Greening healthcare: systematic implementation of environmental programmes in a university teaching hospital

peer-reviewedThe provision of healthcare creates significant environmental impacts, and their mitigation is being attempted in a variety of ways which vary from nation to nation in line with differing policy priorities and resource availability. The environmental performance of hospitals has been enhanced through, for example, green building, waste and energy management, and product design. However, unpredictable occupant behaviour, new research outcomes and evolving best practice requires healthcare to react and respond in an ever challenging and changing environment, and clearly there is no one set of actions appropriate in all jurisdictions. Many authors have pointed up negative environmental impacts caused by healthcare, but these studies have focused on particular aspects of mitigation in isolation, and are for this reason not optimal. Here it is argued that tackling impact mitigation through a whole system approach is likely to be more effective. To illustrate what this approach might entail in practice, an evaluation of a systematic implementation of impact mitigation in Ireland's largest teaching hospital, Cork University Hospital is presented. This approach brings together voluntary initiatives in particular those emanating from governmental and non-governmental organisations, peer supports and the adaptation of programmes designed originally for environmental education purposes. Specific measures and initiatives are described, and analysis of results and planned future actions provides a basis for evaluation of successes achieved in achieving mitigation objectives. A crucial attribute of this approach is that it retains its flexibility and connectivity through time, thereby ensuring continual responsiveness to evolving regulation and best practice in green healthcare. It is demonstrated that implementation in Cork resulted both in mitigation of existing impacts, but also a commitment to continual improvement. For such a systems approach to be widely adopted, the healthcare sector needs both leadership from regulators and stakeholders, and strong supports. In Cork it was found that environmental education programmes, especially action and reward based programmes, as utilised by the campus's academic affiliates in particular University College Cork, were especially effective as a framework to address sustainability challenges and should be developed further. However, within healthcare implementation of environmental initiatives must prioritise patient safety. This approach has now been adopted for delivery across the health services sector in Ireland. (C) 2016 Elsevier Ltd. All rights reserved.ACCEPTEDpeer-reviewe

Tourism and the landscape Landscape management by consensus

Project co-funded by LIFE, DG XI European CommissionAvailable from British Library Document Supply Centre-DSC:OP-IRE/600 / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Informal strategies of power in the local planning system

Existing studies that question the role of planning as a state institution, whose interests it serves together with those disputing the merits of collaborative planning are all essentially concerned with the broader issue of power in society. Although there have been various attempts to highlight the distorting effects of power, the research emphasis to date has been focused on the operation of power within the formal structures that constitute the planning system. As a result, relatively little attention has been attributed to the informal strategies or tactics that can be utilised by powerful actors to further their own interests. This article seeks to address this gap by identifying the informal strategies used by the holders of power to bypass the formal structures of the planning system and highlight how these procedures are to a large extent systematic and (almost) institutionalised in a shadow planning system. The methodology consists of a series of semi-structured qualitative interviews with 20 urban planners working across four planning authorities within the Greater Dublin Area, Ireland. Empirical findings are offered that highlight the importance of economic power in the emergence of what essentially constitutes a shadow planning system. More broadly, the findings suggest that much more cognisance of the structural relations that govern how power is distributed in society is required and that ‘light touch’ approaches that focus exclusively on participation and deliberation need to be replaced with more radical solutions that look towards the redistribution of economic power between stakeholders.Irish Research CouncilAuthor has checked copyrightDM, 9/12/201