Making products and manufacturing more sustainable

It doesn’t matter what sector you operate in, when it comes to being more sustainable, the key factors are products, the manufacturing process and the supply chain. The healthcare sector is no exception. It’s also a sector where there’s plenty of room for improvement. Medical products produce huge quantities of waste, for example. Hospitals produce six times as much waste per patient as the average person, one operation generates more waste than a family of four produces in a week, and hospitals fail to recycle thousands of tons of stainless steel every year.

There’s no shortage of reasons why companies should want to place greater emphasis on sustainability. As we see it, there are three main drivers: pressure from legislators, customers and employees; sustainability-related opportunities; and not least the fact that more and more companies feel a moral obligation to do business responsibly.  

In the context of healthcare products and production processes, sustainability is primarily about sustainability goals 6 (clean water and sanitation), 7 (affordable and clean energy), 8 (decent work and economic growth), 9 (industry, innovation and infrastructure), 10 (reduced inequality), 12 (responsible consumption and production), 13 (climate action), 14 (life below water) and 15 (life on land).  

Specifically, it’s first and foremost about the following points: 

• reducing waste 
• lowering carbon emissions 
• using less resources generally 
• using more sustainable raw materials (no/fewer conflict minerals, etc.) 
• lowering costs (and thus creating a bigger market/greater reach) 

Vast amounts of single use packaging is not sustainable 

Right now, across our projects in the healthcare sector we find that the main focus for manufacturers is on time and budgets. In 95% of all project enquiries we receive, sustainability is not even considered. Quite the opposite – the trend in hospitals is towards ever more single use packaging, simply because it’s cheaper for manufacturers and hospital operators. This is one area where we believe there is huge potential for the sector to significantly reduce its footprint without compromising in areas such as product safety.  

The key here is to analyse sustainability across the product life cycle as a whole. An important point is that this enables the identification of areas where rapid action is required.  

In our view, there are four specific approaches, though these can (and should) also be used in combination: 

1. in-depth analysis of supply chain sustainability  
2. the use of sustainability engineering to optimise the sustainability of products over the entire product life cycle  
3. a consistent strategy for recycling/re-using medical devices or hospital equipment  
4. the development of new business models based on reprocessing or leasing of products, etc.  

Step 1 – life cycle assessment 

Life cycle assessment is an important step in developing a well-founded sustainability strategy and planning your next steps. By evaluating all of the various phases, from manufacture to end of life, you can identify which areas offer the greatest scope for improvement. In addition, a well designed life cycle assessment enables you to analyse and compare a range of different scenarios. Quantifying the impact of different strategies enables you to work out where best to deploy resources in order to produce the greatest reduction in the environmental impact of your product.  

1. Supply chain analysis 

One area that offers lots of opportunities for enhancing the sustainability of your products and manufacturing process is the origin of raw materials and semi-finished products. An ever growing range of certification programmes are providing manufacturers with much greater clarity over what they are buying. But it’s also important to take your suppliers to task. An integrated sustainability vision with specific goals helps to keep the focus on sustainability.  

A key factor in supply chain analysis is transparency about the footprint of intermediate goods. This means obtaining information from suppliers at all levels of the supply chain, including information on working conditions (cf. the German Due Diligence Act) and on risks to security of supply (e.g. from geopolitical upheaval or natural disasters). Companies can now choose from a wide range of IT tools to help ensure the transparency of their supply chains.  

2. Sustainability engineering 

While sustainability engineering is a very young discipline, it builds on established methods for reducing manufacturing costs by, for example, focusing on energy efficiency and efficient use of raw materials. Just as products are optimised to minimise manufacturing costs, sustainability engineering is about optimising products right across the product life cycle – from manufacture to disposal – to enhance their sustainability (see also our blog post “Nachhaltige Produkte – Auf diese Kriterien kommt es an”).  

We recommend applying the following criteria: 

• Avoid harmful substances. This relates to both the materials used and the manufacturing process itself. You should start by analysing the parts list for your device to see which components might contain harmful substances. For bought-in components, the key document is the purchase specification. Also important is fully cataloguing and analysing the manufacturing process itself. A degree of pragmatism is required, as it’s not always possible to replace all harmful substances immediately.  
• Minimise resource use in product and component manufacturing. The idea here is to examine the life cycle of all of the raw materials and semi-finished goods used to manufacture your product. Natural raw materials, for example, may require large volumes of water for extraction, but they are often naturally biodegradable. To compare alternative materials, you therefore need to be able to estimate factors ranging from post-consumer recycling rates to water availability in the country of manufacture.  
• Make it easy to recycle. In addition, it also makes sense to look at the end-of-life stage of the product life cycle. To facilitate recycling, it helps to use as few different materials as possible. There should be a strong focus on designing product sub-assemblies so that they are easy to dismantle, making products easier to maintain and extending product lifespan. These factors also contribute to making the product easier to recycle. A particular issue in the healthcare sector, however, is that it’s not always possible to make products recyclable, especially if they come into contact with biological substances during use.  

Sustainability engineering is closely related to ecodesign. The ecodesign approach is in principle no different from other product development processes. But ecodesign goes further – the aim is to look at the whole of the production process and product life cycle and to design both so that all stakeholders benefit. The focus is less on the product and more on the overall social context. The designer becomes an intermediary between the end consumer, the environment and the company.  

3. Reprocessing and re-use 

One approach that has the potential to significantly boost sustainability in the health sector specifically is re-use of devices and durable goods. For some products, such as hospital beds, wheelchairs and many mobility aids, this is already standard practice. The medical technology field is an area where there is an abundance of untapped potential. Reprocessing and re-use also offers the possibility of new revenue streams, one example being equipment reprocessing fees.  

A key point here is to design equipment so that it is easily repairable. Modularisation can be a useful approach to achieving this. Modularisation involves designing products and systems so that they consist of a number of replaceable functional modules. The objective is to create a flexible system which enables different versions of a product to be manufactured whilst limiting the number of components required to do so. In addition to making the product easier to repair, this approach also offers significant manufacturing benefits. 

Switching from single use to reusable items 

There’s another way of reducing resource use which is particularly relevant to the healthcare sector – switching from single use to reusable items. For manufacturers, this re-use approach can again enable the creation of new business models – e.g. subscription models and take-back systems – and in the long run can even reduce production costs. It can also lower procurement costs for end customers.  

It’s important, however, that sufficient thought is given to usability and the user experience. In the hospital setting in particular, switching from single use to reusable products can paradoxically increase costs – and potentially even increase, rather than reduce, resource use (where, for example, devices have to undergo an energy-intensive sterilisation process). That’s why it’s essential to consider the product life cycle as a whole.  

4. New business models 

Consistent re-use of devices and durable goods can even give rise to new business models. Examples include selling medical devices on a pay-per-use basis, deposit systems for reusable items, and reprocessing services. If you can make this kind of model commercially successful, you have achieved the holy grail of combing sustainability and competitive advantage in a single package, killing two birds with one stone.  

This is an area where it’s often helpful to think beyond just your own company. Many of these business models are better implemented via a network or consortium – a good example being a deposit system.  

A sustainability vision is essential 

Boosting sustainability in the healthcare sector is definitely possible – and there’s no shortage of reasons to do so. Companies need to be a little bolder in certain areas and need to be able to think outside the box. The key factor for a successful outcome, however, is taking a coherent approach to sustainability right across the company. That requires a well-grounded sustainability vision (see also blog post 1).  

Other insights in our blogpost series "Sustainability in the Health-ecosystem":

• Three reasons medtech and pharma need a sustainability vision in 2023

• How digital technologies can make healthcare companies more sustainable

• Making products and manufacturing more sustainable