Journal of critical care
August 8, 2026 · via Europe PMC
Implementation of sustainability interventions in ICUs in the Netherlands: A survey of the green ICU.
Zeeman J, van Raaij EM, Hunfeld N.
AI summary — for doctors, generated from the abstract only
A survey of Dutch ICUs found wide variation in the implementation of 85 sustainability interventions, with some measures like establishing a "green team" universally adopted among responding units while others were rarely or never implemented.
What was studied
A survey of 72 Netherlands ICUs conducted in May 2024, using a 24-question questionnaire covering 85 sustainability interventions across seven thematic areas identified by the Dutch Green ICU network, assessing implementation frequency and ICU size (number of beds).
Key findings
- 46 of 72 ICUs (64%) opened the questionnaire, and 28 ICUs (39% response rate) rated all sustainability interventions.
- "Establishing a green team" was implemented by 100% of responding ICUs, making it one of the most commonly adopted interventions.
- "Using NaCl 0.9% instead of ultrasound gel" was implemented by 0% of responding ICUs, representing one of the least commonly adopted interventions among those surveyed.
Clinical relevance
This may be relevant to ICU leadership and sustainability advocates seeking to benchmark their own environmental practices, identifying which interventions have gained wide traction (organizational measures like green teams) versus which remain rarely adopted (specific clinical substitutions), which could help prioritize future sustainability initiatives.
Who should care
Limitations
The survey had a modest response rate (39% of ICUs rated all interventions), which may introduce response bias if units with more or less interest in sustainability were more likely to respond; this is a descriptive, self-reported survey without independent verification of actual implementation.
Dutch ICUs have widely adopted organisational sustainability measures like green teams, but many specific clinical sustainability interventions remain rarely implemented, according to this national survey.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
The healthcare sector's environmental impact is mostly caused by hospital care, with Intensive Care Units (ICUs) being a significant source of pollution. The Dutch Green ICU network shares sustainability interventions and best practices on its online platform, supporting ICUs in making their ICUs more sustainable. However, it remains uncertain which measures are actually implemented by ICUs in the Netherlands. Our objective is to investigate which sustainability interventions of The Green ICU network have been implemented in Dutch ICUs.
Methods
A questionnaire (in Dutch) was sent to 72 ICUs in the Netherlands in May 2024 and contained 24 questions encompassing all sustainability interventions identified by The Green ICU. The interventions were divided into seven thematic areas. The ICU size was also measured, as the number of beds. The data analysis included frequency counts of the interventions and qualitative analyse of the given open answers.
Results
In total, 46 ICUs (64%) have opened the questionnaire, of whom 28 ICUs (response rate 39%) rated all sustainability interventions. This article provides detailed information on the implementation frequency of 85 sustainability interventions. One of the most commonly implemented interventions is: 'Establishing a green team' (implemented by 100% of responding ICUs). One of the least commonly implemented interventions is: 'Use NaCl 0,9% instead of ultrasound gel' (0%).
Conclusions
This survey facilitates the identification of implemented sustainability actions and focus-areas in Dutch ICUs. A national platform that shares sustainable interventions can help drive the shift towards a green healthcare system.
DOI
10.1016/j.jcrc.2026.155697
PMID
42570537
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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