During the Community of Practice on Thursday 17 September 2026, moderated by Ellen Bakker (WP6 lead), the focus was on making healthcare protocols more sustainable. Nicole Hunfeld (ESCH-R Principal Investigator, Erasmus MC) and Maike Tietschert (ESHPM) shared the results of a practice-based approach at an intensive care unit (ICU), in which nurses reviewed existing protocols through a sustainability lens. Using the 10R ladder, a model for circular strategies, they explored opportunities to reduce material and resource use in healthcare. The session brought together professionals from different healthcare institutions to share experiences, examples and practical solutions.

An important conclusion of the session was that there are often already many opportunities within individual departments to make healthcare more sustainable. Participants emphasised the importance of regularly reviewing existing protocols. Four key questions emerged from the approach:

• Is an action or material clinically necessary?
• Can the quantity, frequency, packaging or preparation be reduced without affecting the clinical outcome?
• Can the same function be achieved in a different way?
• What conditions regarding safety, evidence and implementation need to be met before a change can be introduced?

At the same time, sustainability efforts remain subject to important conditions, including infection prevention, patient safety, regulations and the available scientific evidence. The approach is therefore primarily intended as a first step towards systematically identifying opportunities for greater sustainability in healthcare protocols. The actual implementation of changes requires further assessment and follow-up.

The session demonstrated that nurses can identify many concrete opportunities to make healthcare protocols more sustainable. By making use of this knowledge and structurally embedding sustainability into protocols, improvements can become less dependent on individual staff members and instead become part of standard practice.

Watch the recording (in Dutch) via this link!