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The calculation of buildings’ carbon footprint (CFP) is an important basis for formulating energy-saving and emission-reduction plans for building. As an important building type, there is currently no model that considers the time factor to accurately calculate the CFP of hospital building throughout their life cycle. This paper aims to establish a CFP calculation model that covers the life cycle of hospital building and considers time factor.

On the basis of field and literature research, the basic framework is built using dynamic life cycle assessment (DLCA), and the gray prediction model is used to predict the future value. Finally, a CFP model covering the whole life cycle has been constructed and applied to a hospital building in China.

The results applied to the case show that the CO₂ emission in the operation stage of the hospital building is much higher than that in other stages, and the total CO₂ emission in the dynamic and static analysis operation stage accounts for 83.66% and 79.03%, respectively; the difference of annual average emission of CO₂ reached 28.33%. The research results show that DLCA is more accurate than traditional static life cycle assessment (LCA) when measuring long-term objects such as carbon emissions in the whole life cycle of hospital building.

This research established a carbon emission calculation model that covers the life cycle of hospital building and considered time factor, which enriches the research on carbon emission of hospital building, a special and extensive public building, and dynamically quantifies the resource consumption of hospital building in the life cycle. This paper provided a certain reference for the green design, energy saving, emission reduction and efficient use of hospital building, obviously, the limitation is that this model is only applicable to hospital building.

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

Energy-saving is a growing challenge worldwide because of population growth, economic activity and high consumption rates that are unsustainable in the long term. Health-care facilities and hospitals face the challenge of increases in operational costs. This paper aims to appraise challenges to adopting energy-saving policies and proposes a roadmap for sustainability and energy efficiency management in hospitals and health-care facilities.

Eight hospitals were examined as case studies through qualitative interviews with hospital senior management, executives and health-care facilities managers in addition to collecting relevant data from the literature; there is critical appraisal and content analysis of this data.

This study established factors influencing implementation and challenges to energy-saving strategies. This study proposed guidelines for efficient energy management in hospitals and health-care facilities. This study concluded that the best performance is secured by integrating the proposed guidelines with the adoption of ISO 50001 energy management systems to achieve the United Nations’ sustainable development goal – SDG 7 “affordable and clean energy”.

This study is limited to the initiatives/experiences of the hospitals studied in the Middle East and North Africa region.

This study’s findings, conclusions, recommendations and proposed guidelines enrich the body of knowledge. This will allow industry key stakeholders, hospitals and health-care facilities managers to overcome challenges of implementing energy management. In addition, adopting the proposed guidelines will improve energy efficiency and help hospitals in green initiatives as they seek to demonstrate their support for United Nations’ sustainable development goals.

The purpose of this paper is to provide a detailed accounting of energy and materials consumed during magnetic resonance imaging (MRI).

The first and second stages of ISO standard (ISO 14040:2006 and ISO 14044:2006) were followed to develop life cycle inventory (LCI). The LCI data collection took the form of observations, time studies, real-time metered power consumption, review of imaging department scheduling records and review of technical manuals and literature.

The carbon footprint of the entire MRI service on a per-patient basis was measured at 22.4 kg CO₂eq. The in-hospital energy use (process energy) for performing MRI is 29 kWh per patient for the MRI machine, ancillary devices and light fixtures, while the out-of-hospital energy consumption is approximately 260 percent greater than the process energy, measured at 75 kWh per patient related to fuel for generation and transmission of electricity for the hospital, plus energy to manufacture disposable, consumable and reusable products. The actual MRI and standby energy that produces the MRI images is only about 38 percent of the total life cycle energy.

The focus on methods and proof-of-concept meant that only one facility and one type of imaging device technology were used to reach the conclusions. Based on the similar studies related to other imaging devices, the provided transparent data can be generalized to other healthcare facilities with few adjustments to utilization ratios, the share of the exam types, and the standby power of the facilities’ imaging devices.

The transparent detailed life cycle approach allows the data from this study to be used by healthcare administrators to explore the hidden public health impact of the radiology department and to set goals for carbon footprint reductions of healthcare organizations by focusing on alternative imaging modalities. Moreover, the presented approach in quantifying healthcare services’ environmental impact can be replicated to provide measurable data on departmental quality improvement initiatives and to be used in hospitals’ quality management systems.

No other research has been published on the life cycle assessment of MRI. The share of outside hospital indirect environmental impact of MRI services is a previously undocumented impact of the physician’s order for an internal image.

This paper investigates the optimization of window design factors (WDFs) in hospital buildings, particularly in government hospitals within the arid climate of the Qassim region, with the aim of achieving a better cooling load reduction. Continuous monitoring of the hospital ward section is crucial due to patients' needs, requiring optimal indoor air quality and cooling load.

The study identifies the optimal conditions for WDF design to mitigate cooling load, including window-to-wall ratio (WWR), window orientation (WO), room size and U-value (thermal properties), effectively reduce energy consumption in terms of sensible cooling load (MWh/m2) and comply with local codes. Data collection involved a smart weather station, while the Integrated Environmental Solution Virtual Environment (IESVE) software facilitated the simulation process.

Key findings reveal that larger patient rooms were about 40% more energy-efficient than smaller rooms. The northern orientation showed lower energy consumption, and specific WWRs and glazing U-values significantly affected energy loads. In an analysis of U-value changes in energy performance based on the Saudi Building Code (SBC), the presented values did not meet the minimum energy consumption standards. For a valid 40% WWR with a thermal permeability of 2.89, 0.181 MWh/m2 was consumed, while for an invalid 100% WWR with the same permeability but facing the north, 0.156 MWh/m2 was consumed, which is considered an invalid practice. It is vital to follow prescribed standards to ensure energy efficiency and avoid unnecessary costs.

Focus lies in emphasizing the significance of adhering to prescribed standards, such as SBC, to guarantee energy efficiency and prevent unwarranted expenses. Additionally, the authors highlight the crucial role of optimizing glazing properties and allocating the WWR appropriately to achieve energy-efficient building design, accounting for diverse orientations and climatic conditions.

The purpose of this paper is to investigate the performance of public‐private partnership (PPP) and the ability of private consortia and public authorities to together develop solutions that reduce building energy consumptions.

The paper reviews the performance of PPP projects based on criteria such as respect for timely delivery and costs, innovation, service quality and life cycle costing; then a case study focusing on energy saving performance contract (ESPC) is expounded.

The research indicates that PPP performs well on issues such as respect of timetable and contracted prices but does not establish that PPP promotes innovation, quality of service delivery and life cycle costing. It also appears that energy issues are gradually integrated in contracts in progress under the influence of thermal regulations. Among PPP projects, ESPC focuses on energy savings measures. Their success mainly requires that public authorities have a good knowledge of the status, occupation level and energy consumptions of their buildings. Information disclosure in the contract also reduces uncertainty and creates trust among partners.

The research should raise the awareness of public authorities on imperatives to have a good knowledge of the status, occupation level and energy consumptions of their buildings.

Most PPPs have been evaluated at the design and construction stages. Evaluations of PPPs in operation are less frequent. Examining the first ESPC in operation in France is an original contribution that opens doors for further empirical investigations in this field.

The purpose of this paper is to overcome the problems surrounding the operational performance of health care foodservice systems and provide a comprehensive comparison and analysis of the performance of all the different types of foodservice systems. The paper seeks to show that research addressing the operational performance of health care foodservice systems is subjective and outdated.

Discussion with foodservice managers, coupled with a review of the literature, was undertaken to determine the variables of operational performance in the different types of foodservice systems. Statistical analysis was then used to determine the areas of difference between the systems based on a sample of 90 hospital foodservice operations.

Results showed significant differences between the systems with regard to critical variables such as labor, skill level of employees and size of the production area. However, no significant differences were found for other variables such as food and energy costs.

Hospital foodservice managers are under increased pressure to reduce the operational costs of their departments while maintaining high productivity. Findings from this study should allow foodservice directors to distinguish between the operational performance of the different foodservice systems and as result introduce the system that best suits their individual hospital.

The determination of critical variables and comparison of foodservice systems using all the operational variables address significant gaps in the literature. These findings should also reduce the subjectivity in the systems' comparison, and contribute to better decisions in the selection of a particular system.

Cities are key actors in the fight against climate change. They have developed integrated strategies harnessing the power of information and communication technologies (ICT) as part of the move towards smart(er) cities. In spite of our knowledge of the role of technological infrastructure in tackling climate change, the role of governance mechanisms to actively pursue environmental sustainability is often understated. Therefore, the purpose of this paper is to analyse governmentality mechanisms developed by a small town in Europe to render energy savings and new energy sources visible and to create new identities with which the citizen and other cities could then identify with, thereby participating in the fight against climate change.

Data were gathered through non-participant observation, interviews and access to internal data from the city’s energy control project.

The outcome of these governmentality mechanisms was to create two new identities: the “good citizen”, responsible to lower his impact on climate change, and the “model city”, a laboratory that would serve as a guide for future policies to tackle climate change at the city level. While the “model city” was successful and identification happened with other small cities taking example from it, the “good citizen” failed and inhabitants did not identify with this role model that was defined for them as a way to participate in the fight against climate change.

This case study is a concrete example, based on a longitudinal study, of a city’s strategy and actions on climate change. Other small cities will be able to use this case study to gauge their possibilities for action on climate change. Notably, it is an example of how a network of mechanisms can achieve results in CO₂ emissions reduction. It also demonstrates the difficulty to enrol citizens into an environmental sustainability scheme.

This paper has implications for how climate change can be tackled in rural areas by small cities. While the role of organizations and large cities (e.g. C40 city network) has been acknowledged, there is a possibility for smaller local actors to act upon grand challenges with local strategies and their own governmentality mechanisms.

The case study contributes to the literature on cities, bringing new insights into how they can become actors of climate change beyond acting on internal controls, and the literature on governmentality by demonstrating how mechanisms can act upon a population without being calculative.

The aim of this study is to identify the critical factors of green supply chain (GSC) and to adapt these factors to the taxonomy of green practices in healthcare.

A qualitative multiple-case study approach was followed based on 60 interviews with nine French hospitals. An intra-case and a cross-case analysis were implemented.

The findings provide a taxonomy of healthcare GSC and show that regulation, cost reduction, top management commitment, employee training, information technology and measures of environmental performance are critical factors for GSC implementation. The study also underlines a few emergent critical factors including the purchasing group, environmental champion, building construction, combining safety and green approaches.

This study was conducted in France following a qualitative methodological approach. Future research can consider other national and cross-national investigations and other quantitative or mixed methods approaches.

The research provides managers and policy makers numerous invaluable suggestions for the implementation of GSC practices in healthcare facilities. To accelerate GSC implementation, managers can invest in the construction of new buildings, in information technology, and in the automation of flows.

To the authors’ knowledge, this is the first paper identifying the critical factors of GSC implementation in the healthcare sector. It is also the first attempt to provide a taxonomy of hospitals according to their green approaches (reactive, receptive, and proactive).

The purpose of this paper is to introduce the term Slow Tech as a way of describing information and communication technology (ICT) that is good, clean and fair. These are technologies that are human centred, environmentally sustainable and socially desirable.

The paper's approach is based on a qualitative discourse that justifies the introduction of Slow Tech as a new design paradigm.

The limits of the human body, and the need to take into account human wellbeing, the limits of the planet and stakeholders' interests in decision making, all suggest the need for a new paradigm, Slow Tech, in the design of ICT and ICT systems. Three scenarios are described as case studies.

In order to prepare the next generation of researchers and computer professionals, many different actions need to be taken. Universities and colleges need to redesign education programmes for computer scientists and engineers by introducing subjects related to the social and ethical implications of computing (currently, only few countries, like the UK, have already done this), and computer professionals' associations need to introduce a code of ethics or ethical analysis into their members' career development. As a result, future computer professionals who are familiar with the Slow Tech approach will be able to collaborate much more easily across the kind of cross disciplinary teams suited to design human centred, sustainable and desirable technologies.

Rather than simply focusing on the role of computer professionals, all members of society are called to play a new role in the design of future ICT scenarios. Starting a societal dialogue that involves computer professionals, users, researchers, designers, ICT industrialists, and policy makers is very much needed.

The value of this paper is in its call for reflection followed by action. Based on an holistic approach to the design of new ICT systems, the paper advocates a new starting point for systems design: it should be based on a long-term view of the desirability and social importance of technologies, their environmental impact and sustainability, and the fairness and equity of the conditions of workers involved in the computing manufacturing processes.