Three years ago I was appointed as “environmental coordinator” of the physiotherapy department at Haukeland University Hospital in Bergen, Norway, in addition to working full time as a physiotherapist in the burns centre of the hospital. The goal is for every department in the hospital to have its own environmental coordinator and there are currently more than a hundred of us.
The role of the environmental coordinator is to assist the department manager with environmental issues. This includes being acquainted with the environmental policies and objectives of the hospital, responding to questions from management and staff, motivating the staff to comply with environmental measures, and drawing up yearly environmental objectives for the department.
We regularly take part in local meetings and seminars, and occasionally national conferences, about environmental subjects. Relevant information is passed on to the rest of the department. Other tasks may depend on the needs of each hospital department. For most of us, a central task is facilitating waste sorting: informing and reminding the staff about current routines and making sure there are appropriate localities and containers for waste sorting.
In some departments, it is important to ensure good routines for handling chemical or medical waste. For others, it is relevant to assess the use of single-use items: how to reduce the amount, and which items can be replaced with multiple-use items. Recently, there has also been an increased awareness about deleting unnecessary e-mails and files on shared folders, to reduce the need for server capacity and, thereby reducing energy consumption.

Pål Vermedal-Skjold
PT, Environmental Coordinator, Haukeland University Hospital, Bergen, Norway
Pål has worked as a physiotherapist in the hospital setting for the past nine years, mainly in relation to burn injuries, traumatic brain injuries, cancer and lymphoedema. He enjoys hiking in nature with his family (often picking up trash along the way), gardening and martial arts.
You can contact Pål on pal (at) helse-bergen.no

I have been pleasantly surprised by the level of ambition in the environmental work within our hospital. A stated objective is that the hospital’s environmental obligations should be stricter than the minimum obligations set by the national authorities. The hospital is intended to be “fossil-free” by 2030, which means both heating and transportation (including ambulances) should rely on renewable energy. There is also a goal of making construction sites in relation to the hospital fossil-free. There is a range of exciting projects already in action: the use of transparent solar panels in the windows of newly constructed buildings, projects to reduce the emission of microplastics in the laundry, a roof garden with herbs, vegetables and endangered plant species, free usage of electric cars and electric bikes for work-related journeys, systems for exchanging used furniture and surplus equipment between departments, among many other things.
With a five-digit number of employees, fairly simple measures can have a significant effect, but their success depends on whether each employee is compliant with the measures. It can be a challenge to motivate people to sort their waste thoroughly and correctly when the routines for waste sorting are a bit complicated, and sometimes don’t align with how people should sort their waste at home. There is also an ongoing consideration of maintaining hygiene and infection control, versus environmental impact. Still, my general impression is that most hospital employees are motivated and interested in making environmentally sound choices, as long as they get sufficient information and there are well-facilitated systems for following through. We, environmental coordinators, play an important part in informing and facilitating.
All of society has been affected by the Covid-19 pandemic in the past two years, and it has probably affected the carbon footprint of the hospital in several ways. For instance, there has been a great increase in the usage of face masks and other protection measures, increased usage of hand disinfectant, more frequent use of single-use articles (often wrapped in plastic) or more frequent washing of reusable articles, and periodically the recommendation to use a personal car rather than public transportation going to work. On the other hand, work-related journeys – and the emissions they contribute – have been reduced to a minimum, and most people have realized the potential of video meetings and video outpatient consultations. The latter are likely here to stay to a certain degree. Even though video consultations in many ways can’t replace a physical examination and treatment by a physiotherapist, we have experienced that it can be a very useful supplement, particularly when the patients have a long distance to travel.

Based on my own experiences, I’d like to contribute the following advice (and notes to self) when it comes to carrying out environmental measures:
1) Make time for the environmental work
If you plan on doing this work when you have “time to spare”, it tends to get down-prioritized and postponed.
2) Make time for self-studies
Read reports and articles, listen to digital seminars and lectures etc. on environmental topics.
3) Start implementing specific measures
Once you get past the idea stage, and actually get to work on a specific task, it’s easier and more motivating to pick it up again later.
4) Don’t bite off more than you can chew
Try as far as possible to finish a project before starting on the next one.
5) Cooperate with others
Discussing and working with others who are involved in the same field, is inspirational and motivational, and can make it easier to implement plans.
6) Use measurable indicators
The effect of a measure is easier to evaluate and visualize if it can be quantified, for instance by registering the usage of copy paper or certain single-use items, to see the change of patterns over time.
7) Set up a good framework
It is easier to motivate others to follow up on environmental measures if the measures are logical, simple and intuitive.
Hi Pal,
Thank you so much for your sharing your experience & knowledge & skills as an environmental coordinator. This is a well timed article for me as I have just taken in the role of Environmental Officer for my business & our national hand therapy association in Australia. We are a long way behind you, here in Australia. I feel like I’m having to figure all of this out by myself, but it is reassuring to realise I just need to look a little more globally for guidance! My current project is reducing waste related to wound care interventions. I love your advice about finishing one project for y starting the next! And your advice about cooperating with others! How would you feel about meeting with me over zoom to share ideas about waste reduction in a bit more detail? With thanks! Emma Kite
Hi, Emma,
I’m glad you find the post useful! I’m on holiday for a few weeks, but I’d love to get back to you when I’m back at work.
A few immediate thoughts concerning waste management related to wound care: That’s one of the areas where – as I mentioned – one needs to weigh environmental considerations up against infection control. Because of the latter, a lot of products need to be single use, and some equipment need extra wrapping to be sterile, both causing more waste.
Some principles that can be helpful, though:
If possible, choosing products with wrapping that is recyclable – I find that a lot of wound care products have a combined plastic/paper wrapping that is hard (or not possible) to recycle.
Not opening more equipment, or bringing more equipment into the patient room, than necessary – thereby reducing how much needs to be thrown away or washed afterwards.
Using necessary protection garments, but not more than necessary – being more mindful about how (and why) we use disposable gloves, face masks etc. can help us reduce the amount we use.
Good luck with your important task!
Regards, Pål Vermedal-Skjold