the products used (medical hospital devices, chemical products, medical
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 19 of 89
hospital clothes, paper consumption), medical waste generated, wastewater produced and
emissions to the atmosphere. Also, it was considered which parameters have an influence
on these aspects; some of these are the constructed area, the number of beds, treatments
provided, location, etc.
Task A1.3.- Identification of the best functional unit “for monitoring the economic and
environmental impacts identified”. Responsible: LEITAT. Status: Finished.
Before this analysis, the parameters that defined the best functional unit were established
and the key indicators to quantify the environmental performance of the hospital were
settled, as it can be seen in the deliverable D3.
Task A1.4.- Definition of the most appropriated Key performance indicators. Responsible:
FHSPST. Status: Finished.
The previous tasks done in this action provided useful information to identify the best
KEPIS. These indicators are considered to express the environmental and economical
performance of the healthcare centres.
Main Outputs
The bibliographic research showed that the most relevant phase of the life cycle of healthcare
centres is the use phase due to their long life (about 50 years). Therefore, the LCA/LCC
analyses have been focused on this phase. On the other hand, the project is focused on the
decision making process during the management of the centre (i.e. use phase).
From the analysis it was obtained that the energy is the main aspect that needs to be managed
in order to reduce the global impact (See Figure 3). The electricity from grid is the main
energy source consumed in a hospital; the natural gas and fuel oil are consumed in minor
quantity (See Figure 4). The economic impact of electricity consumption represents the 70%
of the global environmental impact of energy consumption. The electricity has the main
contribution of the environmental impact (from 97% to 43 %) depending on each impact
category. This demonstrates that it is important to establish measures of energy efficiency.
The second aspect that needs special attention is the medical waste. It was identified that the
application of good practises in waste management as recycling can contribute to the
environmental improvement. The environmental analysis identifies that the environmental
impact of hazardous waste is relevant considering the quantity of this waste in comparison
with the non-hazardous waste (15% of the total waste generated). The consumption of water
and chemicals has more or less the same contribution to the all impact categories.
Figure 3.- Contribution of each item considered
to the environmental impact (CML 2001)
Figure 4.- Contribution of the energy
consumption to the environmental impact
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 20 of 89
The other results obtained from this preparatory action are the key performance indicators to
measure the hospital activity. Fifty (50) key performance indicators have been defined as the
most appropriated indicators:
Seven (7) key performance indicators about energy consumption
Eight (8) key performance indicators about water consumption
Five (5) key performance indicators about products consumed
Four (4) key performance indicators about wastewater
Fourteen (14) key performance indicators about generated waste
Twelve (12) economic indicators
Also these indicators have been classified according to the difficulty level of applying them.
All the indicators and its classification are clearly reported in the Deliverable 3.
And finally, the functional unit for monitoring the environmental and economical impact has
been described. The parameters that are necessary to define this functional unit have been
establish as the following: the constructed area, the green area, the weighted activity, the
degree day, the number of water source points and types, the availability of renewable energy
sources, the number of patients attended, the number of beds, the number of meals served, the
amount of washed clothes, the number of dialysis treatments, the number of oncology
treatments, the number of determinations done at the laboratory, the availability of wastewater
treatment plant.
The Deliverable D3 “Report on proposed KEPIs and functional units”, is attached as
Annex 4 (electronic form). The deliverable was finalized as it was planned on December
2013, but on January 2014 some improvements and other information from the hospital visits
(B1.1) were included. The deliverable was presented in the Inception report (April 2014).
Major Problems/drawbacks
The main difficulty found in this task was the variability of environmental data in the
healthcare centres. This is due to the variability of different activities or services offered by
each centre (laundry service, catering, surgery...) and its characteristics as the number of beds,
the constructed area, the green area, the location, the number and type of attended patients …
To solve this difficulty, the methodology previously described was implemented.
Continuation after end of the project
No continuation after end of the project, this was a preparatory action.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action A1 List of appropriated KPIs List of 50 KPIs (D3) Success
List of appropriated
"functional units"
List of 14 functional units
(D3)
Success. Highly
dependent on the type of
healthcare centre
LCA & LCC study
"average" hospital
Assessed an "average"
hospital of 200 beds (D3)
Success. Difficulties to
define this "average"
hospital
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 21 of 89
5.1.2. Action A.2.- Review of BATs and best practices
Main Objectives
The objective of this action has been to review, from a technical, economic, social and
environmental point of view, the already existing Eco-design Guidelines, Best Available
Technologies (BATs) and best practices that could be applied to the Health sector.
These best available technologies and practices are classified according to the different
environmental aspects to be improved, and in particular regarding to:
Energy efficiency and Renewable Energy Sources (RES)
Water management
Waste management
Chemicals use
Green procurement
Activities/Progress/Modifications
Type Preparatory Action Status Finished
Duration month 2 to 7 Schedule On time
Leader LEITAT Modifications No
Collaborate SIMPPLE, Xarxa AIE Objectives Achieved
Deliverables D4. Report on Best Available Techniques and Best Practices
The details of the tasks carried out in this Action are presented hereafter:
Task A2.1 Collection and review of BATs and the best environmental and social practices.
Responsible: LEITAT. Status: Finished.
In this task, LEITAT gathered information related to best available techniques and good
practises that can be implemented in the healthcare sector. Environmental improvement
measures have been collected from existing publications and studies, relevant websites
dealing with sustainable healthcare (e.g. NHS Sustainable Development Unit, Centre for
Sustainable Healthcare and Practice Greenhealth) and also from the know-how of
consortium members. Additionally, the direct interviews conducted with hospitals under
Action B1 allowed identifying some good practices.
Task A2.2. Classification of the selected technologies/practises according to the
environmental aspect improved. Responsible: LEITAT. Status: Finished.
The information collected in the previous task, was classified according to the
environmental aspect improved (water, energy, product consumption, waste generation,
chemicals consumption).
Task A2.3.- Development of simplified sheets to describe the BATs and best practises.
Responsible: LEITAT. Status: Finished.
A descriptive sheet for each practice was created to present the information collected in a
user friendly way. The content of the descriptive sheet includes the sections outlined
below:
o Area of application: refers to the area of the healthcare centre where the improvement
measure presented has a positive impact.
o Description: in this section a description of the BAT or good practice is provided, as
well as recommendations for its implementation.
o Benefits: the environmental, economic and social benefits of the improvement
measure are described, quantifying the impacts when possible.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 22 of 89
o Case study: successful experiences already implemented have been included in the
report with the aim to promote the transfer of knowledge and encourage the healthcare
sector to implement environmental improvement measures. The results achieved in
case studies where quantified when possible.
Main Outputs
The main result achieved in Action A2 has been the D4. Report on Best Available
Techniques and Best Practices, which presents 50 BATs and good practices to be
implemented in the healthcare sector. The report contains:
Fourteen (14) energy improvement measures
Twelve (12) water improvement measures
Eleven (11) waste improvement measures
Seven (7) chemicals improvement measures
Six (6) green procurement measures
The report encourages the implementation of BATs and best practices in healthcare facilities,
reducing the environmental impact of their activities. This report was uploaded on the project
website and it was disseminated through the dissemination channels as: social networks,
newsletter and press release.
These BATs and best practises are included in the demo version tool to provide information
on how to improve the environmental performance of the healthcare centre. The report D4
was included in the Inception Report (April 2014) and it is attached to this report as Annex 5
(electronic form). The Figure 5 shows an example of these descriptive sheets.
Figure 5.- Example of descriptive sheets for selected BATs
Major Problems/drawbacks
No problems and drawbacks are found.
Continuation after end of the project
No continuation after end of the project. This was a preparatory action.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action A2 50 summary sheets for
identifies BATs
50 summary sheets: 14
energy, 12 water, 11 waste,
7 chemicals and 6 green
procurement (D4)
Success.- In some cases
difficulties to find the
savings achieved in real
cases
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 23 of 89
5.1.3. Action B.1.- Tailored decision making process for Healthcare centres
Main Objectives
The objective of this action has been to develop a practical and tailored decision making
process to support management to define the “Sustainable Action Plans” that better fit the
centre needs from an environmental and economic view point.
This decision making process is based on a life cycle perspective to assess the best measures
and its implementation is based on a PDCA process (Plan-Do-Check-Act), leading to a
continuous improvement of the environmental performance of the health centres.
The Figure 6 shows the proposed working flow for this decision-making process. It is based
on the premise that it is needed to prioritise the different alternatives in order to support the
final decision.
Definition and
Implementation
“Sustainable
Action Plans”
Action Plans
Monitoring
and Revision
Comparative
Assessment
with Initial
situation
Prioritisation of
the most
relevant
environmental
aspects
Prioritisation of
the potential
BATs for these
aspects
Life Cycle Assessment
Life Cycle Costing
Best Available
Techniques Assessment
Procedures
(e.g. data collection, prioritisation criteria, etc.)
Key Performance
Indicators (KEPIs) and Functional Unit
Figure 6.- Decision-making process scheme
The approach has four main parts:
Assessment of the healthcare centre, allocating the different environmental aspects
to its services/sections
Prioritisation of the identified environmental aspects based on practices already
proposed in environmental management standards (i.e. ISO-14001 and EMAS)
Prioritisation of the best available techniques and practices that can reduce these
environmental aspects, based on economic and environmental criteria
Definition and monitoring of the selected "Sustainable Actions" to be
implemented in the healthcare centre
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 24 of 89
Activities/Progress/Modifications
Type Implementation Action Status Finished
Duration month 4 to 11 Schedule On time
Leader SIMPPLE Modifications No
Collaborate LEITAT, FHSPST, Xarxa AIE Objectives Achieved
Deliverables Deliverable D5.- Report on proposed decision-making process (reviewed after
monitoring team comments)
The details of the tasks carried out in this Action are presented hereafter:
Task B1.1.- Direct contact and interviews with healthcare centres in Spain, with experience
on environmental management. Responsible: LEITAT/SIMPPLE. Status: Finished.
The idea is to know how they are working, which type of environmental indicators they are
using, etc. The Table 8 summarises the meetings held during this period:
Organisation
Date of the
first
meeting
Number
of
centres
Web-sites
Club EMAS. Health Care Sector. 13/11/2013 9 http://www.emas.cat
Consorci Hospitalari de Vic 17/01/2014 4 http://www.chv.cat
Serveis de Salut Integrats Baix Empordà 20/01/2014 6 http://www.ssibe.cat/
Hospital de la Santa Creu i Sant Pau 05/02/2014 1 http://www.santpau.es
Consorci Sanitari de Terrassa 20/02/2014 16 http://www.cst.cat
Corporació Sanitària Parc Taulí 13/03/2014 7 http://www.tauli.cat/
Mútua de Terrassa 25/03/2016 14 http://www.mutuaterrassa.cat/
Institut d'Assistència Sanitària 14/04/2014 24 http://www.ias.scs.es/
Consorci Hospital General Universitari de
Valencia 23/04/2014 22 http://chguv.san.gva.es/
Fundació Sanitària Mollet 07/05/2014 4 http://www.hospitalmollet.cat/
Consorci Sanitari de l'Anoia 11/11/2014 5 http://www.csa.cat/
OSAKIDETZA 17/07/2014 372 http://www.osakidetza.euskadi.net
Servicio Andaluz de Salud Phone call
Table 8.- List of meetings held with healthcare centres and organisations
During these meetings, the following topics have been covered:
o Presentation of the BOHEALTH project
o Explanation of its tasks and objectives
o Reasons for collaborating with BOHEALTH project
o Direct dialogue to better know how the healthcare centres are working with
environmental aspects (e.g. indicators, monitoring, actions, etc.)
o Needs for a better monitoring and decision-making process
o Presentation of the initial approach to consider the different environmental aspects
(EXCEL mock-up)
o Best available techniques or best practices used in the centres
The initial target of contacts with 15 Spanish health care centres has been achieved, because
the interviews include not only centres but also organisations with several centres. For
example in the Club EMAS meeting there were present 9 healthcare organisations and
Osakidetza represents 372 centres (3 OSIs-Integrated Sanitary Organisations were present in
the meeting: Barrualade-Galdakao; Basurto-Bilbao and Goierri-Alto Urola).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 25 of 89
Task B1.2.- Assessment of the different services or units that healthcare centres could offer
and collection of the needed data. Responsible: SIMPPLE. Status: Finished.
In this task it was defined the information to be gathered in order to characterise the
environmental profile of the different units. For doing this, the first step was to ask to the
healthcare centres responsible, which are the most relevant environmental aspects
associated to each service. The Figure 7 shows the results of this survey, where a higher
score means a higher relevance. It is not possible to compare between different services,
because not all centres have the same services (not comparable number of answers).
Environmental aspects
Energy consumption in HVAC C
Energy consumption in Lighting L
Energy consumption in Equipment E
Water consumption (hot sanitary & fresh) W
Materials consumption (chemicals, consumables, etc.) M
Waste / Residue generation (by group) R
Environmental Aspects
C L E W M R
Services I II III IV
Parking 4 25 3 1 0 2 0 0 0
Primary Care 20 15 2 1 0 0 2 10 0
Outpatients 40 29 8 6 0 0 14 10 0
Operating Rooms 40 24 14 4 1 0 1 12 13
(Non-ambulatory) Minor Surgery 35 24 10 3 0 0 1 15 8
Haemodialysis 21 9 6 23 0 3 9 13 0
Rehabilitation 30 22 5 3 0 0 9 3 0
Laboratories 29 9 30 4 3 0 0 27 3
Medical Imaging 31 15 32 3 0 0 2 7 0
Locker room 12 17 4 18 0 5 0 0 0
Offices 33 27 18 3 2 11 0 0 0
Kitchen 9 7 28 10 11 20 0 0 0
Dining room 29 21 9 4 0 17 0 0 0
Hospitalization 39 23 3 15 0 0 7 21 0
Emergency Department 39 31 6 9 0 0 3 23 0
Laundry 4 6 16 8 5 5 0 0 0
Warehouses 22 34 5 4 0 17 0 0 0
intensive care unit (ICU) 24 11 17 5 3 0 2 17 0
Pathological anatomy 16 3 5 8 7 0 0 0 29
Maternity Service 30 15 6 4 0 0 8 8 0
Pharmacy 35 15 16 3 0 3 2 0 26
Radiotherapy 8 3 10 0 0 0 0 0 2
Data Processing Centre 19 3 17 0 0 0 0 0 0
Archive 10 8 0 0 0 3 0 0 0
Day Hospital 20 16 3 1 0 2 0 0 9
Hyperbaric chamber 0 0 5 0 0 0 0 0 0
Figure 7.- Results of the survey related on relevant environmental aspects for each service
After the analysis of this information, the methodology to allocate the general energy
consumption (e.g. electricity, gas, etc.), the water consumption, and the wastes generated
to each section was defined.
The Figure 8 shows the proposed approach, which consists in assessing the energy demand
of each section (based on climatic, lighting and equipment requirements), and allocate to it
the energy consumed by the system that generates these services (e.g. HVAC systems,
etc.). It also includes the type of information needed for the entire centre and for each
section.
The proposed methodology includes several assumptions and default data to reduce as
much as possible the quantity of data to be collected.
The final result of the application of this methodology is the allocation of the energy
consumption, water consumption and waste generation to each section, characterised by
their use. For example, in the case of energy consumption it is characterised by heating,
cooling, ventilation, lighting and equipments (e.g. medical, ICT or general services such as
laundry, etc.). Also it is divided between electricity and thermal energy (e.g. from natural
gas).
More details can be found in the Deliverable D5.- Report on proposed decision-making
process, which is attached as Annex 6 (electronic form). This deliverable was submitted in
paper form as an Annex of the Mid-term Report.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 26 of 89
Allocation using
Top-Down
Approach
Calculation (per Section):
- Energy needs for cooling
- Energy needs for heating
- Ventilation requirements
- Equipments consumption
- Water consumption
- Waste generated
Calculation of:
- Total air conditioned flow
- Total energy for cooling
- Total energy for heating
Comparison of
results and
adjustment if
needed
Comparison of
results and
adjustment if
needed
Allocation per area
according to its
ventilation requirements
Calculation of
aggregated
values
Comparison
of results and
adjustment if
needed
Allocation of general
utilities consumption,
etc. to each section
Sections Data
o Constructed area (m2)
o Height (m)
o Operation hours (h/year)
o Type of lighting
o Main equipment & consumption (desktops,
screens, etc.)
o Water use (points of consumption)
o Indicator of activity (e.g. number of laboratory
tests, menus, etc.)
o Elevators (number/type)
General Data
o Type, units and characteristics heating system
o Type, units and characteristics cooling system
o Type, units and characteristics air treatment units
General Data
o Energy consumption in winter / summer
General data
o Type of centre
o Electricity consumption(kW/year)
o Gas consumption (kWh/year)
o Water consumption (m3/year)
o Green area (m2)
o Kitchen/Laundry (yes/no)
Figure 8.- Scheme for the allocation of environmental aspects to each section
Task B1.3.- Definition of the procedure to prioritise the most relevant environmental
aspects. Responsible: LEITAT. Status: Finished.
In this task, it was defined the needed procedure based on existing Environmental
Management Systems (EMS) such as EMAS or ISO-14001. The approach is based on the
assignment of ratios for severity, magnitude, etc. for the different environmental aspects.
The proposed criteria are just a proposal, because the healthcare centres that have an
implemented EMS use their own criteria.
The Figure 9 shows an example for energy use. Similar criteria have been defined for
"Water Consumption", "Products Consumption", "Waste Generation", "Air emissions",
"Wastewater", "Noise generation" and "Emergency situations".
To obtain the environmental significance of the environmental aspects analyzed, the
following formula is proposed for each one:
Where x is the number of criteria established to assess each environmental aspect
considered. The environmental significance will be a value between 5 and 15 where 5
represents low environmental impact and 15 represents high environmental impact.
More details can be found in the Deliverable D5.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 27 of 89
Figure 9.- Example of criteria for environmental aspects prioritisation
Task B1.4.- Definition of the procedure to prioritise the best practices or BATs.
Responsible: LEITAT/SIMPPLE. Status: Finished.
In this task, it was defined a procedure to prioritise the best practices or Best Available
Technologies (BATs) that can be implemented to reduce the environmental aspects
identified in the previous step.
The proposed procedure is based on the assignment of environmental and economic
criteria to each BAT, based on the amount of reduction, the relevance and the period of
return of the investment.
Environmental Aspects: Economic Aspects:
Impact Factor:
Energy consumption
distribution in each area
Impact factor
> 40 % 10
40 ≥ x > 20% 5
20 ≥ x > 10% 3
≤ 10 1
This approach has been applied to the 50 best practices identified in Action A2.
More details can be found in the Deliverable D5.
Task B1.5.- Definition of the procedure to monitor the evolution of the proposed
"Sustainable Action Plans". Responsible: FHSPST/Xarxa. Status: Finished.
In this task, it was defined a procedure to monitor the evolution of the proposed Action
Plans. The proposed approach includes the monitoring of the following aspects:
o Name of the Action
o Description
o Vector (e.g. Energy, water etc.)
o Reference Value (e.g. kWh, m3, etc.), before action implementation
o Present Value (e.g. kWh, m3, etc.), after action implementation
o % of improvement (%) achieved
o Person responsible for the action
o Start Date of the action
o Scheduled End Date
o % time passed
o % of Action performed
o Initial Budget (€)
Environmental aspect Environmental criteria
Energy consumption % of energy saving
% of CO2 emission reduction
Water consumption % of water savings
Waste generation % of waste reduced
Chemicals use Risk of chemicals
Green procurement Green Purchasing Programme
ROI Economic
score
≤ 3years 420
3-6 years 200
6-10 years 100
> 10 years 25
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 28 of 89
o Consumed Budget (€)
o % Consumed Budget
o Comments
It is proposed to review periodically the status of the action, but the frequency of this
revision depends on the type of action and its expected impact. For example, in actions
related to the HVAC system it is proposed the review it every month, but the final results
should be analysed in a year period to cover all the climatic conditions.
Main Outputs
The Deliverable D5.- Report on proposed decision-making process, explains in detail the
outputs of the previous tasks. This report was presented to the Monitoring Team in the 3er
General Assembly (Tarragona, 14/10/2014). The monitoring team expressed the need to
include also the results of task B1.5. The version attached as Annex 6 (electronic form) is a
reviewed version of the original report (already submitted in paper as Annex of the Mid-Term
Report).
The main output is the definition of a decision-making process to be implemented in the
proposed web-based application (Action B2). This methodology was presented to the
stakeholders in the 1st Workshop held on July 18
th 2014, with a very good acceptance. The
stakeholders considered that it was a good approach to cover their needs.
Major Problems/drawbacks
The main problems encountered to define the methodological approach were associated to
allocate the general environmental aspects to each section. This implies the simulation of the
characteristics of each section (e.g. energy demand for ventilation, etc.) which require
complex models and detailed data. Therefore, it was needed to arrive to a compromise
between complex simulations (a lot of detailed data) and a simplified approach (less data
needs but lower accuracy).
Continuation after end of the project
The proposed decision-making process has been implemented in the web-based application,
which will be commercially exploited after the end of the project. A demo version of the web-
application will be freely available for testing in the project web-site.
The proposed approach will be tested and implemented, not only in the proposed two centres
of FHSPT, but also in some of the centres of the stakeholders.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action B1 Definition of practical
approach for decision
making
10 meetings with external
hospitals
Approach that assesses the
environmental aspects and
prioritise these aspects and
the BATs that can reduce
them (D5)
Meetings/contacts with
more than 15 external
organisations/hospitals
Success. Needed to
arrive to a compromise
between the needed data
vs. estimations and
default data
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 29 of 89
5.1.4. Action B.2.- Integrated web-based application to support the decision process
Main Objectives
The objective of this action has been to develop an integrated web-based application to
support the use of the methodology proposed in task B1, facilitating the decision making
process of management in healthcare centres (e.g. data entry, calculation processes,
assessment of the results, definition of action plans, etc.).
The web-based application was developed in three phases:
Alpha version. This version was not fully operative because it includes only dummy
data, but it showed to the partners/stakeholders the functionality and interfaces that will
be used in the final version. This alpha version, including partners’ and stakeholders
comments, was used as basis for the development of the beta version.- Status: Done
Beta version. This version includes all the methods and calculation processes described
above. This version was fully operative and it was the version to be validated in the
proposed case studies. It can be used through the web site http://bohealth.simpple.com/.-
Status: Done (with 1 month delay due to the inclusion of additional stakeholders'
comments)
Final version. This version includes the comments gathered during the testing in the
case studies and the detected bugs are solved.- Status: Done
Demo version. This version is fully operative, but with a limited time of use (i.e. tree
months). This demo version is accessible through the project web-site or directly via the
link. http://bohealth.simpple.com/.- Status: Done
The web-based application was presented to stakeholders in a workshop held on December 1st
2014 in order to receive their comments. Some recommendations for improvement have been
collected in the meeting and most of them have been implemented in the new beta version,
released in March 2015. The modified version has been presented to stakeholders in a
workshop held on May 7th
2015.
Activities/Progress/Modifications
Type Implementation Action Status Done
Duration Foreseen: month 8 to 24
Actual: month 8 to 25 Schedule On time. Delay of 1
month
Leader SIMPPLE Modifications No (only type of
demo version)
Collaborate LEITAT, FHSPST, Xarxa AIE Objectives Achieved
Deliverables Deliverable D6.- Demo version of the web-based application
(http://bohealth.simpple.com/)
The details of the tasks carried out in this Action are presented hereafter:
Task B2.1.- Definition of web application requirements & specifications, based on the
results of the Action B1. Responsible: SIMPPLE. Status: Finished
The methodology, assumptions and default data defined in Action B1 was used as
reference to define the requirements and specifications of the web-based application. This
methodology fixed the type of information to be asked, the calculation procedures and the
type of results.
The Figure 10 shows the diagram flow of the web-based application.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 30 of 89
Entry
User/Password
Input General
Data for the center
Input Data for
each section
Select Center
from list or add
new center
Select Section
from list or add
new section
Sections Data
o Constructed area (m2)
o Year of construction
o Climatic system used in this
section (from previous definition).
One area can have different
systems
o Type of lighting (various predefined
types - sub areas m2)
o Main equipment & consumption
o Water use (points of consumption)
o Wastes (by group)
o Chemicals used
o Hours in operation (by day)
o Indicator of activity (e.g. number of
laboratory tests, menues, etc.)
o Others (user input)
Prioritization of
Environmental aspects
at Global level
Input
Environmental
Data for the
Center
Environmental Data
o Electricity consumption
o Gas / Fuel consumption
o Water consumption
o Chemical consumption
o Wastes Generated (per Group)
o Recyclable wastes
o Air and Water emissions
o Paper
o Others (user input)
General data
o Location
o Type of centre
o Total Constructed area
o Number of floors / elevators
o Number of beds
o Green area
o Parking type and area
o Type of Climatic systems
o Hot Sanitary Water system type
o Activity (surgery, hospitalization,
emergency, etc.)
o Renewable energy capacity
o Others (user input)
Distribution of general
environmental aspects
to each section
Based on type of climatic system,
lighting type, hours of use, etc.
Weighted for all the sections
Distribution of consumption by
service (clima, sanitary water,
etc.). Default data (per climatic
area) or user definition
Relationship between global
environmental aspects
and sections relevance
Default list of
BATS per
environmental
aspect or
technologies
proposed by user
Prioritization of BATs
at Global level and per
section
Based on ROI,
potential
environmental
improvement,
etc.
Based on ISO-
14001/EMAS
criteria
Selection of Actions
(Definition of Action
Plan per section)
Selection of KEPIs
to be used for
monitoring
(proposal for each
section affected)
Definition of
Base Line for
comparison
(General & per
section)
Results report
(exportable tables and
graphics
BOHEALTH TOOL. DIAGRAM FLOW
Version: March 2014
Definition of
timing and
responsible for
the actions
Implementation
of the proposed
Actions
KEPIs comparison
Initial situation vs.
Improved situation
Registration
Monitoring
(Data collection)
Predefined Criteria/
Procedure
Automatic action done by
the web tool
User Action
Figure 10.- Diagram flow of the web-based application
Task B2.2. Definition of user interface (e.g. main menus, layout, etc.), taking into account
the profile of potential users (i.e. managers and technical staff). Responsible: Xarxa
AIE/FHSPST. Status: Finished
It was designed a clear interface, with clear questions, drop-down lists, menus, etc. The
used language is understandable for technicians familiarised with environmental
management or utilities management. The main entry page is classified by centres and by
year, to allow the monitoring of the actions. There are five main steps, accessible from the
entry page:
1. Assessment of the healthcare centre (i.e. allocation of general aspects by section)
2. Prioritisation of the environmental aspects
3. Prioritisation of the best practices
4. Action Plans definition and monitoring
5. Comparison of different centres and years
The Figure 11 shows
the entry page of the
web-based
application.
Figure 11.- Screenshot
of the entry page of the
web-based application
Environmental Aspects
Best Practices
Action Plan monitoring
ComparisonCentre Assessment
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 31 of 89
Task B2.3. Analysis of the data needs and how to enter this data in the web application.
Definition of the required questionnaires, etc. Responsible: LEITAT. Status: Finished
In this task, it was defined the data needs (according to the results of Action B1) and how
this data should be entered. Clear and concise questionnaires have been defined, including
open windows for some type of information. Informative bubbles have been included to
clarify to the user which information is being asked.
The Figure 12 shows an example how the information is entered in the Assessment
Module. This module includes 8 data entry tabs:
1. General Data (main
characteristics of the healthcare
centre)
2. Activity Data (e.g. number of
operations, etc.)
3. General consumptions and waste
generation (e.g. electricity
consumption, etc.)
4. Climatic Data (e.g. degree-days,
etc.)
5. General Utilities (e.g.
characteristics of the HVAC
systems, etc.)
6. Equipment (inventory of relevant
medical, ICT and general
equipment)
7. Services/sections description
(main characteristics of the
sections, e.g. surface, lighting
types, etc.)
8. Default data (default data and
assumptions used in the
calculations)
Figure 12.- Screenshot of the assessment module of the
web-based application
Task B2.4. Integration of the proposed calculation methods and assumptions needed to
assess the defined Key Performance Indicators. Responsible: SIMPPLE. Status: Finished
In this tasks it was defined the needed data and calculation methods to allow the
calculation of the KPIs by the user (e.g. Activity data, healthcare centre characteristics,
etc.)
Task B2.5. Implementation of the methods and procedures to prioritise the different
environmental aspects, Best Available Techniques and “Sustainable Action Plans”.
Responsible: SIMPPLE. Status: Finished
In this task, the proposed methods for prioritising the environmental aspects, Best practices
and action plans have been implemented in the web-based application.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 32 of 89
The Figure 13 shows the data entry page
for the module of Environmental aspects
prioritisation => Direct aspects =>
Energy. It includes 3 tabs (i.e. Criteria,
Data entry and Evaluation). The user
can add or delete environmental aspects
and define his criteria for the evaluation.
Figure 13.- Screenshot of the
environmental aspects prioritisation
Task B2.6. Definition of how these results should be presented (e.g. type of graphics,
tables, etc.). Responsible: FHSPST/Xarxa. Status: Finished
In this task it was defined the format of the results. The basic idea is to present the results
by the entire centre and by sections in an easily understandable manner. Three main types
of results are included:
1) Environmental aspects distribution, per type (e.g. energy, water, etc.) and use
(lighting, cooling, etc.)
2) Cost associated to the energy and water consumption and waste management
3) kg CO2 equivalent emissions, associated to energy and water use and waste
management
The results are presented in pull-down tables and graphics.
The Figure 14 shows an example how the results are presented. Please note that it includes
"dummy" results (i.e. not corresponding to any real health care centre)
Figure 14.- Screenshots of the results presentation
Task B2.7. Implementation of the methods and procedures to monitor the evolution of the
“Sustainable Action Plans” (e.g. procedure to monitor the status of the Action Plan,
including person in charge, calendar, budget status, etc.). Responsible: SIMPPLE. Status:
Finished
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 33 of 89
In this task the proposed methods and procedures were implemented in the web-based tool,
using three main tabs: 1) List of actions; 2) Actions monitoring and 3) Achievements.
The Figure 15 shows
how the user enters
the data on the list of
actions and how to
access to the other
tabs.
Figure 15.- Screenshot
of the module Action
Plan definition and
monitoring
Task B2.8. Implementation of the methods to assess and quantify the environmental,
economic and social benefits achieved with the “Sustainable Action Plans”
implementation. Comparison with the base case to know the savings achieved.
Responsible: SIMPPLE. Status: Finished
In this task it was implemented a "Comparison" module that allows the user to compare the
status of the centre in different years (before and after Actions Implementation) and also
compare different centres and years.
The Figure 16 shows an
screenshot of the results
obtained with this
comparison. Please note
that it includes "dummy"
results (i.e. not
corresponding to any real
health care centre).
Figure 16.- Screenshot of the
"Comparison" module
Task B2.9. Implementation of the needed templates to support the communication of the
achieved benefits (internally and externally) and the exportation of the results. For
example, automatic generation of reports (e.g. pdf files) or modules to export data to
EXCEL files. Responsible: SIMPPLE. Status: Finished
The results presented in task B2.6 are exportable in pdf and EXCEL format by using the
buttons included in this section.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 34 of 89
The Figure 17 shows an example of the pdf file generated
using this option.
Figure 17.- Example of pdf report generated by the tool
Main Outputs
The main output of this Action is the web-based tool for supporting the decision-making
process. The final and demo version were released in July 2015 (Deliverable D6).
The web-based tool is accessible using the link: http://bohealth.simpple.com/ or via the
project website (not written report is associated to this demo version).
The final/demo version include an automatic registration process, where the user enter their
basic data (name, e-mail), and define the desired password. The user receives an e-mail of
confirmation and a link to access to the web-tool. The demo version includes a "Case Study"
to guide the user in the type of information needed and the type of results that can achieve
using the tool.
The beta version was used in the two healthcare centres proposed in action B.3. In addition,
some stakeholders have asked for access to this version to test the tool by their own.
Major Problems/drawbacks
The alpha and the beta versions of the tools were released on time (month 13 and 18
respectively). However, some modifications have been made to this initial beta version,
following the comments received from stakeholders in the workshop held on 1/12/2014. The
beta version was finally released in March 2015. The Final and Demo version were released
in July 2015 (one month later than initially scheduled).
On the other hand, it is proposed a change in the scope of the Demo version. Initially it was
proposed that "This version will not be fully operative, but will show to the third interested
parties the benefits of using the proposed web-application". After discussions inside the
consortium and with stakeholders it was decided that this demo version should be fully
operative, but with limited use in time (i.e. 3 months use). It is considered that this approach
will show better the potential of the web-based tool and it will engage more potential users.
The main drawback in this Action is that the different stakeholders have different points of
view about what could be required to the tool. This is because they have different levels of
development in their environmental management systems, type of installations, services, etc.
From one hand this is good, because different points of view are listened, but on the other
hand, it makes difficult the inclusion of all the requirement in one unique tool.
Continuation after end of the project
The demo version will be freely available for testing in the project web-site (five years after
project ending). The stakeholders will have an unlimited access to the final version of the tool.
In the future, it is scheduled the development of a commercial version of the web tool, which
will be advertised and distributed by SIMPPLE.
Consultancy services will be offered associated to the web-tool (e.g. support in its
implementation on healthcare centres, customisation of the web-tool for specifics needs, etc.).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 35 of 89
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action B2 Easy to use web-based
application based on the
proposed approach (demo
and final versions)
Interviews to obtain
feedback (15 internal
meetings)
Developed the demo and
final version of the tool
10 internal meetings
14 external interviews
(stakeholders)
Success. Good results
obtained in both cases
studies. Released the
demo version (fully
operative). Available via
the project web site.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 36 of 89
5.1.5. Action B.3.- Approach & web application implementation in two centres
Main Objectives
The objective of this action has been to implement the proposed approach and the developed
web application in two Healthcare Centres belonging to FHSPST. The intention is to:
Check the applicability of the approach in different centres and validate the results with
real measures
Check the functionality and usability of the web application
Estimate the time and resources needed to implement the new approach
Assess the economic, environmental and social benefits of its implementation
Collect the management and stakeholders’ opinion about the usefulness of the proposed
approach and web application (in order to improve the final version of the tool)
The two healthcare centres selected for this implementation are described in the Table 9. The
first one is a Day hospital next to a Geriatric Centre and the second one is a small inpatient
hospital.
Centre de Llevant Hospital de Vendrell Built Area: 14.933 m
2 Built Area: 15,798 m
2
Year of Construction: 2002 Year of construction: 2005
Main Services:
Day Hospital (5,894 m2)
o Secondary healthcare centre
o Rehabilitation centre
o Diagnostic Imaging Services
o Major ambulatory surgery
Primary healthcare centre (1,449 m2)
Geriatric Centre:
o Inpatients (120 beds.- 2,762 m2)
o Day hospital (20 places)
o Residence (60 beds.- 3,053 m2)
Main Services:
Inpatient Hospital
o Inpatient (128 beds)
o Urgencies (10 beds)
o Major ambulatory surgery (10 beds)
o Day hospital (10 beds)
Rehabilitation Services
Diagnostic Imaging Services
Major ambulatory surgery
Urgencies
Laboratories
Secondary health care centre
Pharmacy
Table 9.- List of selected health care centres for the implementation
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Activities/Progress/Modifications
Type Implementation Action Status Done
Duration Foreseen: month 18 to 24
Actual: month 18 to 25 Schedule Nearly on time (one month
delay)
Leader FHSPST Modifications No
Collaborate SIMPPLE, LEITAT Objectives Achieved
Deliverables Deliverable D7.- Report on action plan implementation
The details of the tasks carried out in this Action are presented hereafter:
Task B3.1. Division of the centre in representative sections and identification of the most
relevant flows. The most appropriate KEPIs and functional units for each section were
defined when required. Responsible: SIMPPLE. Status: Finished.
The selected healthcare facilities were divided in representative sections (e.g. laboratories,
surgery theatres, etc.) and the most relevant flows (Inputs-Outputs) were identified (e.g.
energy consumption, water consumption, waste generation, use of different equipment,
etc.).
Task B3.2. Implementation of the beta version of the web application, collecting the
needed data, filling in the needed questionnaires, etc. Responsible: SIMPPLE. Status:
Finished.
The needed information about the characteristics of the general equipment (e.g. chillers,
boilers, etc.), medical equipment (e.g. X-ray imaging devices, etc.), and supporting
equipment (e.g. industrial dishwashers, washing machines, ovens, etc.) were collected. In
total, more than 60 different equipments were included for each centre.
Additionally, information about the type of lighting per section, construction
characteristics, points of water consumption, climatic conditions, etc. were gathered,
analysed and entered in the web-based application in order to simulate both centres.
It was also collected the general consumption of energy (i.e. electricity and natural gas)
and water for present and previous years (bills, etc.). Similar for the sanitary waste
generated in the centres (i.e. official reports on waste generation).
This information was collected in collaboration with FHSPST.
Once this information was collected, on-site visits and meetings with people in charge
were carried out to confirm and validate the gathered information.
Once validated, the information was entered in the web-tool, and both centres were
simulated and assessed using the Assessment module of the tool. The Figure 18
summarised the results for the Centre de Llevant for electricity consumption (more details
in Annex 7.-Deliverable D7).
www.bohealth.eu – [email protected] LIFE2012 ENV/ES/000124 10
Global resultsElectricity-2014
Global
ClimatisationEquipment
Electricity kWh/year €/year kg CO2/year %
Air conditioning 1.009.237 133.576 250.291 37
Cooling 651.452 86.222 161.560 24
Heating 0 0 0 0
Ventilation/Air conditioning 357.785 47.354 88.731 13
Lighting 563.532 74.586 139.756 21
Elevators 46.680 6.178 11.577 2
Other general services 606.087 80.218 150.310 22
Medical equipment 213.650 28.277 52.985 8
Diagnosis equipment 156.654 20.734 38.850 6
Treatment equipment 18.996 2.514 4.711 1
Support equipment/vital treatment 38.001 5.030 9.424 1
Equipment Associated Services 265.738 35.171 65.903 10
Cooking equipment 130.746 17.305 32.425 5
Laundry equipment 93.977 12.438 23.306 3
Others 41.014 5.428 10.172 2
IT Equipment 914 121 227 0
IT equipment - Desktop 352 47 87 0
IT equipment - Monitor 561 74 139 0
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 38 of 89
www.bohealth.eu – [email protected] LIFE2012 ENV/ES/000124 13
Results per section
Section Area (m²)
Aparcamiento 2.744
CAP 1.396
Cocina 1A Planta 847
Cocina PB 169,4
Consultas Externas 1.234
Diagnóstico por la imagen 918
Diálisis 510
Lavandería 50
Oficinas 528
Quirófanos 1.015
Rehabilitación 594
Residencia 2.235
Servicios generales 1.036
Sociosanitario 1.771
Vestuarios 105
Section % Electricity % Thermal % Water % Wastes
CAP 4.45 3.04 4.88 2.84
Consultas Externas 4.87 3.45 13.93 2.84
Aparcamiento 0.32 0.00 0.01 0.95
Diálisis 5.11 5.13 34.41 4.73
Cocina PB 4.82 0.20 1.71 4.73
Quirófanos 8.83 13.47 2.02 14.20
Rehabilitación 2.53 8.56 2.27 4.73
Diagnóstico por la imagen 12.72 7.08 0.37 4.73
Residencia 19.51 10.74 13.71 14.17
Sociosanitario 23.04 27.26 13.43 12.09
Oficinas 2.38 1.34 0.00 2.84
Cocina 1A Planta 3.22 18.45 1.25 28.35
Vestuarios 0.39 1.26 11.63 0.00
Lavandería 4.60 0.03 0.38 0.00
Servicios generales 3.22 0.00 0.00 2.84
TOTAL 100 100 100 100
Figure 18.- Global Results. Assessment of Centre de Llevant (electricity)
Task B3.3. Identification, quantification and prioritisation of the most significant
environmental aspects associated to these centres, using the web application and the
defined KEPIs. Responsible: LEITAT. Status: Finished
Using the results of the previous assessment, the different environmental aspects were
prioritised using the respective module of the web-tool. This prioritisation allowed the
identification of most relevant aspects, such as electricity consumption in refrigeration, etc.
Figure 19 shows the results obtained for the Centre de Llevant (red labels show the
relevant aspects in this case).
Figure 19.- Prioritisation of environmental aspects (Centre de Llevant)
Task B3.4. Identification and prioritisation of the most feasible measures (BATs) that can
be applied to each centre, using the web application. Responsible: FHSPST. Status.
Finished
The respective module of the web-tool was used in both cases to prioritise the most
feasible measures in the assessed healthcare centres.
Figure 20 shows the first results for the Centre de Llevant (using the BATs proposed in the
project.- See Action A.2).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 39 of 89
Figure 20.- Prioritisation of best practices (Centre de Llevant)
Task B3.5. Development of training and communication sessions with involved staff (e.g
managers, sections' responsible, etc.). Responsible: FHSPST. Status: Finished
Once the web-based application was tested and verified, training sessions have been
carried out with the future users of the web-tool in order to present it. In this case it was
decided to centralise the presentations to the main responsible of the analysed centres and
other centres of FHSPST (potential future users), to show the web-tool, the results
achieved and the potential benefits of implementing the tool in the respective centres.
During the implementation process and the direct work with the centres, SIMPPLE
collected their feedback about the usability of the tool, possible bugs, possible
improvements, etc. Some of these comments were considered in the development of the
final version of the tool.
Main Outputs
The main output of this Action is the implementation of the proposed methodology and web-
based tool in two healthcare centres of FHSPST (i.e. Hospital de Vendrell and Centre de
Llevant), and the verification of their applicability and usability. The results obtained from
this implementation allowed the responsible of the centres to better know the environmental
profile of the centre and their sections, and also to have a clear picture of the aspects and
sections were the improvement actions will be more effective.
Apart of the two centres initially proposed in the project, some stakeholders show their
interest to also test the web-based application. These additional testing actions have provided
more feedback for the improvement of the final version of the tool.
The results of this implementation are reported in the Deliverable D7.- Report on action plan
implementation (annexed in paper and electronic format as Annex 7 of this report).
Major Problems/drawbacks
The 1 month delay on the development of the beta version of the web tool produced a minor
delay in the process of entering the data in the tool. During this period, the needed
information for both centres has been gathered, which in some cases were more complicated
than expected because the information was dispersed in various departments, not clear
inventory of all the installed equipment, lack of data from some equipment, etc. In some
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 40 of 89
cases, due to this lack of information, some equipment has been simulated using bibliographic
data of similar equipment.
It is expected that the implementation in other centres will be easier, if the information is
more accessible. This could be the bottleneck of the process, because the introduction of the
collected information in the tool is quite easy.
Continuation after end of the project
The idea is that the two selected centres will use the tool in the future and, based on their
experience, the tool would be implemented in other centres belonging to FHSPST.
During the project a new healthcare centre has been assessed with the tool (i.e. CAP de
Vilaseca, which is a primary & secondary healthcare centre, including urgency services and
rehabilitation. Its built area is about 4.430 m2).
Also it is expected that some of the involved stakeholders will completely implement the tool
in their centres in the near future.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action B3 Real implementation of
the approach and web
tool in two health care
centres
10 meetings per centre
(20)
3 informative session per
centre (6)
Technical report for each
centre (2)
Satisfaction survey for
each centre (2)
Collection of the needed
data in the two selected
centres, and input of this
date in the tool
2 general meeting
presentation for people in
charge (for both centres
and other centres with
potential interest)
6 general meetings with
people responsible for data
collection (the rest via
direct communication
between responsible and
people in charge)
Deliverable D7, showing
the results in both centres
Success: The proposed
methodology and web-
tool have been
successfully
implemented in the two
healthcare centres,
giving good results.
The feedback of users is
good, but they have
highlighted the time
needed to collect the
information, depending
on the level of detail and
data availability
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 41 of 89
5.1.6. Action B.4.- Definition and implementation of “Environmental Action Plans”
Main Objectives
The objective of this action has been to define and implement the most appropriated
“Sustainable Action Plans” that will lead to reduce the environmental impact of the activity of
the analysed healthcare centres (e.g. lower energy or water use, better waste segregation, etc.).
These Action Plans were defined taking into account the results of the previous Action, and
they were monitored using the web-tool.
Activities/Progress/Modifications
Type Implementation Action Status Done
Duration Foreseen: month 20 to 26
Actual: month 20 to 34 Schedule Delay of 8 month due to
internal budget restrictions
and other issues. Prolonged in
order to include as much
actions as possible.
Leader FHSPST Modifications Not all proposed actions were
fully implemented, but their
potential impacts have been
estimated. Extended the
duration of the Action to try to
implement more actions
Collaborate LEITAT, SIMPPLE Objectives Mainly achieved
Deliverables Deliverable D7.- Report on action plan implementation
The details of the tasks carried out in this Action are presented hereafter:
Task B4.1. Definition of the potential "Sustainable Action Plans". Responsible: SIMPPLE.
Status: Finished.
The potential "Sustainable Action Plans" have been defined considering the most feasible
BATs identified in the previous Action and the results obtained with the web-tool (e.g.
most relevant uses (e.g. climatic units) and sections (e.g. surgery theatres).
The developed web-tool has been used to analyse and prioritise different alternatives.
Task B4.2. Assessment of the potential benefit of the proposed Actions. Responsible:
LEITAT. Status: Finished.
The potential impact of the different actions have been assessed or estimated considering
the specific characteristics of each centre, based on the results obtained with the web-tool
(e.g. % of contribution of lighting in different sections and potential saving).
For those actions really implemented, the real monitoring of the impact has been done in
Action C1.
Task B4.3. Selection of the most feasible "Sustainable Action Plans". Responsible:
FHSPST. Status: Finished.
The most feasible Sustainable Action Plans for each centre has been selected considering
aspects such as the needed time for implementation, the needed resources, the needed
investment, the potential payback period (ROI), etc.
Task B4.4. Definition of people in charge, etc. for the implementation of the selected
"Sustainable Action Plans". Responsible: FHSPST. Status: Finished.
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Based on the selected actions, it was defined the timing for each action, the needed budget,
the people in charge, the potential indicators to monitor the action, etc. This information
has been introduced in the web tool to facilitate the monitoring of the actions.
The people in charge have been informed about their responsibilities and implementation
schedule.
Task B4.5. Implementation of the selected "Sustainable Action Plans". Responsible:
FHSPST. Status: Partially Finished.
The Table 10 summarises the proposed actions for each centre, showing the environmental
aspect covered, their potential impact, their status, etc.
Centre de Llevant
Action System &
aspect
Objective Expected Saving Estimation
per year
Installation of electric
meters (power, etc. with
register) in three Chillers
Air
conditioning
(energy)
To monitor the actual
consumption of the chillers
to optimise their use
according with the demand
5 % of the estimated
energy consumption
on refrigeration
(651.452 kWh/year)
32.500 kWh =
4290 € = 8060
kg CO2eq
Installation of automatic
control of lighting (43
sensors)
Lighting
(energy)
To control the lighting via
sensors of occupancy and
daylight
10% of the energy in
the sections where the
control is placed
56.353 kWh =
7459€ =13976
kg CO2eq
Installation of water
meters (in 4 sections)
Water To monitor the actual
consumption of water to
optimise their consumption
(e.g. detection of leaks,
etc.)
5 % of the water
consumption (e.g.
residence & external
consultation)
265 m3 =
1018 € = 105
kg CO2eq
Installation of CVMs in
the secondary electric
panels (6 CVMs, one per
floor)
Various
(energy)
To monitor the electricity
consumption per floor and
detection of major
consumers
2 % of the global
consumption due to
optimisation
54.117 kWh =
7.163 € =
13.421 kg
CO2eq
Installation of heat
recovery modules in the
air conditioners of
surgery service (3 units)
Air
conditioning
(energy)
To recover the heat from
the re-circulated air.
Selected the major
consumers of ventilation
20% of the
consumption in this
area (112.715 kWh/y)
22543 kWh =
2984 € = 5591
kg CO2eq
Inventory of the
equipment
All (Energy
& Water)
To know the power of all
the equipment installed in
the center, their location
and maintenance
requirements
Indirect saving
Maintenance
management system
All (Energy
& Water)
Update the maintenance
management system
(revisions, etc.)
Indirect saving due to
a better maintenance
Maintenance routes
update
All (Energy
& Water)
To review the status of the
equipment by revision
routes to be done by
maintenance staff.
Indirect saving due to
a better maintenance
and malfunction
detection
Hospital de Vendrell Action System &
aspect
Objective Expected Saving Estimation
per year
Substitution of the
heating system (2 boilers)
Heating and
Sanitary hot
water
(energy)
To increase the
efficiency of the heating
and SHW system
9% thermal efficiency
increase (from 97% to
106%)
143.144 kWh
(12.193 m3
n.g) = 6.920 €
= 26.427 kg
CO2eq
Installation of electric
meters (power, etc. with
Air
conditioning
To monitor the actual
consumption of the
5 % of the estimated
energy consumption
32.500 kWh =
4290 € = 8060
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 43 of 89
Hospital de Vendrell Action System &
aspect
Objective Expected Saving Estimation
per year
register) in three Chillers (energy) chillers to optimise their
use according with the
demand
on refrigeration
(651.452 kWh/year)
kg CO2eq
Installation of automatic
control of lighting (151
sensors)
Lighting
(energy)
To control the lighting
via sensors of occupancy
and daylight
10% of the energy in
the sections where the
control is placed
56.353 kWh =
7459€ =13976
kg CO2eq
Installation of water meters
(in 4 sections)
Water To monitor the actual
consumption of water to
optimise their
consumption (e.g.
detection of leaks, etc.)
5 % of the water
consumption (e.g.
residence & external
consultation)
265 m3 =
1018 € = 105
kg CO2eq
Installation of CVMs in the
secondary electric panels (6
CVMs, one per floor)
Various
(energy)
To monitor the electricity
consumption per floor
and detection of major
consumers
2 % of the global
consumption due to
optimisation
54.117 kWh =
7.163 € =
13.421 kg
CO2eq
Inventory of the equipment All (Energy
& Water)
To know the power of all
the equipment installed in
the center, their location
and maintenance
requirements
Indirect saving
Maintenance management
system
All (Energy
& Water)
Update the maintenance
management system
(revisions, etc.)
Indirect saving due to
a better maintenance
Maintenance routes update All (Energy
& Water)
To review the status of
the equipment by revision
routes to be done by
maintenance staff.
Indirect saving due to
a better maintenance
and malfunction
detection
Use of closed &
refrigerated containers for
sanitary waste (in 2 areas)
Sanitary
waste
(Waste)
Use of closed &
refrigerated containers for
sanitary waste
10% reduction in the
number of containers
collected
4333 ltr
Programmed / Done
Table 10.- List of Action Plans for each Centre
As the Table 10 shows, not all the programmed actions have been completed during the
project development. It is needed to mention that these actions are self-financed by FHSPST,
and their costs were not included in the project budget. The delays in the scheduled date for
implementation are due to internal budget restrictions during years 2015 and 2016, not
availability of needed resources (workload of the necessary staff) and difficulties to stop
programmed operations (e.g. stop of climatic unit of surgery theatres).
This risk has been identified in the project proposal, and the proposed corrective actions have
been carried out (i.e. estimation of the impact of all the proposed actions, and implementation
in the web-tool).
Despite that not all proposed action were really implemented, the objectives of the action have
been achieved because:
It was possible to define Action Plans based on the results of both centres
It was possible to monitor the Implementation of the Action Plans using the web-based
tool, testing the usefulness of this module
It was possible to assess and quantify the potential impact of all the actions (in some
cases with estimations)
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 44 of 89
The Figure 21 shows
some pictures of the
implemented actions:
Figure 21.- Example of
implemented action
(Hospital de Vendrell)
Main Outputs
For each analysed centre, it was defined Action Plans to improve their environmental profile,
based on the web-tool, and the prioritisation of potential actions. The selected Action Plans
have been scheduled, and the people in charge have been defined, etc. The monitoring of the
actions has been done using the specific module of the web tool.
For those actions that was not possible to implement, it has been estimated their potential
environmental and economic impact.
The results of this Action has been reported in the Deliverable D7.- Report on action plan
implementation, attached to this Report as Annex 7 (in paper and electronic format).
Major Problems/drawbacks
As mentioned above, the main problem was associated to the impossibility to really
implement all the proposed actions during the project development. The costs of these actions
were not included in the project budget and they have been self-financed by FHSPST. The
present economic situation has generated significant budget restrictions in the sanitary sector,
making necessary to prioritise the possible investments. Other factors that have hindered the
implementation of some actions were the workload of the necessary staff and the
impossibility to programme the needed stop-of-operations to implement the actions.
Continuation after end of the project
The programmed actions will be implemented after the end of the project, when the necessary
budget and conditions were available.
The implemented actions will be operative after the end of the project and they will be used as
example for other centres interested in the implementation of the proposed approach and web-
based application.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action B4 Implementation of the
proposed action plan in
the two centres (10 action
per centre)
Definition of Action Plans
(8 actions in Centre
Llevant and 9 actions in
Hospital del Vendrell)
Partial Success: As
mentioned above, not all
the scheduled action
have been fully
www.bohealth.eu – [email protected] LIFE2012 ENV/ES/000124 8
Examples of some actions (1 of 5)
More efficient boilers
New boilers and better system isolation
(Hospital del Vendrell).- Done
New boiler (x2) Old Boiler
Model EuroCondens SGB 470 E ADINOX BT Polyvalente 500
Type Condensing boiler Low temperature boiler
Maximum Power (kW) 496.6 (1) 464.8
Minimum Power (kW) 102.8 154.6
Water Capacity (ltrs.) 84 112
Modulation range 16-100% -
Energy Performance 105.9 % 95%
Weight (kg) 598 470
(1) Temperature output/return of 50/30 ºC
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Action Foreseen in the revised
proposal
Achieved Evaluation
These actions cover
different aspects (energy,
water and waste)
Assessment of the actions
using the web-based tool
implemented during the
project development
(own financed by
FHSPST)
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5.1.7. Action C.1.- Monitoring of project impact after Action Plans implementation
Main Objectives
The objective of this action has been the monitoring of the project impact on the
environmental aspects covered by the proposed “Sustainable Action Plans”.
To achieve this objective, it was taken into account:
the specific characteristics of each healthcare centre
the implementation time
the potential benefit of all actions (estimation of those not fully implemented)
the potential impact if these actions and results are replicated in other healthcare centres
(at national and international level)
Activities/Progress/Modifications
Type Monitoring Action Status Done
Duration month 22 to 34 Schedule On time
Leader FHSPST Modifications Not used the sub-
contracting budget for
monitoring
Collaborate LEITAT, SIMPPLE, Xarxa Objectives Achieved
Deliverables Deliverable D8.- Report on project impact monitoring
The details of the tasks carried out in this Action are presented hereafter:
Task C1.1. Sustainable Action Plans validation and results monitoring Responsible:
FHSPST. Status: Finished.
The implemented "Sustainable Action Plans" have been monitored in order to assess the
real benefits achieved during the project development. Those that were not finally
implemented have been estimated in order to know their potential impact.
Due to the characteristics of the centres and the type and number of actually implemented
measures, it was considered not profitable to use the budget for external assistance, which
was planned in order to carry out an Energy Audit of the centres by using electricity
meters, etc.
The monitoring has been done using the existing meters and/or estimating the potential
savings by using the developed web-tool.
The Figure 22 shows the monitoring of the savings achieved by the change of the boilers in
the Hospital de Vendrell during one year. To reduce the effect of climatic conditions, the
new situation has been compared with the average value of the four previous years (base-
line). As normal, the main difference corresponds to winter period.
This monitoring shows that the saving achieved in natural gas consumption, only with this
action, in this period (12 months) is about 479.342 kWh (28,878 € / 87,996 kg CO2eq).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 47 of 89
-100.000
0
100.000
200.000
300.000
400.000
500.000
600.000
Co
nsu
mo
(kW
h)
Meses
Hospital del Vendrell.- Comparativa consumo gas
Linea base
2015-2016
Acumulado
Figure 22.- Example of action monitoring (Hospital del Vendrell)
Task C1.2. Assessment of the achieved improvements using the proposed “key
performance indicators” and the most appropriated “functional unit” for these centres.
Responsible: LEITAT. Status: Finished.
By using the monitored data and the assumptions made (in some needed cases), it has been
assessed the potential environmental impact of the project, considering the environmental
aspects where these actions had some effect (i.e. the consumption of electricity, natural gas
and water and the generation of sanitary waste).
In order to carry out this assessment, the achieved results have been compared with a base
case that considers the average values of the five previous years (when data is available).
This assessment includes some of the KEPIs identified in the Action A1 (e.g. kWh/m2 or
kWh/bed).
Environmental benefits by applying the action plan implemented in each healthcare centre
have been expressed and have been quantified by the main KEPIs. The saving measures
implemented have led to energy reduction, water reduction, and a waste management
improvement. The results have been reported in the D8.
Task C1.3. Revision of the results and new "Sustainable Action Plans". Responsible:
FHSPST. Status: ongoing.
The intention of this task was to analyse the results achieved and define new action plans.
However, due to the fact that not all the proposed actions have been fully implemented, the
decision has been to wait until all the actions were finished and validated in order to define
the new ones. This task will be followed after the end of the project.
Task C1.4. Extrapolation of the results. Responsible: SIMPPLE. Status: Finished.
In this task, the results obtained for the two healthcare centres have been extrapolated at
regional, national and European level. The idea is to estimate the potential impact of the
project if other healthcare centres use the web-based tool, define similar action plans and
obtain similar results than the case studies.
In order to make this estimation, it was analysed the number of healthcare centres and the
number of bed which are located at regional, national and European Level. Afterwards, an
implementation rate has been assumed for each level, and it was assumed a similar impact
reduction per bed and centre than the average obtained in both cases.
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The Table 11 shows the assumptions made for the calculation and the potential results.
Level Catalonia Spain Europe 28
Nº of hospitals 211 789 7154
Nº of beds 34.437 162.070 2.646.673
Average nº beds/hospital 163 205 370
Implementation rate 30% 10% 2%
Nº of implemented hospitals 63 79 143
Nº of implemented beds 10.331 16.207 52.933
Electricity saving (kWh/year) 10.839.474 15.225.350 39.732.519
Natural Gas savings (kWh/year) 7.841.457 11.051.714 29.075.788
Water savings (m3/year) 80.679 113.412 296.515
Table 11.- Estimations and results for the extrapolation of the case studies
According to these estimations, the potential savings at global level would be the
following:
Electricity saving (kWh/year): 65.797.343
Natural Gas (kWh/year): 47.968.958
Water (m3/year): 490.605
Task C1.5. Development of a comparative LCA studies of the analysed centres.
Responsible: LEITAT. Status: Finished.
Comparative analysis has been done to determine the environmental improvement reached
by the action plan implemented in each healthcare centre. These environmental
assessments have been done based on the LCA methodology. The results obtained have
demonstrated the potential environmental impact reduction expressed with the different
impact categories as climate Change, acidification, eutrophication, ozone depletion, water
depletion and resources depletion. The results have been detailed in D8.
The comparative analysis of Hospital del Vendrell shows that after the sustainable action
plan implementation, the potential environmental impact has been reduced in 5.9% (from
5.3% to 6.8%). In terms of carbon footprint avoided (CO2 eq.), BOHEALTH project avoids:
Figure 23.-Quantity of CO2 eq. avoided at Hospital del Vendrell
And the comparative analysis of Centre de Llevant demonstrates that after the sustainable
action plan implementation, the potential environmental impact has been reduced in 6.9%
(from 6% to 7.5% depending on each impact category). The carbon footprint reduction in
this case study is the following:
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 49 of 89
Figure 24.-Quantity of CO2 eq. avoided at Centre de Llevant
These LCA results take advantage of the Task A1.2, where a "representative" hospital was
assessed using LCA and LCC methodologies. In this case, real data of both healthcare
centres has been used.
Main Outputs
The results of this action have been reported in the Deliverable D8.- Report on project
impact monitoring, attached to this report as Annex 8 (in paper and electronic format).
This action allowed the monitoring, estimation and assessment of the project environmental
benefits (e.g. energy savings, etc.) and environmental impact reduction (e.g. Global Warming
Potential), using the LCA methodology.
These results have been extrapolated to regional, national and European level, making some
assumptions (e.g. level of implementation in each level, etc.). This estimation showed the
high potential impact of the proposed approach, web-tool and implementation of Sustainable
Action Plans"
Major Problems/drawbacks
The main problems to develop this action were the need of estimating the impact of non-
implemented actions and the definition of some hypothesis needed to extrapolate the results at
regional, national and European level.
Also, the fact that not all the activities included in the Action Plans had been implemented has
an effect on the monitoring of these actions and on the most profitable way of doing it. The
consortium decided do not spend the proposed budget for external assistance (i.e. energy
audits and metering), because it was considered that the implemented actions could be
monitored in another way, without spending this budget. If all the actions had implemented,
this external assistance would have had more sense.
Continuation after end of the project
The implemented actions will be monitored after the end of the project to analyse their
evolution and to confirm the achieved benefits.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action C1 Monitoring of the project
impact in the two centres
75% of actions
implemented,
80% of expected impact
achieved
The actions have been
monitored using the web-
tool
The actions not fully
implemented have been
simulated and identified
the potential saving
Success: The
implemented actions
have been monitored and
relevant reductions on
the expected impact
have been achieved.
In some cases, the
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 50 of 89
Action Foreseen in the revised
proposal
Achieved Evaluation
Monitoring of the energy,
water and sanitary waste
generated
Actions Implemented (11
over 17: 65%)
Reduction Gas Natural in
H. Vendrell: objective 5%;
achieved 23%
Reduction Sanitary Waste
H.Vendrell.- Objective 3%,
Achieved: 13% (Group
III); 35% (Group IV)
Deliverable D7 showing
the results in both centres
reduction cannot be only
assigned to the
implemented actions.
Extrapolated the
potential environmental
impact at regional,
national and EU level
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 51 of 89
5.1.8. Action C.2.- Assessment of the socio-economic impact of the project
Main Objectives
The objective of this action has been to assess the socio-economic impact achieved by the
project after the implementation of the proposed approach and the associated “Sustainable
Action Plans”, in each case study: Hospital del Vendrell and Centre de Llevant. Both centres
are located in Tarragona (Spain). The analysis has compared the baseline scenario (before the
project implementation) with the scenario after the project implementation to quantify the
economic improvement reached and the social benefits obtained.
Activities/Progress/Modifications
Type Monitoring Action Status Finished
Duration month 31 to 35 Schedule On time
Leader LEITAT Modifications No
Collaborate FHSPST, SIMPPLE Objectives Achieved
Deliverables Deliverable D8.- Report on project impact monitoring
The details of the tasks carried out in this Action are presented hereafter:
Task C2.1. Life cycle costing comparative assessment, quantifying from an economic point
of view the project impact. Responsible: LEITAT. Status: Finished.
The methodology that has been applied to assess the economic impact has been based on
the Life cycle costing methodology (LCC). According to this methodology the stages that
have been followed are: goal and scope definition, inventory, assessment the impact and
interpretation of the results. The economic values that have been considered are: the
investments related to each implementation action, the operational costs related to the
action plan, and the economic benefits obtained by the sustainable action plan
implementation. And also the eco-cost2 has been considered; this value has been employed
to represent the cost which should be made to reduce the environmental impact. To express
the results of the economic impact of the project, a period of 10 years has been considered.
Task C2.2. Assessment of the social effects associated to the developed actions in the
analysed hospitals. Responsible: LEITAT. Status: Finished.
To assess the social impacts of the project, these steps have been followed: goal and scope
definition, mapping the areas of impact (identification the project stakeholders and the
potential social impacts), definition the baseline, definition and quantification the social
impacts after the project implementation and interpretation.
Task C2.3. Assessment of the potential socioeconomic impact of the project at national and
European level. Responsible: SIMPPLE. Status: Finished.
The potential socioeconomic impacts of the project have been estimated at regional,
national and at European level. To quantify the impact, the results of the previously
analysis performed (economic, environmental and social impact) and the number of
hospitals and beds have been considered. To estimate the impact, it has been assumed that
potential benefits achieved have been similar than the benefits reached by case studies
where the project has been implemented.
2 Eco-cost Value. TUDelft (http://www.ecocostsvalue.com/)
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Main Outputs
The economic analysis has determined that the total potential economic savings for a period
of 10 years at Hospital del Vendrell would be 340.611 €. The 89% of these savings would be
due to the energy saving measures; 8% due to the water saving measure and 3% related to
waste management improvement. The total cash-flow for this period would be 231.675 €. The
following table summarizes the global economic impact of BOHEALTH project implemented
at Hospital del Vendrell:
Investment cost (€) Annual economic saving (€) Annual cash-flow (€)
2015 - Year 0 108.936 29.384 -79.552
Year 1 0 29.669 -49.884
Year 2 0 29.963 -19.920
Year 3 0 30.268 10.348
Year 4 0 30.584 40.932
Year 5 0 30.910 71.842
Year 6 0 31.247 103.090
Year 7 0 31.595 134.685
Year 8 0 31.955 166.640
Year 9 0 32.326 198.966
2025 - Year 10 0 32.709 231.675
Table 12.-Global economic impact of BOHEALTH at Hospital del Vendrell
The eco-costs avoided per year related to the proposed action Plan to be implemented at
Hospital del Vendrell have been the following:
Eco-costs Electricity Natural gas Water Waste
Eco-costs avoided (€) per year 15.297 € 7.475 € 102 € 9 €
Table 13.-Total eco-costs avoided at Hospital del Vendrell
The total potential economic savings at Centre de Llevant due to BOHEALTH
implementation have been 272.336 €, considering a period of 10 years. In this case, 92% of
these savings would be due to the energy saving measures and 8% due to water saving
measures. The total cash-flow for a period of 10 years would be 261.748€. The same as the
Table 12, the following table summarizes the global economic impact of BOHEALTH
project at Centre de Llevant:
Investment cost (€) Annual economic saving (€) Annual cash-flow (€)
2015 - Year 0 10.588 22.317 11.729
Year 1 0 22.770 34.500
Year 2 0 23.235 57.734
Year 3 0 23.710 81.444
Year 4 0 24.197 105.642
Year 5 0 24.697 130.338
Year 6 0 25.208 155.546
Year 7 0 25.732 181.278
Year 8 0 26.269 207.547
Year 9 0 26.819 234.366
2025 - Year 10 0 27.382 261.748
Table 14.-Global economic impact of BOHEALTH implementation at Centre de Llevant
The eco-costs avoided per year related to the proposed action Plan to be implemented at
Centre de Llevant have been the following:
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 53 of 89
Eco-costs Electricity Natural gas Water Waste
Eco-costs avoided (€) per year 18.608 804 81 0 €
Table 15.-Total eco-costs avoided at Centre de Llevant
As results of the socioeconomic analysis, the main project stakeholders and the
socioeconomic impacts have been identified:
STAKEHOLDER IMPACTS
Healthcare centre
Provides a model of sustainable healthcare centre
Reduces the environmental impact (energy consumption, water consumption,
waste generation)
Economic benefits due to the improvement of the environmental performance
Responsible for
environmental
management in
hospital
Facilitates the identification of the relevant environmental aspects
Increase the knowledge on the environmental impact of the healthcare centre
Availability of a tool for the decision-making process in the environmental
management
Patients and
healthcare centre
workers
Healthy environment for patients and HEALTHCARE CENTRE WORKERS
Sustainable value of the healthcare service
Increases the quality of the services that they receive
Technology
providers
Increase sales of their sustainable technologies or measures
Job creation
Sustainability as an added value of their products (technology, services...)
Government
Promoting a sustainable territory at different levels (city, region, country)
Availability of a tool to promote the change to more sustainable healthcare
centres
Reduce the environmental loads of a region (e.g. Climate Change programmes)
Table 16.-Stakeholder of BOHEALTH project and the impacts
The detailed results of this action have been reported in the Deliverable D8.-Report on project
impact monitoring, attached to this report as Annex 8 (in paper and electronic form).
The results obtained in this Action supply the needed information to answer the requirement
of the Commission expressed in the letter sent on 20/07/2016 (Project visit): Technical Issues. Point 1: Task C2. Please be reminded about the importance of the socio-
economic impact originated by the LIFE BOHEALTH project, and include an analysis of the
expected benefits or the potential for economic growth and social development in the deliverable
D8. Report on project impact monitoring.
Major Problems/drawbacks
No problems and drawbacks has been found.
Continuation after end of the project
No continuation after end of the project once assessed the impact of the project.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action C2 Assessment of the socio-
economic impact of the
project
LCC analysis
The socio-economic
impact has been assessed
using a LCC approach
(economic) and a Social
Success: The LCC
methodology shows the
economic impact of the
project in both cases, but
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 54 of 89
Action Foreseen in the revised
proposal
Achieved Evaluation
SLCA analysis methodology that takes
into account the impact of
the project effect on
several stakeholders
Deliverable D8 showing
the impact of the project
also the potential impact
at regional, national and
EU level.
The social impact is
focused on centre users,
personnel and suppliers
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 55 of 89
5.1.9. Action E.2.- Networking with other projects
Main Objectives
The objective of this action has been to define the networking with other projects that cover
similar topics. Some potential candidates have been identified in the original project proposal
and other have been found during the project development.
The idea is to collaborate with these projects in order to potentiate the synergies between the
projects, especially on technical collaboration and dissemination.
Activities/Progress/Modifications
Type Management Action Status Done
Duration month 1 to 36 Schedule On time
Leader SIMPPLE Modifications Change of candidates
Collaborate LEITAT, FHSPST, Xarxa Objectives Achieved
Deliverables n/a
The details of the tasks carried out in this Action are presented hereafter:
Task E2.1.- Analysis of potential candidates for networking. Responsible: SIMPPLE.
Status: Finished
The original list of potential candidates, which was indicated in the project proposal, have
been reviewed and checked in order to select the most appropriated candidates for
networking. However, in some cases it was not possible to identify the right person to
contact in order to propose these networking activities and in other cases, some of the
identified projects were already finished (low interest in new dissemination activities).
Therefore, a new search for additional projects were done, especially focused on running
projects with similar interests in dissemination activities.
Due to the few number of running projects with similar characteristics, the analysis
included also organisations and healthcare associations.
Task E2.2.- Contacts with the coordinators or persons in charge of these projects to define
collaborative actions. Responsible: SIMPPLE. Status: Finished
Contacts with preselected project have been carried out via e-mail and teleconferences.
As a result of these contacts, some additional teleconferences and meeting have been
scheduled. However, in other cases it was not a positive feedback.
Table 17 summarises the most relevant contacts done in order to propose networking
activities with BOHEALTH project.
Type Name Contact Person Link
EU project-
LEONARDO
(running project)
EU-HCWM M. Passalacqua (Club
EMAS- partner of the
project)
www.hcwm.eu/
EU project
LIFE+ (running
project)
Smart Hospital R. Lopez (CARTIF- project
coordinator)
www.lifesmarthospital
.eu/
EU project -
LIFE+ (running
project)
OPERE Eva Mª Ben (USC-project
coordinator)
www.life-opere.org/
EU project - FP7
(running project)
RESSEEPE G. Barbano (IES-project
coordinator)
www.resseepe-
project.eu/
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 56 of 89
Type Name Contact Person Link
EU project - IEE
(finished project)
Green@Hospital D. Barrachina (Fundació
Sanitària Mollet- partner of
the project)
www.greenhospital-
emcs.eu/emcs
EU project - CIP
(finished project)
HosPilot N. Fisekovic (Philips-
Project coordinator)
http://hospilot.eu/
EU project -
LIFE+ (finished
project)
e-hospital EMAS V. Bourounis (Project
Coordinator)
--
Organisation NHS and Public Health
England Sustainable
Development Unit
J. Baddley (Head of Unit) www.sduhealth.org.uk
Organisation green Hospital Via Twitter greenhospitals.net/en
Organisation Health Care Without
Harm
Via Twitter noharm-global.org
Organisation Club EMAS-Healthcare
Group
M. Passalacqua (Director) clubemas.cat/en/
Healthcare
Association
Consorci de Salut i
Social de Catalunya
J. Sanchez (Coord. of the
General Services
Commission)
www.consorci.org
Healthcare
Association
Unio Hopitals P. Pascual (Technical
Advisor)
www.uch.cat
Healthcare
Association
Osakidetza I. Gomez (General
Direction)
www.osakidetza.euska
di.net/
Healthcare
Association
Servicio Andaluz de
Salud
M. Huerta (Coord.
Environmental Management)
juntadeandalucia.es/ser
vicioandaluzdesalud
Healthcare
Association
ICS D.Edo (Director of General
Services)
www.gencat.cat/ics/
Table 17.- Most relevant contacts for Networking
Task E2.3.- Potential signature of agreements and development of the proposed
collaborative actions. Responsible: FHSPST. Status: Finished
The Table 18 summarises the successful agreements and the collaborative activities done
during the project.
Project /Organisation Common Activities
EU-HCWM Mutual attendance to workshops (opportunity to disseminate each
other results)
Meeting on 22/04/2015
Project websites interlinked
Followers on Twitter and news retweet
Involvement in BOHEALTH final conference
Smart Hospital Testing Bohealth tool
Use of Deliverable D4 as source of information
Teleconferences & Meeting in Sevilla (AGACS 2015)
Project websites interlinked
Followers on Twitter and news retweet
Involvement in BOHEALTH final conference
OPERE Project websites interlinked
Followers on Twitter and news retweet
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 57 of 89
Project /Organisation Common Activities
Link to Hospital 2050 project (Galician Health Service project)
Involvement in BOHEALTH Final Conference
RESSEEPE Project websites interlinked
Results sharing about application on health care hospitals.-
RESEEPE demo sites at Hospital Terrassa and Hospital Taulí
(Barcelona, Spain)
Followers on LinkedIn & Twitter and news retweet
Involvement in BOHEALTH final conference
Green@Hospital Testing Bohealth tool
green Hospital Followers on Twitter and news retweet
Health Care Without Harm Followers on Twitter and news retweet
Club EMAS-Healthcare
Group Meeting on 13/11/2013
Member of the project Advisory board
Involvement in BOHEALTH final conference
Consorci de Salut i Social de
Catalunya 2 Workshops (8/10/2014 & 10/02/2016)
Unio Hopitals 2 Workshops (27/03/2015 & 31/03/2016)
Osakidetza 1 workshop (17/07/2014)
Testing Bohealth tool
Table 18.- Summary of common activities during Networking
The Figure 25 shows some screenshots of the projects web-sites interlinked with BOHEALTH
project.
Figure 25.- Screenshots of the projects with Networking activities
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 58 of 89
Main Outputs
The main output of this action has been the active Networking done with the mentioned above
projects (e.g. inter-linkage of the projects, use of the results of BOHEALTH project in other
projects, etc.), which have been reinforced with the final Conference organised by
BOHEALTH (on 25/05/2016), where these four project presented their results, and a direct
discussion was maintained to analyse further future collaborations (e.g. possible use of
BOHEALTH tool in one of the project, further common conferences, etc.)
The Networking with Healthcare associations allowed the dissemination of the project results,
carrying out workshops with these multiplier entities (more than 650 healthcare centres
related to the involved associations).
These networking activities allowed also increasing BOHELATH presence in social
networks.
Major Problems/drawbacks
The major problems were related to the difficulties to find the right contact person in each
project or organisation. Some of the indicated contacts are not operative and/or they have
changed. In other cases the projects were closed and there is not interest to collaborate in
further activities.
On the other hand, it was decided to postpone some of the contacts until more practical results
were obtained in our project (e.g. demo version of the web-based tool), in order to favour the
interest and collaboration of other projects.
Continuation after end of the project
The intention is to maintain the achieved networking (and increase it if possible) after the end
of the project, in order to better exploit and disseminate the results of the project.
The results obtained in this Action come from the efforts done to increase the Networking
according to the indications of the Commission expressed in the letter sent on 20/07/2016:
Technical issues.- Point 2.- Networking. I see that you have improved the networking with
similar Spanish LIFE projects and initiatives. I encourage you to contact with more European
healthcare organisations in order obtain valuable synergies.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action E2 Contacts with other
projects (15)
Agreements for
collaboration (5)
Common dissemination
activities (10)
Contacts with other
projects/organisations (16)
Agreements for
collaboration (8)
Common dissemination
activities (15)
Success. Networking
activities with 4 projects
(attendance to
conference, etc.) and 4
organisations (followers,
meetings, etc.)
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 59 of 89
5.1.10. Action E.3.- After-LIFE Communication Plan
Main Objectives
The objective of this action has been to produce an “After-LIFE Communication Plan” as a
separated chapter of the final report. This plan sets out how to continue disseminating and
communicating the results after the end of the project.
Activities/Progress/Modifications
Type Management Action Status Finished
Duration month 33 to 36 Schedule On time
Leader LEITAT Modifications Not foreseen
Collaborate Objectives Achieved
Deliverables Deliverable D10.- After-LIFE Communication Plan
Main Outputs
The final output has been the reviewed version of the Deliverable D10.- After-LIFE
Communication Plan, which has been submitted with this Final Report. This Deliverable is
submitted as Annex 10 (paper and electronic version). The deliverable presents the
background of the project, the communication strategy and the implementation plan.
The identified target groups are the following:
Managers of healthcare facilities or the Responsible for environmental management in
the healthcare centres.
Government that promotes sustainable regions with sustainable organizations.
European Associations at International Level that promote the sustainability in the
healthcare centres.
The identified results to be disseminated are the following:
A guide of best available technology (BATs) to apply in the healthcare centre in order
to improve its environmental performance.
A methodology and a web based tool to facilitate the decision making process (demo
version).
The application of the methodology and the tool in two healthcare centres.
Reduction of the environmental impact of the centres and other economic and social
benefits.
The identified dissemination channels are the following:
Project website
Partner's websites
Social media
Fairs, congresses and other events
Workshops and events
Web tool
The initially estimated budget to perform these actions after the end of the project is about
2,600 € (during the first year).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 60 of 89
Major Problems/drawbacks
Not major problems have been found.
Continuation after end of the project
The proposed Communication activities will be developed after the end of the project,
following the proposed actions in this Plan.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action E3 After Life
Communication Plan
(about 20 activities)
Deliverable D10 Success. Submitted the
After- LIFE
communication plan,
including future
activities
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 61 of 89
5.1.11. Action E.4.- Audit
Main Objectives
The objective of this action is to verify the financial statements provided to the Commission
in the final report. FHSPST has nominated an independent auditor to carry out this audit,
which has verified the respect of national legislation and accounting rules and also has
certified that all cost incurred respect Life + Common Provisions 2012.
Activities/Progress/Modifications
Type Management Action Status Finished
Duration month 36 to 37 Schedule On time
Leader Xarxa / FHSPST Modifications No
Collaborate External assistance Objectives Achieved
Deliverables Deliverable D11.- Audit Certificate
Main Outputs
The main output of this action is the Audit report, done by
- Name: Sr. EDUARD MEZQUIDA ANDREU
- Address: Rambla Nova 75
TARRAGONA (SPAIN)
N.I.F.: 39735484V
Member nº 10.053 of the Association of Economists of Catalonia
Member nº 5.061 of the Register of Economic Auditors
Member nº 21.296 of the Register of Official Accounts Auditors (ROAC)
The auditor's report (i.e. Deliverable D11 attached to this report as Annex 28) follows the
format of the standard audit report form. In particular the auditor clearly states that the
financial report is in compliance with the LIFE+ Programme Common Provisions, the
national legislation and accounting rules.
Major Problems/drawbacks
No main problems
Continuation after end of the project
Not applicable
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action E4 Audit certification Deliverable D11 Success. Submitted the
results of the external
Audit (Report)
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 62 of 89
5.2. Dissemination actions
5.2.1. Objectives
The main objectives have been to ensure that BOHEALTH actions, results and benefits have
disseminated to different stakeholders (Healthcare centres, Governments, environmental
managers, NGOs...). According of this, different actions and material have produced, which
have been summarised in the updated Communication Plan (D12).
In the proposal, the dissemination plan was not planned as a deliverable. The Consortium
considered the opportunity of creating a dissemination plan as a deliverable (D12) to make
easy the comprehension of the different dissemination activities. The deliverable has been
updated according to the project process. For more details see the updated Communication
Plan (D12) attached as Annex 12 in this report (electronic and paper form).
5.2.2. Dissemination: overview per activity
5.2.3. Action D.1.- Project website, including web 2.0 communication channels
Type Dissemination Action Status Finished
Duration month 1 to 36 Schedule On time
Leader LEITAT Modifications No
Collaborate Objectives Achieved
Deliverables Deliverable D12.- Communication Actions
The objective of this action has been to develop a specific project website for the
dissemination of the project activities, progress and results.
Task D1.1.- Design and development of the initial project website, including the Public
and restricted areas. Responsible: LEITAT. Status: Finished
At the beginning of the project execution, a website was created www.bohealth.eu to
provide information about the project (actions, results, partners...), background material
and all the public documents of the project to the project stakeholders. Another aim of the
website has been to provide a virtual space to share information among all the project
partners.
Related to the objectives, the website contains two main sections: the first concerning the
project information (public access) and the second one regarding all the confidential
information of the project (restricted to the partners and Advisory Board members). All
public contents have been collected in the public area of the website. These contents have
been organised in the menu by means of the following categories:
o Home: The contents of this section appear in the front-page of the website, where an
overview of the project is presented.
o News: It contains the news related to the project.
o Project: This is an abstract of the project idea, objectives and actions.
o Partners: This section contains information about each project partner.
o Photo gallery: Images related to the project has been uploaded in this section.
o Stakeholders: This section contains the name of all the collaborative entities of the
project and the networking contacts.
o Dissemination: It contains all the dissemination material that has been created during
the project execution (leaflets, newsletters, poster, public deliverables, ...)
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 63 of 89
The private area has been restricted to the registered users as the project partners. Each
partner has a username and a password that should enter into the Login Form. This section
contains information with restricted access and it has been organized with the following
structure: “Management” which contains information available for the partners and
“reports” which contains information available for the advisory board members (see
Figure 26). The management area is divided in the following sections:
o Admin management. This section is related to the administrative tasks of the project.
Documents can be uploaded and downloaded and are organized according to the
following files:
- Relevant documents such as Grant Agreement, Consortium Agreement, etc.
- Meetings: information related to project meetings such as minutes,
presentations, etc.
- Reports: all reports of the project are uploaded in this area. Each partner is
responsible of uploading the publications of which are responsible.
o Communication tools: It contains all the material generated during the project related
to its dissemination and exploitation. The communication plan, project logos, leaflets
as well as other dissemination material is available in this section.
o Technical Management: It contains information on the technical aspects of the
project.
Figure 26.-Structure of the private area in the website
The total website visits from August 2013 to July 16 (01/07/2016) have been 7,423
(average visits per month 225); the total users from August 2013 to July 2016 have been
6.352 (average users per month 192). The Figure 27 shows the distribution of visits and
users per month:
Figure 27.- Number of visits and users of the project website
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 64 of 89
The total number of foreseen visits in the proposal was 10,000 visits. It has been achieved
a 74 % of the target, which perhaps was too optimistic taking into account the specific
targeted audience (technicians and managers of healthcare centres).
The higher number of visits coincided in time with the AGACS 2015 presentation, the 3er
workshop with stakeholders and the release of the final beta version of the webtool.
The website information has been periodically updated with the information that the
project has produced (news, gallery, publications, articles, reports...). All of them have
been uploaded according to the project development.
Following the recommendation made by the Commission after the second monitoring visit,
the website has included in more detailed and updated information about the project status
(via graphic representation).
Task D1.2. - Launch and maintenance of the Web 2.0 Social Networking with
stakeholders, using existing social networks. Responsible: LEITAT. Status: Finished
A twitter (@LIFE_Bohealth) and a LinkedIn profile have been created to spread the
project information to different stakeholders interested in BOHEALTH project. In the
LinkedIn profile, the group “Sustainable Hospitals in Europe - BOHEALTH project” was
created to promote a debate related to the main issue the sustainability in Hospitals.
Related to the social networks, BOHEALTH twitter has done 130 tweets and it has 79
followers. And the LinkedIn profile of BOHEALTH has 133 contacts; and in the group
“Sustainable Hospitals in Europe - BOHEALTH project” 35 contacts have been linked.
The total number of followers has been 247, lower than the foreseen number of 1000.
Similar to the web site, the reason could be the specific profile of the expected followers
(i.e. technicians and managers of healthcare centres). This specific audience is difficult to
reach and engage, with limited dissemination channels, which made the original figure too
optimistic. However, this lower number of followers does not imply a lower impact of the
web tool (directly presented in workshops, etc.).
Task D1.3.- Regular update of the public area. Responsible: LEITAT. Status: Finished.
The public area has been updated during the project execution. News, dissemination
material (public deliverables, leaflets, newsletters, publications), photos, and the
description of project progress, have been updated on the project website.
Task D1.4.- Regular update of the restricted area. Responsible: SIMPPLE. Status:
Finished.
The restricted area has been regularly updated with the documents needed for the
administrative and technical management of the project, including draft documents of the
reports, meeting minutes, templates, etc.
Major Problems/drawbacks
No main problems found in the development of project website and web 2.0 communication
channels. The main difficulty was to arrive to the pretended audience.
Continuation after end of the project
The project web site will be maintained during 5 years after the end of the project to support
the dissemination actions proposed in the After LIFE+ Communication Plan (see Annex 10).
Project Indicators & evaluation
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 65 of 89
Action Foreseen in the revised
proposal
Achieved Evaluation
Action D1 Project website (10,000
visitors)
Social networks (1,000
followers)
News in the web site (20)
Shared documents in the
internal part (30)
Project website (7,423
visitors)
Social networks (247
followers)
News in the web site (14
news; 130 tweets)
Shared documents in the
internal part (27)
Partially achieved. It was
difficult to achieve the
target of visitors and
followers (perhaps too
optimistic for this type
of project, with a very
specialised audience)
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 66 of 89
5.2.4. Action D.2.- LIFE+ information boards and other printed material
Type Dissemination Action Status Finished
Duration month 1 to 36 Schedule On time
Leader LEITAT Modifications No
Collaborate SIMPPLE, Xarxa AIE Objectives Achieved
Deliverables Deliverable D2.- Dissemination printed material
The objective of this Action has been to design, print and distribute or display at strategic
places accessible to the public, the printed material associated to the project.
One information board has been designed in order to be distributed in different places to
promote BOHEALTH project to general public. According to this, twelve posters were
displayed at strategic places: ten copies were placed in different healthcare centres in waiting
rooms for patients and reception and lobby. One copy, with higher size, was placed in
FHSPST, SIMPPLE and LEITAT. In total, the information boards have been located in 24
different places (see attached list).
Date Location Place
December 2013 Hospital del Vendrell Reception
December 2013 Hospital del Vendrell Urgencies
December 2013 Hospital del Vendrell RX
December 2013 Hospital del Vendrell Rehabilitation
December 2013 Hospital del Vendrell Outpatient visits
December 2013 Centre de Llevant Reception
December 2013 Centre de Llevant Outpatient visits
December 2013 Centre de Llevant Imaging diagnosis
December 2013 Centre de Llevant Rehabilitation
December 2013 Hospital Sta. Tecla Reception
December 2013 SIMPPLE Main meeting room
December 2013 LEITAT LEITAT posters project area
July 2015 Hospital Sta. Tecla Outpatient visits
July 2015 Hospital Sta. Tecla Imaging diagnosis
July 2015 Hospital Sta. Tecla Urgencies
July 2015 Hospital Sta. Tecla Nurses area
July 2015 CAP Vila-seca Reception
July 2015 CAP Vila-seca Outpatient visits
July 2015 CAP Vila-seca Rehabilitation
July 2015 CAP Vila-seca Urgencies
July 2015 Xarxa Headquarter Reception
July 2015 Xarxa Headquarter Principal meeting room
July 2015 SIMPPLE Reception
July 2015 LEITAT Meeting room
Three leaflets of BOHEALTH project has been published along the project:
o The first leaflet was about the project objectives, actions and expected results
o The second one was about the web tool
o The third one was about the project results.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 67 of 89
All of them have been printed in English, Catalan and Spanish. The electronic versions of the
three leaflets were uploaded on the project website. 1000 copies of theses leaflets (300 copies
of 1st leaflet, 400 copies of 2
nd leaflet and 300 copies of 3
rd leaflet) have been printed and have
been distributed during workshops and meetings with stakeholders.
For more details see the examples of the panel and leaflets (in three languages) in the Annex 3
of this report. The Information board and the 1st Leaflet are attached only in electronic form
(already submitted in the Inception Report). The 2nd and 3rd Leaflets (in the three languages),
are attached in electronic and a paper form.
Figure 28 shows the
information board
and the First Leaflet
Figure 28.- Printed
material.
Information board
an 1st Leaflet
In the original proposal, it was indicated to print only two different versions of the leaflets
(500+500). During the project development it was decided that the new approach (three
releases) could have a higher impact, giving specific information during the different phases
of the project development. Looking to the time and resources needed to design and translate
the leaflets, it was decided to use the produced electronic versions as e-flyers (to be uploaded
to the project website). Therefore, only three revision of e-flyers have been released.
Major Problems/drawbacks
No main problems found in the design and printing of information boards and leaflets. Some
difficulties have been found in the printing process of the third leaflet, due to the coincidence
with an overworking period of the external assistance.
Continuation after end of the project
The remaining project printed leaflets will be used as dissemination material after the end of
the project, offering them during future workshops or project presentations. The information
boards will be moved to other places if possible (due to public exposure, some of them have
suffered some damages).
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action D2 Information Board (12)
displayed in 24 places
Information Board (12)
displayed in 24 places
Success.. The
information boards have
Information Board 1st Leaflet
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 68 of 89
Action Foreseen in the revised
proposal
Achieved Evaluation
Number of printed flyers
(1,000). 2 releases
(500+500)
e-flyers update (4)
Number of printed flyers
(1,000). Three releases
(300+400+300)
e-flyers update (3)
been moved to 12 new
places.
Three versions of flyers
have been released: 1st
on project description
(300), 2nd on the web-
based tool (400) and 3rd
on project results (300)
The electronic version of
the flyers have been
uploaded to the project
website
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 69 of 89
5.2.5. Action D.3.- Layman’s report
Type Dissemination Action Status Finished
Duration month 36 Schedule On time
Leader LEITAT Modifications No
Collaborate SIMPPLE, FHSPST Objectives Achieved
Deliverables Deliverable D9.- Layman's Report
The objective of this action has been to design and publish the Layman’s report associated to
the project. LEITAT has been the responsible for this action; FHSPST and SIMPPLE have
contributed to the design and the correction of this material.
The Layman’s report has been presented as project Deliverable 9 (D9). It has been created in
three languages: Spanish, Catalan and English. The electronic format has been uploaded on
the project website, and the printed copies will be used as dissemination material in future
workshops and project presentations according to the After-Life Communication plan (see
Annex 10).
This deliverable is attached as Annex 9 of this report (electronic and paper form). Figure 29
shows the first page of the English version.
Figure 29.- BOHEALTH Layman's report
Major Problems/drawbacks
No main problems found in the design and printing of the Layman's Report. Some difficulties
have been found in the printing process due to the coincidence with an overworking period of
the external assistance.
Continuation after end of the project
The Layman's report will be used as dissemination material after the end of the project,
offering them during future workshops or project presentations. It will be sent electronically
to potential future stakeholders.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action D3 Layman's report (5-10
pages) in English.
Spanish and Catalan
Deliverable D9
Printed 200 copies
Success. Submitted the
Layman's report in three
languages
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 70 of 89
5.2.6. Action D.4.- Workshops with other Healthcare institutions and employees
Type Dissemination Action Status Finished
Duration Month 11 to 36 Schedule On time
Leader FHSPST Modifications No
Collaborate LEITAT, SIMPPLE, Xarxa AIE Objectives Achieved
Deliverables
The objective of this action has been to organise or to attend to specialised workshops with
other stakeholders of the Healthcare sector, to present the results of the project as soon they
are obtained and define collaborative actions to implement the proposed methodology and
web-based application in other hospitals or healthcare centres after project ending.
Task D4.1.- Take part in the technical commissions of the most relevant Hospitals
Associations in Catalonia. Responsible: FHSPST/Xarxa. Status: Finished.
Unió Catalana d’Hospitals and Consorci de Salut i Social de Catalunya are the most
relevant Hospitals Associations in Catalonia. Two workshops have been held with each
Association in different stages of the project development. The intention of the first
workshop was to attract the attention on the project and involve some of the associated as
stakeholders. The second workshop had the intention of presenting the project results and
the web-tool.
The workshops have been organised taking advantage of the regular meetings that both
organisations (i.e. Unió Catalana d’Hospitals and Consorci de Salut i Social de Catalunya)
maintain for the different working groups. In this case, the presentations of the
BOHEALTH project have taken place in the working groups of General Infrastructures
and Equipment (i.e. managers of the general services of different hospitals, directly
involved in the aspects of energy efficiency, etc.). These four workshops are summarised
hereafter:
Unió Catalana d'Hospitals (web: http://www.uch.cat/)
Place: Headquarter in Barcelona
Working Group: Technical Advisory Board on Infrastructures and Equipment
1st Workshop.- Date: 27/03/2014
Topics: Presentation of the project, objectives and status
Number of Attendants: 15. List of organisations:
Hospital Sant Pau Hospital Clínic
Parc Taulí Fundació Asil de Granollers
Hospital de Mollet Hospital Esperit Sant
Institut Guttman Institut d'Assistència Sanitària (IAS)
Mútua Terrassa Hospital de Vic
2nd Workshop. Date: 31/03/2016
Topics: Presentation of the project web-tool and results
Number of Attendants: 11. List of organisations:
Corporació Sanitària Clínic Parc Sanitari Pere Virgili
Fundació Hospital de l'Esperit Sant Althaia
Fundació Sanitària de Mollet Hospital Plató Fundació Privada
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 71 of 89
Hospital de la Santa Creu i Sant Pau Institut d'Assistència Sanitària
Fundacio Assil de Granollers Consorci Sanitari Integral
Fundació Institut Guttmann
Consorci de Salut i Social de Catalunya (web: http://www.consorci.org/)
Place: Headquarter in Barcelona
Working Group: General Services (Infrastructures and Equipment)
1st Workshop. Date: 08/10/2014
Topics: Presentation of the project, objectives and status
Number of Attendants: 19. List of organisations:
Consorci Corporació Sanitària Parc Taulí Consorci Sanitari de l'Anoia
Consorci Sanitari del Maresme Consorci Sanitari Integral
Consorci Sociosanitari de Vilafranca del
Penedès
Corporació de Salut del Maresme i la Selva
Corporació Sanitària Clínic Fundació de Gestió Sanitària
Fundació Hospital Asil de Granollers Fundació Privada Josep Finestres
Hospital de Sant Joan de Déu Hospital Germans Trias i Pujol
Hospital Sant Joan Despí Moisès Broggi Institut Català de la Salut
Institut Català d'Oncologia (ICO) Institut d'Assistència Sanitària
Parc Sanitari Pere Virgili Hospital de la Santa Creu i Sant Pau
2nd Workshop. Date: 10/02/2016
Topics: Presentation of the web-tool and project results
Number of Attendants: 16. List of organisations:
Institut d'Assistència Sanitària Fundació de Gestió Sanitària Hospital de la
Santa Creu i Sant Pau
Gestió Pius Hospital de Valls, SAM Corporació Sanitària Clínic
Hospital de Sant Joan de Déu Serveis de Salut Integrats del Baix Empordà
Hospital Universitari de Sant Joan de
Reus, SAM
Consorci Sanitari del Maresme
Institut Català de la Salut Consorci Sociosanitari de Vilafranca del
Penedès
Consorci Sanitari de l'Alt Penedès Institut d'Assistència Sanitària
Centre Integral de Salut Cotxeres Hospital de Sant Joan de Déu
Workshops with specific stakeholders
The objective has been to involve the stakeholders in the project development, to obtain their
vision and opinion in the different stages of project development (e.g. project objectives,
methodological approach and web-based tool). Their comments have been included, when
possible, in the web-tool.
Three individualized workshops have been done with some of these organisations to have a
direct feedback from them. These workshops have been organised in LEITAT (Terrassa) to
facilitate the attendance of these organisations.
1st BOHEALTH Workshop with stakeholders Date: 18/07/2014
Topics: Presentation of the methodology and direct discussion about its potential
applicability and improvements
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 72 of 89
Number of Attendants: 10. List of organisations:
Universitat URV Serveis Salut integrats Baix Emporda
Institut d'Assistència Sanitària Hospital Parc Taulí
Consorci Sanitari Terrassa Consorci Hospitalari Vic
2nd
BOHEALTH Workshop with stakeholders Date: 1/12/2014
Topics: Presentation of the web-based tool, applicability and improvements
Number of Attendants: 16. List of organisations:
Universitat URV Consorci Hospitalari de Vic
Serveis Auxiliars a la Sanitat Institut d'Assistència Sanitària
Club EMAS Fundació Sanitària Mollet
Hospital de Sant Pau Consorci Sanitari Anoia
3rd BOHEALTH Workshop with stakeholders Date: 7/05/2015
Topics: Presentation of the new version of the tool and project preliminary results
for implementation
Number of Attendants: 11. List of organisations:
Consorci Hospitalari de Vic Fundació Sanitària Mollet
Institut d'Assistència Sanitària Consorci Sanitari Anoia
Club EMAS
Task D4.2.- Organise a conference at national level. Responsible: LEITAT. Status:
Finished.
The final conference of BOHEALTH “Innovation to improve the environmental
performance in Healthcare centres” was held in Barcelona on 24th of May 2016. During
the event, different initiatives to improve the environmental behaviour in healthcare centres
have been presented: EU HCWM project, SMART HOSPITAL project, RESSEPE
project, OPERE project, and a project to minimize the not consumed meals at hospital. The
results obtained from the BOHEALTH project have been presented and also a presentation
about the BOHEALTH tool has been introduced to different healthcare centre managers.
Figure 30.- BOHEALTH Final Conference
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 73 of 89
A summary of the Final BOHEALTH conference has been reported as Annex 11 (paper
and electronic form). This document explains in detail the material developed, the
programme, the attendants, photos and the results obtained. Figure 30 shows some of these
pictures.
Task D4.3.- Organise a workshop with relevant people from the Institut Català de la Salut.
Responsible: FHSPST/Xarxa. Status: Partially finished.
The intention was to arrange a workshop with the Institut Català de la Salut (regional
health service in Catalonia), to present the project and its results. Unfortunately, it was not
possible to arrange this meeting due to the difficulty to identify the right contact person in
this organisation. Several staff were contacted (e.g. General Services manager), but
without success. The purpose is to continue the contacts and arrange this workshop after
the end of the project.
A part, a workshop has been held with the environmental department of the Catalan
Government (Departament de Territori i Sostenibilitat), presenting the BOHEALTH
project and the tool (19/12/2014). 4 people attended the meeting.
Task D4.4.- Involvement in the workshops organised by other institutions. Responsible:
SIMPPLE. Status: Finished.
The project is also communicated and disseminated to and through estate, regional and or
local environmental authorities and entities.
BOHEALTH project has participated, and was presented, in the following workshops
organised by other institutions:
- Club EMAS.- Workshop on EMAS certified Health care organisations. Presentation of
the BOEHALTH project and working session on EMAS indicators
- EU HCWM Project.- Workshop on waste management and training. Short
presentation of Bohealth project and leaflets distribution
Task D4.5.- Organise two workshops with FHSPST employees. Responsible:
FHSPST/Xarxa. Status: Partially finished.
Two workshops have been held with managers and technical staff of different healthcare
centres, to present BOHEALTH results and status.
One of these workshops was originally planned with general staff (employees), but it was
difficult to arrange it, due to holiday's periods and the limiting factor of trying to find the
right day to join an important number of medical staff without compromising the normal
operation of the hospitals. If possible, it will be done after the end of the project, inside the
After Life+ Communication Plan.
Workshop Location Date Number of
attendants
Comment
1st Workshop within
FHSPST
Tarragona 12/02/2015 12 Methodological
approach
2nd Workshop within
FHSPST
Tarragona 04/03/2016 13 Project Results
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 74 of 89
Major Problems/drawbacks
The main problem found in this Action was to find the right moment and place to carry out
the workshops, involving the maximum number of participants. This problem was solved in
most of the cases.
Continuation after end of the project
Additional workshops are planned in the After Life+ Communication Plan, involving
healthcare staff and management. The intention would be to present the project results to
other healthcare centres, using the BOHEALTH dissemination material (Layman's report,
leaflets, etc.).
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action D4 4 workshops with
hospitals' managers
(associations and
organisations)
1 workshop with ICS
2 workshops with
FHSPST staff
1 conference at national
level
4 workshops with Unió
Hospitals i Consorci
Sanitari (people in charge
of Infrastructures). About
45 attendant organisations
in total
3 workshops with health
organisations
(stakeholders).- 37
attendants in total
workshop with ICS (not
achieved).
2 workshops with FHSPST
staff (25 people)
1 conference at national
level (45 registered
people).
Success
Several meeting with
potential replicators (i.e.
healthcare associations)
have been done, trying
to involve key
stakeholders (in total
234 specialised
attendants).
The only objective not
achieve has been the
meeting with ICS
personnel (to be
scheduled after the end
of the project if
possible). Instead
workshop with the
Catalan Government
(Sustainability Dept.)
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 75 of 89
5.2.7. Action D.5. - Papers and oral presentations
Type Dissemination Action Status Finished
Duration month 36 Schedule On time
Leader SIMPPLE Modifications No
Collaborate LEITAT, Xarxa AIE, FHSPST Objectives Achieved
Deliverables
The objective of this action is to present the project and its results in specialised forums and to
the general public.
Task D5.1.- Publication of technical papers in specialised Journals. Responsible: all.
Status: Finished.
Five technical articles have been published:
- One article in“Boletin Hospitecnia” (http://www.hospitecnia.com)
- One article in “BUILDUP EU. BOHEALTH TOOL” (http://www.buildup.eu/en). This
is the European portal for energy efficiency in buildings.
- One technical article has been presented in Life cycle conference [avniR] in
(http://www.avnir.org/)
- One article has been presented in Symposium of environmental management in
hospitals (AGACS 2015)
- And one technical article has been presented in the XI Jornadas Nacionales de
Innovación de Servicios Generales Hospitalarios
The original technical papers are attached in the Annex 15 (Dissemination annexes), in
electronic form.
Task D5.2.- Publication of technical articles in the weekly newsletters published by the
Hospital associations. Responsible: all. Status: Partially achieved.
Until now, some difficulties have been found to publish information about the Bohealth
project in these newsletters. However, new contacts will be made after the end of the
project to try to publish some technical articles about BOHEALTH project on them.
The objective of this task was partially achieved because references to BOHEALTH
project has been published in July 2016 in the “Butlletí d’Etiquetatge Ecològic i Gestió
Ambiental" (ISSN 2339-5796 DL: B.11357-2013, #11) and "Butlletí d'innovació i recerca"
(#20). Departament de Territori i Sostenibilitat, GENCAT (Catalan Government).
Task D5.3.- Oral or poster presentation in National or Intentional congresses. Responsible:
all. Status: Finished.
- A poster has been presented in a life cycle conference [avniR] in Lille, in November
2014.
- A technical communication has been presented in CONAMA congress, a National
congress of environment, in November 2014.
- A networking presentation has been done in the Symposium of Environmental
management in hospitals, in Seville 2015. Symposium organised by AGACS
(Association of Environmental Management at Healthcare Centres).
- And a poster has been presented in the “XI Jornadas Nacionales de Innovación de
Servicios Generales Hospitalarios, in Toledo 2016.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 76 of 89
These posters and Communication are attached as Annex 14 (Dissemination annexes), in
electronic form.
Also, BOHEALTH project has been presented in ECOENERGETICA fair in April 2014,
with special remark on the first results obtained, the report of the best available
technologies and good practices.
Task D5.4.- Periodical press releases. Responsible: LEITAT. Status: Finished.
Five press releases have been made and they have been sent to the media. The first press
release has been elaborated to promote BOHEALTH project and the main objectives,
actions, expected results of the project were explained. The second one has been created to
communicate the report about BATs and good practises to improve the environmental
behaviour of the healthcare centres; the third one has explained the BOHEALTH tool and
its functionalities; the fourth press release has been elaborated to promote the final event
and the last press release has been create to summarize the results and the benefits
obtained.
The results of these press releases can be seen in the number of internet articles (30) that
have been published in different websites. In the proposal this type of article was not
planned, but the project execution has shown that the internet is a good way to spread
results on a mass scale. The list of the internet articles has been reported in the
Communication Plan (updated version4).
Task D5.5.- Publication of 6 general articles at newspapers. Responsible: All. Status:
Finished
Six articles have been published in general newspapers. The first article was published
on 8th March 2014 in “Diari de Terrassa” newspaper. The second were published on 15th
October 2014 in “Noticies TGN” newspaper. The third article was published in the "Diari
de Tarragona" newspaper on 20th October 2014. The fourth article was published in
November 2015 in ”Diari de Tarragona”. The fifth article was published in “Noticies
TGN” newspaper in November 2015. The sixth article was published in May 2016 in
“Construible” magazine (electronic format).
These articles are attached as Annex 16 (Dissemination annexes), in electronic form.
Task D5.6.- Production of two promotional videos for general public. Responsible:
FHSPST. Status: Finished
Two videos have been produced; the first one presents on what consist the BOHEALTH
project, the target audience, the activities, the project partner and the main results
(https://player.vimeo.com/video/154980777). The second video shows the functionalities
of the BOHEALTH tool and how to use it (https://vimeo.com/151000048). This task is
self-financed by FHSPST.
Major Problems/drawbacks
The main problem found in this Action was to find the right technical magazine to publish the
BOHEALTH results to maximise the impact. There are several magazines associated to
healthcare, but few of them consider the environmental aspects of healthcare centres. Similar
problem applies to congresses (few of them focused on environmental aspects of healthcare
centres). The Table 19 summarises the efforts done in publications:
Publication Objective Done Achievement
Press releases 5 press
releases 5 press releases 100%
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 77 of 89
Publication Objective Done Achievement
Technical
papers/articles
5 technical
articles
5 technical articles published
in: Hospitecnia, Build Up,
avniR, AGACS, Jornada
innovación servicios
hospitalarios generales
100%
Articles published in
general newspaper
magazines
6 articles
published
6 articles
30 Internet articles
100%
Internet articles
were not
planned in the
proposal
Poster or oral
presentation presented
in national and
international
congresses
4
4 communication activities
have been done:
- Avnir congress (poster)
- CONAMA congress
(communication)
- AGACS symposium
(poster)
- XI Jornada innovación
servicios hospitalarios
generales (poster)
100% achieved
Promotional Videos
2 for
general
public
- 1 for general public
- 1 for potential users of the
tool
100% achieved
Table 19.- Summary of BOHEALTH publications
Continuation after end of the project
As mentioned in the After Life+ Communication Plan, the intention is to present additional
papers to magazines and congresses, to show the BOHEALTH results.
Project Indicators & evaluation
Action Foreseen in the revised
proposal
Achieved Evaluation
Action D5 4 papers or poster
presentation in
National/International
congresses
5 technical articles at
specialised magazines
6 general articles
published in general
newspapers
5 press releases
2 promotional videos
4 papers or poster
presentations
5 technical articles at
specialised magazines
6 general articles published
in general newspapers
5 press releases
2 promotional videos
30 internet articles
Success. Achieved the
target of papers, posters
and articles.
Additionally 30 internet
articles (not considered
in the proposal).
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 78 of 89
5.3. Evaluation of Project Implemention
5.3.1. Methodology
The methodology used for the project development has worked well. The communication
between partners has been fluent and the assigned roles have been carried out by the
beneficiaries.
Each beneficiary has developed its work, with the support of the other beneficiaries when
needed. The developed actions have generated the expected results, in most of the cases
on time or with minor delays (max. two months). Not major delays were occurred in the
Actions, and the deliverables have accomplished the expectations (i.e. technical quality
and resources invested).
Only to notice that some deviation has occurred during the implementation of the actions
plans in the two selected healthcare centres, which didn't have an assigned budget in the
project and that were own financed by FHSPST. Due to internal budget restrictions and
resources availability, some of the actions have not been fully implemented during the
project development (to be done after project ending). However, the expected results of
these actions have been simulated, allowing the identification of the potential impact of
the project. The actually implemented actions reached the objective of testing the tool for
improvement actions monitoring.
The involvement of external stakeholders has been very successful, with direct
involvement in the proposed approach and web-based tool development. Also, some of
the stakeholders have tested the web-tool, given valuable feedback.
5.3.2. Results
The Table 20 compares all the results achieved against the objectives, trying to quantify
them. In general, the proposed actions have achieved the indicated targets in most of the
cases. Only small deviations have occurred in some Actions, for example the number of
visitors of project web-site and number of followers in Social Networks that perhaps
were too ambitions for this type of projects.
Action Foreseen in the revised
proposal
Achieved Evaluation
Action A1 List of appropriated KPIs List of 50 KPIs (D3) Success
List of appropriated
"functional units"
List of 14 functional units
(D3)
Success. Highly
dependent on the type of
healthcare centre
LCA & LCC study
"average" hospital
Assessed an "average"
hospital of 200 beds (D3)
Success. Difficulties to
define this "average"
hospital
Action A2 50 summary sheets for
identifies BATs
50 summary sheets: 14
energy, 12 water, 11 waste,
7 chemicals and 6 green
procurement (D4)
Success.- In some cases
difficulties to find the
savings achieved in real
cases
Action B1 Definition of practical
approach for decision
making
Approach that assesses the
environmental aspects and
prioritise these aspects and
the BATs that can reduce
them (D5)
Success. Needed to
arrive to a compromise
between the needed data
vs. estimations and
default data
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 79 of 89
Action Foreseen in the revised
proposal
Achieved Evaluation
10 meetings with external
hospitals
Meetings/contacts with
more than 15 external
organisations/hospitals
Action B2 Easy to use web-based
application based on the
proposed approach (demo
and final versions)
Interviews to obtain
feedback (15 internal
meetings)
Developed the demo and
final version of the tool
10 internal meetings
14 external interviews
(stakeholders)
Success. Good results
obtained in both cases
studies. Released the
demo version (fully
operative). Available via
the project web site.
Action B3 Real implementation of
the approach and web
tool in two health care
centres
10 meetings per centre
(20)
3 informative session per
centre (6)
Technical report for each
centre (2)
Satisfaction survey for
each centre (2)
Collection of the needed
data in the two selected
centres, and input of this
date in the tool
2 general meeting
presentation for people in
charge (for both centres
and other centres with
potential interest)
6 general meetings with
people responsible for data
collection (the rest via
direct communication
between responsible and
people in charge)
Deliverable D7, showing
the results in both centres
Success: The proposed
methodology and web-
tool have been
successfully
implemented in the two
healthcare centres,
giving good results.
The feedback of users is
good, but they have
highlighted the time
needed to collect the
information, depending
on the level of detail and
data availability
Action B4 Implementation of the
proposed action plan in
the two centres (10 action
per centre)
Definition of Action Plans
(8 actions in Centre
Llevant and 9 actions in
Hospital del Vendrell)
These actions cover
different aspects (energy,
water and waste)
Assessment of the actions
using the web-based tool
Partial Success: As
mentioned above, not all
the scheduled action
have been fully
implemented during the
project development
(own financed by
FHSPST)
Action C1 Monitoring of the project
impact in the two centres
75% of actions
implemented,
80% of expected impact
achieved
The actions have been
monitored using the web-
tool
The actions not fully
implemented have been
simulated and identified
the potential saving
Monitoring of the energy,
water and sanitary waste
generated
Actions Implemented (11
over 17: 65%)
Reduction Gas Natural in
H. Vendrell: objective 5%;
achieved 23%
Success: The
implemented actions
have been monitored and
relevant reductions on
the expected impact
have been achieved.
In some cases, the
reduction cannot be only
assigned to the
implemented actions.
Extrapolated the
potential environmental
impact at regional,
national and EU level
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 80 of 89
Action Foreseen in the revised
proposal
Achieved Evaluation
Reduction Sanitary Waste
H.Vendrell.- Objective 3%,
Achieved: 13% (Group
III); 35% (Group IV)
Deliverable D7 showing
the results in both centres
Action C2 Assessment of the socio-
economic impact of the
project
LCC analysis
SLCA analysis
The socio-economic
impact has been assessed
using a LCC approach
(economic) and a Social
methodology that takes
into account the impact of
the project effect on
several stakeholders
Deliverable D8 showing
the impact of the project
Success: The LCC
methodology shows the
economic impact of the
project in both cases, but
also the potential impact
at regional, national and
EU level.
The social impact is
focused on centre users,
personnel and suppliers
Action D1 Project website (10,000
visitors)
Social networks (1,000
followers)
News in the web site (20)
Shared documents in the
internal part (30)
Project website (7,423
visitors)
Social networks (247
followers)
News in the web site (14
news; 130 tweets)
Shared documents in the
internal part (27)
Partially achieved. It was
difficult to achieve the
target of visitors and
followers (perhaps too
optimistic for this type
of project, with a very
specialised audience)
Action D2 Information Board (12)
displayed in 24 places
Number of printed flyers
(1,000). 2 releases
(500+500)
e-flyers update (4)
Information Board (12)
displayed in 24 places
Number of printed flyers
(1,000). Three releases
(300+400+300)
e-flyers update (3)
Success.. The
information boards have
been moved to 12 new
places.
Three versions of flyers
have been released: 1st
on project description
(300), 2nd on the web-
based tool (400) and 3rd
on project results (300)
The electronic version of
the flyers have been
uploaded to the project
website
Action D3 Layman's report (5-10
pages) in English.
Spanish and Catalan
Deliverable D9
Printed 200 copies
Success. Submitted the
Layman's report in three
languages
Action D4 4 workshops with
hospitals' managers
(associations and
organisations)
1 workshop with ICS
2 workshops with
FHSPST staff
1 conference at national
level
4 workshops with Unió
Hospitals i Consorci
Sanitari (people in charge
of Infrastructures). About
45 attendant organisations
in total
3 workshops with health
organisations
(stakeholders).- 37
attendants in total
Success
Several meeting with
potential replicators (i.e.
healthcare associations)
have been done, trying
to involve key
stakeholders (in total
234 specialised
attendants).
The only objective not
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 81 of 89
Action Foreseen in the revised
proposal
Achieved Evaluation
workshop with ICS (not
achieved).
2 workshops with FHSPST
staff (25 people)
1 conference at national
level (45 registered
people).
achieve has been the
meeting with ICS
personnel (to be
scheduled after the end
of the project if
possible). Instead
workshop with the
Catalan Government
(Sustainability Dept.)
Action D5 4 papers or poster
presentation in
National/International
congresses
5 technical articles at
specialised magazines
6 general articles
published in general
newspapers
5 press releases
2 promotional videos
4 papers or poster
presentations
5 technical articles at
specialised magazines
6 general articles published
in general newspapers
5 press releases
2 promotional videos
30 internet articles
Success. Achieved the
target of papers, posters
and articles.
Additionally 30 internet
articles (not considered
in the proposal).
Action E1 Consortium Agreement
(month 3)
Internal Area project
web-site
Monthly Teleconferences
(30)
General Assembly
Meetings (7)
Deliverables (11+1)
Reports (Inception,
MidTerm and Final)
Consortium Agreement
(month 12)
Internal Area project web-
site (done)
Monthly Teleconferences
(18)
General Assembly
Meetings (7)
Deliverables (11+1)
Reports Submitted
(Inception and Midterm
Report. This is the Final
report)
Success. Delay in the
Consortium agreement
due to GA amendment.
All Deliverables
submitted on time.
Organised all the
scheduled General
Assemblies.
Lower number of
teleconferences (good
communication via e-
mail or direct contact).
Action E2 Contacts with other
projects (15)
Agreements for
collaboration (5)
Common dissemination
activities (10)
Contacts with other
projects/organisations (16)
Agreements for
collaboration (8)
Common dissemination
activities (15)
Success. Networking
activities with 4 projects
(attendance to
conference, etc.) and 4
organisations (followers,
meetings, etc.)
Action E3 After Life
Communication Plan
(about 20 activities)
Deliverable D10 Success. Submitted the
After- LIFE
communication plan,
including future
activities
Action E4 Audit certification Deliverable D11 Success. Submitted the
results of the external
Audit (Report)
Table 20.- Assessment of the results against the Objectives
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 82 of 89
The Table 21 indicates which project results are immediately visible and which will only
become apparent after a certain time period.
Result Action Visibility Comments
Project Web site D1 Immediate Dissemination of the project results
Printed material (1,000
leaflets) D2 Immediate
Dissemination of the project results in
meetings, conferences, etc.
Information boards (12) D2 Immediate Dissemination of the project results in
healthcare centres
D3.- Report on KEPIs A1 After a
certain time
Needed for the development of the
methodology. The visible part is the web-tool
D4.- Report on BATs A2 Immediate Public Report. Guideline for healthcare centres
D5.- Report on decision-
making process B1
After a
certain time
Needed for the development of the web-based
application. The visible part is the web-tool
D6.- Final & demo version
of the web-based
application
B2 Immediate
This demo version of the web-tool is available
in the project website. The healthcare
organisations can use it for free to assess their
centres. The demo version is available in
English and Spanish.
The Final version of the web-tool will be used
in other centres of FHSPST, and it will be
offered to other organisations.
D7.- Implementation of
Sustainable Actions B4
Immediate
& After a
certain time
The environmental benefits achieved for the
implementation in the two case studies (e.g.
energy or water consumption reduction) are
immediate and relevant (e.g. 23% savings on
natural gas consumption). Further actions will
be visible after a period of time and their
amount will depend on the type of actions and
the number of centres that implement them.
D8.- Project impact
monitoring (including
socio-economic impact)
C1 Immediate
This results allow to identify the potential
impact of the project, in the case studies, but
also the potential impact at regional, national
and EU level
D9.- Layman's Report D3 Immediate Dissemination of the project results (paper and
electronic versions)
D10.- After-LIFE
Communication Plan E3
After certain
time
The results of this plan would be visible after
some time, once the proposed actions were
done
D11.- Audit report E4 Immediate Support to the final report
D12.- Communication Plan D1 Immediate Summary of all the dissemination activities.
Table 21.- Indication of visibility of the results achieved until date
5.3.3. Project amendment
The proposed amendment of the Grant Agreement had the objective of facilitating the
involvement of some personnel assigned to Xarxa AIE, and has avoided some financial
problems at the time of justifying the allocated resources to FHSPST.
This amendment has not affected the objectives, planning or global budget of the project.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 83 of 89
5.3.4. Effectiveness of the dissemination
The dissemination activities have been summarised in the Deliverable D12.-
Communication Plan, which initially was not included in the proposal, but it was
considered as useful to monitor and report all these activities.
Most of the activities for project dissemination were effective, especially those focused
on healthcare specialists (e.g. workshops, etc.) and internet news.
Also, the number of visits to the project web-site is adequate for this type of project. The
Twitter & LinkedIn channels are quite active and they have a reasonable number of
followers.
The main aspect is that the involvement of stakeholders has been mainly achieved via
direct meetings and workshops with healthcare organisations. Very few request of
additional information have been received via other channels (project web-site, etc.).
The final Conference was successful, and it allowed presenting the results of the project
in detail. Also, it was a great opportunity to potentiate the networking with other projects.
In total, more than 230 specialised attendees participated in BOHEALTH
meetings/workshops.
The printed material was distributed during these workshops, external conferences and
the final conference. The electronic material is available via the project web-site. More
than 1,680 downloads are registered for leaflets. Other material, like D4 report has been
downloaded more than 3,700 times. In total, about 9,289 downloads are registered,
including leaflets, newsletters and reports.
5.4. Analysis of long-term benefits
5.4.1. Environmental benefits
a. Direct / quantitative environmental benefits:
The direct environmental benefits during project duration are associated to the
environmental burden reduction in the two healthcare centres where the web-tool has
been used, and the associated actions implemented during the project. The Table 22
summarises the results achieved in the Hospital del Vendrell, compared with the initial
objective.
Proposal H. Vendrell
Period
(moths)
Comments
Energy -5% Over total consumption
Natural Gas (kWh) -106.232 -479.342 12 78% higher than expected.
Natural Gas (Nm3) -9.029 -40.739 12 idem
Electricity (kWh) -141.471 -86.969 6 62% lower than expected.
Water (m3) -8% Over total consumption
-1.817 -3.852 6 53% higher than expected
Sanitiary Waste -3% Over total production
Group III (ltrs.) -1.555 -4.292 6 64% higher than expected
Group IV (ltrs.) -614 -4.420 6 86% higher than expected
Resource consumption -5% n/a
Waste to landfill -5% n/a
Table 22.- Indication of visibility of the results achieved until date
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 84 of 89
Considering a LCA perspective, the potential environmental impact has been reduced in
5.9%. This implies for example, that 135 tCO2eq has been avoided per year with the
implementation of these actions.
It is needed to mention that the achieved reductions on consumptions or waste generation
are not only due to the implemented actions. Other factors can have an influence in these
reductions, but due to the complexity of the system, it is difficult to differentiate the
specific effect of each action over the total. Taking as reference other centres, where
these actions are not implemented, the achieved reductions are much lower or even they
have suffered an increase in consumption.
b. Relevance for environmentally significant issues or policy areas
The healthcare sector has a significant environmental impact due to the associated
consumptions (energy, water and other resources) and emissions (mainly different types
of wastes). It is estimated that the healthcare centres represent between the 3 % and the
8% of the total carbon footprint of developed countries.
Therefore, the proposed actions will contribute to the reduction of this impact and there
are in line with the 6th and 7th EU Environment Action Programme (EAP).
Regarding the 6th EAP, the results of this project support the following articles and
aspects:
Article 3.- Strategic approaches to meeting environmental objectives
— encouraging wider uptake of the Community's Eco-Management and Audit Scheme
(EMAS) and developing initiatives to encourage companies to publish rigorous and
independently verified environmental or sustainable development performance reports;
Article 5.- Objectives and priority areas for action on tackling climate change:
(v) Reducing greenhouse gas emissions in other sectors:
(a) promoting energy efficiency notably for heating, cooling and hot tap water in the
design of buildings;
Article 8.- Objectives and priority areas for action on the sustainable use and
management of natural resources and wastes
- achieving a significant overall reduction in the volumes of waste generated through
waste prevention initiatives, better resource efficiency and a shift towards more
sustainable production and consumption patterns;
— a significant reduction in the quantity of waste going to disposal and the volumes of
hazardous waste produced while avoiding an increase of emissions to air, water and soil;
— encouraging re-use and for wastes that are still generated: the level of their
hazardousness should be reduced and they should present as little risk as possible;
preference should be given to recovery and especially to recycling; the quantity of waste
for disposal should be minimised and should be safely disposed of
2d). promotion of extraction and production methods and techniques to encourage eco-
efficiency and the sustainable use of raw-materials, energy, water and other resources;
Regarding the 7th EAP, the results of this project support the Priority objective 2: To
turn the Union into a resource-efficient, green and competitive low-carbon economy.
Some sentences of this priority are highlighted hereafter:
There is significant scope for reducing GHG emissions and enhancing energy and
resource efficiency in the Union. This will ease pressure on the environment and bring
increased competitiveness and new sources of growth and jobs through cost savings from
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 85 of 89
improved efficiency, the commercialisation of innovations and better management of
resources over their whole life cycle.
All sectors of the economy will need to contribute to reducing GHG emissions if the
Union is to deliver its fair share of global efforts...
There is also considerable potential for improving waste prevention and management in
the Union to make better use of resources, open up new markets, create new jobs and
reduce dependence on imports of raw materials, while having lower impacts on the
environment...
Resource efficiency in the water sector will also be tackled as a priority to help deliver
good water status...
The project results also promote other relevant Directives or Communications:
o Directive 2012/27/EU of the European Parliament and of the Council of 25 October
2012 on energy efficiency, by promoting the energy efficiency in healthcare centres
o The Communication from the Commission COM(2011) 21: "A resource-efficient
Europe – Flagship Initiative under the Europe 2020 Strategy" and the Thematic
Strategy on the sustainable use of natural resources (COM(2005) 670 final), by
optimising the use of resources in hospitals (e.g. water, fuels, electricity, packaging,
etc.).
o EUROPE 2020. A strategy for smart, sustainable and inclusive growth.
COM(2010) 2020 final and Energy 2020. A strategy for competitive, sustainable
and secure energy. COM(2010) 639 final, by reducing the energy consumption and
CO2 emissions associated to the activity. Additionally the potential use of
renewable energy sources (solar thermal system) in the sector is considered as best
practice.
o Energy Efficiency Plan 2011 (COM(2011) 109 final), by increasing the energy
efficiency of the activity and its equipment
o Addressing the challenge of water scarcity and droughts in the European Union
(COM(2007) 414 final), by reducing the consumption of water associated to the
activity
o The Sustainable Consumption and Production and Sustainable Industrial Policy
Action Plan (COM(2008) 397 final) by improving the environmental and economic
performance of organisations
o Public procurement for a better environment (COM(2008) 400 final; Eco-design
Directive 2010/30/UE (energy related products) and ROHS Directive recast), by
defining purchasing guidelines for the sector
o Directive 2008/98/EC of the European Parliament and of the Council on waste and
repealing certain Directives, by improving the management of the generated wastes
and increasing their reuse/reciclability potential
5.4.2. Long-term benefits and sustainability
a. Long-term / qualitative environmental benefits
The proposed methodology and web-based tool will increase the visibility for
environmental problems and solutions for the management team and will support the
decision making process during the definition of action plans. The following long term
environmental benefits are identified:
o Facilitate the identification of environmental problems and solutions in the
healthcare centres
o Facilitate the implementation and monitoring of Sustainable Action Plans
o Support the environmental management system (ISO-14001 or EMAS), by
identifying and prioritising the significant environmental aspects
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 86 of 89
o Support the efficiency in the centres, allocating the general consumption to each
service/section
o Support the reduction of the Carbon Footprint associated to the centres by reducing
their energy consumption
o Support the reduction of the Water footprint by reducing the water consumption
o Support a better management of the Medical waste generated
o Potentiate the continuous improvement
o Potentiate the life cycle thinking
o Potentiate the use of best available technologies
o Encourage employees to apply similar approaches in their houses
The quantification of long-term environmental burdens reduction will depend on the
implemented sustainable action plans and their real impact on energy, water or waste
reduction in each healthcare centre. The proposed approach has been to start with low
investment/rapid return actions and follow with more expensive actions, using the
achieved savings.
b. Long-term / qualitative economic benefits
The long-term economic benefits will be associated to the savings achieved by the
implementation of the proposed Sustainable Action Plan in energy, water or waste
consumption.
It is difficult to quantify the potential savings because they will depend on the type of
centre, type of implemented measures, etc.
Taking into account bibliographic references and potential improvement actions (e.g.
better climate control or lighting), the potential benefits in an average hospital are
estimated hereafter:
o Resources saving (consumables): 10%.
o Waste reduction: 10%
o Water saving: 20%
o Energy Saving: 10%
o Waste recycling percentage increase: 30%
o CO2 emissions reduction: 15%
o Water emissions reduction: 10%
The LCC study done for both case studies (see Deliverable D8) showed the economic
savings achieved by the implemented actions, but as mentioned before, it is difficult to
quantify these savings for other centres. However, the case studies showed the potential
of the proposed approach, and the long term benefits that can be obtained associated to
the reduction on energy, water or waste generation.
c. Long-term / qualitative social benefits
The project will reduce the environmental impact associated to the healthcare facilities,
making them more efficient. This will result in increasing the comfort of the people that
works or stay at the hospital (e.g. staff, patients and visitors).
The promotion of energy-efficient technologies and initiatives will reduce the running
cost of the heath care system at the mid-long term, which would secure the equity of
access to universal health-care services.
The study on social impact developed in Action C2 (see Deliverable D8) highlighted the
most relevant stakeholders or beneficiaries of BOHEALTH project, and the potential
impact on them. These are (in order of relevance): Healthcare centre, Responsible of
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 87 of 89
environmental management in hospital, Government; Technology providers and Patients,
population and Healthcare centre workers.
The proposed approach on continuous improvement process will make the activity more
economically efficient, resulting in the following social aspects:
o potential direct or indirect employment growth (or at less not jobs losing)
o a higher budget for investments, in order to increase the quality of the services
offered at the centre
o social involvement for the employees (more aware on environmental issues)
o development of more social and charity activities (e.g. by non-profit Foundations
associated to the healthcare sector)
d. Continuation of the project actions by the beneficiary or by other stakeholders.
The compromise is to maintain the project web-site during five years after project ending,
including the demo version of the tool and all the reports, to facilitate the dissemination
of the project results.
The contact with the involved stakeholders will be maintained after project ending,
supporting them in the implementation of the web-based tool. Agreements will be signed
with them and other organisations to promote the use of the tool.
FHSPST and Xarxa have the intention to implement the web-based tool in other centres,
once checked its benefits in the two demonstrative centres. The tool will facilitate the
implementation of future environmental management systems.
The initial exploitation plan of the web-based application includes the commercialisation
of the tool by SIMPPLE after the project ending. This commercialisation plan includes
the needed updating of the tool (e.g. new BATs, new languages, etc.), the inclusion of
new functionality (e.g. customisation if needed) and associated consultancy services. This
exploitation plan will be settled on at the end of the project, once it is analysed the
acceptance of the web-based tool in the health sector.
The target is to implement the proposed approach in at least 70 healthcare centres in a
period of five years after the end of the project. These centres are mainly associated to the
project coordinator (FHSPST) and to the stakeholders that have shown their interest in
the project results, but also in other centres at national and/or European level.
5.4.3. Replicability, demonstration, transferability, cooperation:
The proposed approach and web-based application can be used in different types of
healthcare centres, with different characteristics (age, location, services, etc.). Therefore,
they can be used in other locations at EU level. Some minor adjustments should be
needed in some countries due to the different classification of the medical wastes.
The proposed approach is replicable to other types of buildings with diverse activities
(e.g. hotels, education centres, etc.). In these cases, the web-based tool should be adapted
to these specific activities, considering the most relevant Key Performance Indicators for
them and energy demand requirements.
The main benefits of the proposed approach and web-based application, compared with
other tools or approaches, are:
o Use of a simplified approach to simulate the energy demand of the healthcare
centres, reducing the amount of data needed for this simulation by defining some
default data and assumptions. The user can change this default data if needed.
Final Report LIFE12 ENV/ES/000124 (BOHEALTH) Page 88 of 89
o Allocation of general consumptions (e.g. electricity, water, etc.) to each
section/service, based on their energy demand and the actual equipment installed in
the centre.
o Adaptable system for defining the criteria to be applied during the prioritisation of
environmental aspects. Applicable for beginners and experts in management
systems
o Easy to use prioritization system for BATs and best practices
o Easy to use monitoring of the proposed action plans
According to the research done, there is not in the market any solution with these
characteristics for the healthcare sector, and neither for other type of sectors (hotels, etc.).
The main obstacles detected until now are associated to the level of environmental
conscious of the managers and how the needed information is gathered in each case (lack
of resources for this process).
5.4.4. Best Practice lessons:
From a project development perspective, it has been a good practice to involve the
stakeholders, in the development of the methodology and web-based application, as soon
as possible. This has allowed obtaining valuable feedback from them to improve the
approach and the tool, despite in some cases it makes more difficult or delays its
development due to the different viewpoints to be considered.
The implementation process of the web-tool in each centre has worked well, but it should
be optimised, for example how the data is gathered, the needed resource for it, how the
information is stored and its accessibility, etc. This optimisation process could lead to a
reduction in the time needed to collect the required data.
Looking at the process for implementing the decided actions, the experience showed that
this process can be affected by external factors, in some cases, not under the control of
the responsible for the implementation (e.g. budget or resources availability, etc.). This
could difficult the planning of the actions.
5.4.5. Innovation and demonstration value:
The most relevant Innovative aspects of the BOHEALTH approach and web-based
application, tailored for the Health sector, are:
o Definition of specific “key performance indicators” and "functional unit” for
monitoring & reporting the evolution of the implemented actions (using a
LCA/LCC approach).
o Collection of the most representative Best Available Techniques to support decision
making in this sector, categorised by the environmental aspect to be improved and
showing the economic, environmental and social benefits of their application,
considering its complete life cycle.
o Integration of Life Cycle Thinking (through LCA and LCC) in the decision-making
process of the most feasible “Sustainable Action Plans” to be implemented in each
specific centre. This integration is supported by the development of a tailored
approach for the Health sector, based on the PDCA method and it is compatible
with existing management systems (EMAS III, ISO-14001, ISO-50001, ISO-14006
or ISO-9001).
o Web-based application for easily implement and maintain the proposed approach,
tailored for the Health sector needs. The tool includes the following modules:
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Assessment of the healthcare centre taking into account its specific
characteristics (e.g. climate conditions, type of building, equipment, etc.).
Allocation of the different general consumptions to each service/section.
Prioritization of the environmental aspects
Prioritization of best practices
Definition and monitoring of Action Plans
Comparison between centres
The added value of this approach and web-tool is associated to the selection of the
most appropriated best practices for each specific healthcare centre, focusing the
improvement efforts on the right place, and maximising the achieved impact.
There is not in the market any application or tool with similar functionality.
The case studies showed that the proposed approach is valid for different type of
healthcare centres (e.g. different services, age or weather conditions). The added
value by EU funding is associated to the higher visibility and replicability of the
proposed approach.
5.4.6. Long term indicators of the project success:
The following quantifiable indicators are proposed to be used in futures assessments of
the project success:
o Number of healthcare organisations that are using the web-based tool
o Number of healthcare centres which have implemented the web-based tool
o Number of Sustainable Actions carried out as result of this implementation
o Estimation of the savings achieved with these actions (e.g. energy or water
consumption reduction, etc.)
These indicators will show the level of success of the project after the end of the project.