Implementing Circular Economy (CE) principles is often considered as a key contributor to greater sustainability in the construction sector. As a major kind of infrastructure, there is an urgent need for transport infrastructures to be circular and sustainable. This dissertation answers how to implement CE in transport infrastructure projects, with the aim to achieve sustainability by 1) exploring the material-asset relationship connecting the ability of circular strategies to realize sustainability through a bibliometric analysis and literature review; 2) investigating the real case in a CE-representative city, Jingmen in China; 3) using the Sectoral Innovation Systems (SIS) approach to assess CE in the infrastructure construction sector in both China and the Netherlands to discern how key functions of SIS are related to challenges to CE introduction on the one hand, and solution directions on the other; and 4) proposing an analytical/implementation framework containing specific-related aspects of CE in urban transport infrastructure projects based on current literature.

This thesis answers the question ‘how can VodafoneZiggo improve the ambulance services with IoT in the Netherlands?’. Three subquestions are answered in to finally find the answer to this main question. 

Emergency services often arrive too late. Only one out of three ambulances succeeds in meeting the standard. The arrival time depends on several steps in the process. There is a challenge in the end of the process where the collaboration between ambulances, the reporting room and emergency departments (EDs) can be enhanced. By doing this, the arrival times might improve due to an increase in efficiency.

The design goal was ‘Design an IoT based logistic concept that improves the collaboration between reporting room, ambulance staff, and EDs by giving the ambulance staff direct insight in patient stops set by EDs, and giving EDs insight in arriving ambulances’.

With the CommunicAid, the ambulance nurse fills in several fields in the ‘digitaal ritformulier’ (DRF). Based on this and several external factors the system decides which ED is most eligible. The real-time information will be shared with the certain ED and the reporting room. With the CommunicAid, patient stops at the ED will be set digitally. As soon as an ED does this, the reporting room gets an announcement and the DRF notifies it. It will make sure that the certain hospital is not available anymore in the DRF. One hour later, the patient stop is automatically canceled so the ED becomes available again. IoT is required for the information flows between the different devices.

However, implementing the system brings complications with it. In the healthcare sector, all parties work in their own systems that are not able to ‘talk’ to each other. To make it even more complex, also the systems differ between regions. This makes it complicated, expensive and unrealistic to design a solution that fits every region, unless we start from scratch. The CommunicAid should be used as a wake-up call to prove that IoT indeed can improve the ambulance service in the Netherlands.

The societal impact of implementing the CommunicAid in the Rotterdam-Rijnmond region will be direct and positive. Rotterdam-Rijnmond is chosen because the system is designed based on the outcome of the field research. Most elaborate research took place in this region. For the ambulance nurses the communication improves and time will be saved; the system prevents long waiting times at the ED. By creating insight in the arriving ambulances at the ED, the ED nurses can anticipate on the arriving ambulance patients and in this way efficiency can be increased. For reporting room employees implementing the CommunicAid will reduce their workload by automating communication flows. 

An important future goal should be to harmonize the operations in acute healthcare in all regions for all involved parties. The dream is that all parties in all regions finally operate in one system for a perfect collaboration. VodafoneZiggo can start this major change in the ambulance service by supplying IoT-connections required for implementing the CommunicAid.