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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

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Page 1: LIFE12 ENV/ES/000124 FINAL Report Covering the project ... · Name Beneficiary FUNDACIO HOSPITAL SANT PAU I SANTA TECLA Contact person Mr. Jordi Cañellas Postal address Joan Maragall,

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

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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

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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

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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

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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

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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

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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.

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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

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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.

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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).

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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.).

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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

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Actual

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Actual

Proposed

Actual

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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

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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

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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).

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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)

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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.

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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

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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

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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

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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

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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.

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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

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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

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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).

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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.

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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.

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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

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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

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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.

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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

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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.

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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

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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.

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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.).

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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.

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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

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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).

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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

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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

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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

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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)

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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).

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-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:

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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

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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

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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:

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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

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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

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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/

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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

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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

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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.)

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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).

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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

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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)

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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, ...)

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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

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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

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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)

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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.

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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

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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

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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

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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

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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

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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

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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

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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.)

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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.

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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%

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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).

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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

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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

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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

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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

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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.

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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

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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

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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

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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

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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.

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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.