The healthcare sector in the Netherlands is responsible for about 7% of the CO2 emissions. The Erasmus Medical Center (EMC) has committed to enhancing its environmental sustainability efforts by signing the Green Deal 3.0. This agreement sets ambitious targets for the EMC, including a 55% reduction in CO2 emissions by 2030 compared to the 2018 Green Deal Samen Werken Aan Duurzame Zorg (Green Deal 3.0) | Greendeals, n.d.). These targets are ambitious and call for immediate action.
The endoscopy department is found as the third highest largest contributor to hospital waste (Siau et al., 2021). This highlights the importance of improving the sustainability of the endoscopy department to meet the set targets.

This project set three main goals:
1. Creating an overview of all the consumables within the workflow of HCPs used in colonoscopy procedures at the Erasmus Medical Center.
2. Identifying and addressing the environmental impact hotspots of colonoscopy procedures.
3. Enhancing the sustainability of the reusable colonoscope with a redesign.

To achieve the first goal, the Product Journey Map method is used. Data on waste streams and the human interactions during the use of the colonoscope are gathered through observations and interviews conducted at the endoscopy department at the EMC.

After visualizing the Product Journey of the colonoscope in the EMC, it was easier to identify the environmental impact hotspots. The Value Hill model with the R-strategies was used to design sustainable interventions, to reduce the environmental impact of the hotspots. The identification of the environmental impact hotspots and the design of sustainable interventions are also carried out in a co-creation session with HCPs. Mapping out the colonoscopy procedure in a visual, including waste streams and human interactions, accelerated the ideation process with HCPs.

Furthermore, the focus of this project was on redesigning the colonoscope to enhance its sustainability. To achieve this, the literature was first explored to compare single-use with reusable colonoscopes. It became clear that implementing single-use colonoscopes would result in a 40% increase in net waste mass compared to reusable colonoscopes (Baddeley et al., 2022). However, one of the advantages of single-use colonoscopes was that they were easy to use. This was as an inspiration for the redesign of the reusable colonoscope which detects maintenance on time and prevents the damage that can occur during the use of it.

Finally, all the designed sustainable interventions and the redesign of the colonoscope are compiled into a revised Product Journey map. This revised PJM compares the new ideas with the practices, illustrating how the environmental impact of colonoscopy procedures can be reduced.