A Societal Crisis

U.S. hospital infrastructure is aging at an accelerating pace, and this poses existential threats to national security:

Inability to address infections in face of an antibiotic resistant ‘’superbug’’ crisis
Inability to address energy inefficiencies
Inability to increase efficiencies and manage volume in a crisis (e.g. COVID)
Mounting operational losses and increasing costs

The world is at a crossroad: replace aging and outdated hospital infrastructure in order to make the healthcare system resilient to future challenges, or face a potentially insurmountable challenge in the future.

The Creeping Antibiotic Resistant Crisis

OR sectors do not effectively reduce infections. Health First Europe reports that, 800.000 people suffer from surgical wound infection in Europe each year, with the WHO adding 16.000 SSI related deaths and € 19 billion SSI related costs. In the US, according to the WHO, the costs of extra days patients spend in the hospital due to SSIs on their own already amount to $ 10 billion.

This will only become worse as antimicrobial resistant (AMR) infections are becoming a global crisis expected to affect 10.000.000 people in 2050 – up from 700.000 in 2016 (AMR Review). Currently, in Europe, these AMR infections are already costing € 1.1 billion.

Among the Most Polluting Sectors

Globally, the healthcare industry contributes to about 4,4% of greenhouse gas (GHG) emissions, which is more than the aviation or shipping industries (BMJ). When looking at developed high-income countries this number increases further:

In the US, healthcare is responsible for 8,5% of annual GHG emissions, of which 36% (3,06% of total) is attributable to hospitals and the sector is becoming more polluting (Commonwealth Fund).
o The Netherlands, healthcare is responsible for 7% of annual GHG emissions, of which 28% (1,96% total) is attributable to hospitals. (Consultancy)(RIVM).

The OR is one of the main drivers as ‘’A single operation has equal CO2 emission of a family of four in a week’’. This is multiple reasons:

30% of all hospital trash is produced in the OR (Consultancy), which is also costly as for example in the Netherlands, an instrument of 550 euro is thrown away, after every operation (Destentor).
Medical gasses have disproportionate environmental footprints (Duurzaam ondernemen).
90% of OR energy-use is HVAC related, which translates to 10% of total healthcare emissions in the Netherlands (IAMNascholing).

Most countries have pledged to reach carbon neutral goals between 2030 and 2050 according to the Paris Agreement, to which healthcare facilities must often also comply (Visual Capitalist). But this is a seemingly impossible task with current outdated building infrastructure.

Exploding Costs

Since the 1960’s, hospital infrastructure has become increasingly complex, requiring evergrowing financial support and manpower. These burdens have become unsustainable, and patient rationing has been introduced to manage limitations along with rising costs for patients and governments. The Accenture Report on the financial health of 1,522 EU hospitals in 9 countries reports 33% had operating loss in 2011, with another 13% at risk. In the US, 53% of hospitals were projected to have operating loss by 2023, while the AHA reported hospital and health system losses of more than $329B in 2020.

The operating room sector generates about 65-70% of hospital revenue, yet are as static and outdated as the rest of healthcare infrastructure. In the face of global deteriorating demographics, all these problems create significant public pressure and willingness to reduce costs and increase efficiency im this crucial sector.