title: Sustainable healthcare: how to assess and improve healthcare structures' sustainability.
abstract: BACKGROUND
  Sustainability is a broad and debated subject, often difficult to be defined and applied into real projects, especially when dealing with a complex scenario as the one of healthcare. Many research studies and evaluation systems have handled this topic from different perspectives, but many limits and criticalities still have to be overcome to properly cope with actual needs.
  
  
  METHODS
  The Sustainable Healthcare project has been developed through three main phases: a deep study of the state of the art, unraveling pros and cons of available sustainability scoring systems; an accurate analysis of the stakeholders network and their needs; the realization of an objective evaluation framework, through scientific methods, as the ANP.
  
  
  RESULTS
  The newly developed evaluation system takes into consideration all the three pillars of sustainability, analyzing social, environmental and economic sustainability through a set of criteria, specified by measurable indicators. So the system identifies both global sustainability and specific critical areas, pointing out possible strategic solutions to improve sustainability. The evaluation is achieved through technical analyses and qualitative surveys, which eventually allow to quantitatively assess sustainability, through a sound scoring method.
  
  
  CONCLUSIONS
  This study proposes an innovative evaluation method to determine the sustainability of a hospital, already existing or in the design phase, within the European context. The Sustainable Healthcare system overcomes some of the current evaluation systems' limits by establishing a multidisciplinary approach and being an easy-to-use tool. This protocol is intended to be of support in the identification of the main hospital's weaknesses and in setting priorities for implementation of the solutions.
authors.affiliation: Department ABC, Politecnico di Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Buffoli
authors.forename: S
authors.initials: S
authors.lastname: Capolongo
authors.forename: M
authors.initials: M
authors.lastname: Bottero
authors.forename: E
authors.initials: E
authors.lastname: Cavagliato
authors.forename: S
authors.initials: S
authors.lastname: Speranza
authors.forename: L
authors.initials: L
authors.lastname: Volpatti
mesh_terms: D003661:Decision Support Techniques; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards; D005060:Europe; D006272:Health Facility Environment / Q000592:standards; D006749:Hospital Design and Construction / Q000592:standards; D006801:Humans; D007558:Italy; D015397:Program Evaluation / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D058996:Quality Improvement; D011787:Quality of Health Care