Accelerating the transition from a linear to a circular healthcare sector: ESCH-R: study design and methodology

26 March, 2025

Published in: Frontiers Planetary Health
Authors: Jilske Huijben, Erik van Raaij, Albert Wagelmans, Laura Piscicelli, Wei-Shan Chen, Bas van Vliet, Diederik Gommers, Dick Tibboel, Ellen Bakker, Florijn Dekkers, Redmer van Leeuwen, Jan Carel Diehl, Nicole Hunfeld

Due to the significant environmental impact of healthcare, there is an urgent need to accelerate its circular transition. We provide an overview of the ESCH-R project study design and methodology for accelerating the transition from alinear to a circular healthcare sector through the development an dimplementation of circular interventions in the Netherlands. Using a transdisciplinary approach, we will apply the 10-R ladder framework for a circular economy to hospitals. Methods are presented to analyze current clinical practices, policies and requirements for sustainable behavioral change, from material flows and operations to policy and regulations. We describe methods for the development of circular interventions, including business models, contract templates, and product redesigns. Finally, our approach to dissemination and education is presented. The described study design and methods can be used by other hospital (settings) to identify environmental hotspots for circular interventions in their own healthcare practice and for the cross-transfer of knowledge and anticipated challenges in implementing circular strategies. Ultimately, the ESCH-R project will deliver innovative, scalable approaches for hospitals to reduce procurement of raw materials, retain value of medical products, and reduce waste streams, CO2 emissions and pollution.

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Lecture by Nicole Hunfeld and Erik van Raaij on Sustainable Healthcare at ESHPM

On Friday 4 April, Nicole Hunfeld (PI ESCH-R) and Erik van Raaij (Projectboard member and WP4 Lead) gave a lecture at the Erasmus School of Health Policy & Management (ESHPM), as part of the course Sustainable Healthcare Organisations.

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Kick off ESCH-R Community of Practice for (future) nurses and educators

The first ESCH-R Community of Practice for nurses and educators took place on Thursday 20 March, moderated by Dr. Ellen Bakker (WP6 lead). Prof. dr. Kim Verhaegh highlighted the vital and impactful role of nurses in the transition toward sustainable and circular (hospital) care. With approximately 222.000 registered nurses in the Netherlands – the largest group of healthcare professionals, their trusted status, central position in the healthcare system and close connection to patients make them key drivers of change. 

Yara Gutter, a health scientist, shared the results from her recently completed master thesis: a qualitative exploration of nursing students’ and educators’ perspectives (n = 13) on climate change and educational needs for sustainable caregiving in the hospital setting. Nursing students and their educators acknowledged the importance of addressing climate change in the healthcare sector, yet expressed feeling unprepared to practice sustainable caregiving, due to a lack of necessary competencies, wherein barriers to implement sustainable practices persist.

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Nicole Hunfeld at the CRISMA Conference at the University of Pittsburgh, USA

On March 4 and 5, 2025, Nicole Hunfeld, Principal Investigator (PI) for ESCH-R, presented at the CRISMA Conference and the Grand Rounds of the University of Pittsburgh Medical Center, Department of Critical Care Medicine (UPMC).

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ESCH-R in Barcelona for DesHealth meeting: ‘Prerequisite for Achieving Resilience in the Healthcare Systems’

On February 25, 2025, ESCH-R’s projectboard member and Workpackage 5 leader Prof. dr. Jan Carel Diehl, together with PhD Jasper Klasen, Postdoc Ayşegül Özçelik and Ir. Jotte de Koning attended the DesHealth meeting ‘Prerequisite for Achieving Resilience in the Healthcare Systems’ in Barcelona.

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ESCH-R visit at the Wittenburg Group

The ESCH-R team was invited in March by Anne Traa, Vice Director, and Winfried Lange, Key Account Manager / Global Project Manager Medical Plastics, from Wittenburg Group for an insightful visit to explore their work on circular plastic compounds used to develop products used in hospitals . How does Wittenburg contribute to a circular healthcare sector, and how can the partnership with ESCH-R strengthen this contribution? Winfried Lange, with over 30 years of experience in the field, shared valuable expertise in the plastic industry.

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We are keen to post a bio of everyone involved in this project on the website and in the newsletter as well! 

Herewith the format:

• Who am I?
• What do I do?
• What am I up to during ESCH-R? Connected to which WP? Which cases do I work on?
• What do I expect to accomplish within ESCH-R?

Please share your bio and picture with maaike@esch-r.org.

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WP Lead meeting

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ESCH-R Webinars for PhD’s

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Invitation symposium 
The following symposium is being organized to mark the occasion of the inaugural lecture of prof. dr. ir. Erik van Raaij.

Sustainability by design: Embedding environmental care in the healthcare value chain

Practical details
Date: June 4, 2025
Time: 12.15 – 15.15 – with lunch during walk-in
Time Inaugural Lecture: 16.00
Location: Erasmus University Rotterdam

In the face of global climate and environmental challenges, healthcare systems are being called to do more than deliver care — they must also care for the planet. This requires an intentional and concerted design effort from various stakeholders along the value chain. This symposium explores how sustainable procurement can become a driving force for planetary health, bridging clinical responsibility with environmental ethics.

We invite policymakers, healthcare professionals, procurement specialists, and innovators to join us in reimagining how we source and supply for health — with tomorrow in mind.

The program brings together voices from across the healthcare ecosystem, spanning three key themes:

• Innovation and Design – exploring circular strategies, sustainable product development, and system-level thinking for greener healthcare.
• Practice and Procurement – focusing on real-world implementation, clinical leadership, and the transformation of procurement as a lever for sustainable change.
• Policy and Regulation – addressing the frameworks, incentives, and regulations that shape the future of sustainable healthcare at national and international levels.

Together, we will explore:

• What it means to purchase sustainably in healthcare today
• How procurement decisions can align with the principles of planetary health
• The policy shifts, collaborations, and innovations needed to drive sustainable transformation in supply chains

This symposium aims to foster meaningful dialogue and actionable insights — for a future where healthcare heals more than humans alone.

Inaugural Lecture prof. dr. ir. Erik van Raaij

Following the symposium, prof. Erik van Raaij will deliver his inaugural address, starting at 16:00 hrs. sharp, titled: ‘Purchasing tomorrow: Weaving planetary health into healthcare procurement.’

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ESCH-R Community of practice for Nurses and Educators

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PAC Meeting

Have you attended a conference and presented your research about ESCH-R? We would love to feature your insights!

Please share:

• A short text about your experience: key takeaways, the research you presented, and any relevant highlights.
• Photos of your presentation, poster, or the event.

We will use your contribution for our website, newsletter, and possibly social media!

Please share your text and photos via info@esch-r.org

If you post on social media yourself, feel free to use these hashtags:
#circularhealthcare #circularity #ESCH-R #circularhospital #sustainability #research #greenhealthcare

Are you presenting soon and need a research poster template?
Download the ESCH-R Poster template via the button below.

Would you like to share your ESCH-R news? Whether it’s vacancies, new PhDs, student achievements, research updates, publications, tweets, media appearances, or anything else, we’d love to hear from you! 

Share your updates with us via info@esch-r.org, and we’ll include them in our next newsletter!

Have you been approached by a journalist for an interview or article about ESCH-R? Please let us know! We coordinate PR efforts to ensure clear and consistent messaging.

Before responding, reach out to Maaike and Nicole so we can align and provide any necessary support.

Thank you!

ESCH-R 

Email adress: info@esch-r.org
Email adress: ESCH-R@erasmusmc.nl
Website: www.esch-r.org