3.1 Climate Action
In response to the challenges of climate change, resource consumption, and the need to maintain uninterrupted healthcare services, the Hospital regards environmental sustainability as a fundamental component of healthcare resilience. We actively support the goals of the Paris Agreement and Taiwan’s 2050 Net-Zero Emissions target, with the Sustainability Development Management Committee coordinating initiatives related to energy conservation and carbon reduction, resource circularity, digital governance, and green procurement.
While safeguarding patient safety and healthcare quality, the Hospital continues to pursue improvements across building facilities, energy efficiency, water resource management, waste segregation, and employee behaviour. Through these efforts, routine operational management is gradually being transformed into a practical foundation for low-carbon healthcare and sustainable operations.
The Hospital’s environmental management framework focuses on regulatory compliance, greenhouse gas inventory management, resource efficiency, and organisational participation. We continue to comply with government environmental regulations and relevant requirements, while implementing the ISO 14064-1:2018 standard for greenhouse gas inventories to enhance the quality of emissions data and transparency of carbon management.
Through source reduction, improved energy and water efficiency, circular economy practices, and cross-departmental communication, the Hospital continues to broaden employee participation in sustainability, energy conservation, and carbon management. Key initiatives and achievements are summarised below:
| Issue | Key Actions and Achievements |
| Carbon Reduction and Energy Management | • Completed greenhouse gas inventories and consolidated energy consumption data as the basis for energy conservation, emissions reduction, and regulatory reporting. • Continued to improve the efficiency of air-conditioning, lighting, refrigeration, elevator, and other equipment. • Evaluated solar power installations and smart energy management systems to progressively strengthen the resilience of low-carbon operations. |
| Water Resource Management | • Continued replacing equipment with water-efficient alternatives and optimising hot-water supply management to reduce both water and energy consumption. • Conducted regular monitoring of water quality and wastewater discharge and completed regulatory reporting and management in accordance with applicable requirements. • Strengthened the stability of water use across Hospital campuses through routine inspections and abnormal-event reporting mechanisms. |
| Waste Management | • Implemented segregation systems for general waste, recyclable materials, infectious waste, and food waste. • Provided waste-segregation training for newly recruited employees and outsourced cleaning personnel. • Reduced environmental impact through source reduction, waste segregation, and compliant collection and disposal. |
| Pharmaceutical Waste Management | • Installed collection bins and engaged pharmacists in waste segregation and education to ensure safe disposal. • Needles, antibiotics, liquid medications, and other pharmaceutical waste are collected and handled according to category. • Strengthened procurement-volume control and inventory management to reduce medication waste and disposal risks. |
Building on its existing management of energy, water resources, waste, and pharmaceuticals, the Hospital has further established a climate risk and opportunity management mechanism based on the TCFD framework. Climate adaptation, business continuity, and the low-carbon transition have been incorporated into Hospital-level governance as core elements in the continued advancement of environmental sustainability management.
3.2 Climate Governance and Risk and Opportunity Management
To advance sustainable development in the areas of environment, society, hospital governance, and climate adaptation and management, the Hospital has established a Sustainability Development Management Committee appointed by the Superintendent.
The Committee integrates relevant units across clinical services, medical administration, nursing, engineering, general affairs, procurement, information technology, and branch campuses. Through regular meetings and designated working groups, it promotes climate governance and cross-departmental collaboration.
The results of climate risk and opportunity assessments serve as important references for energy improvement, campus resilience, disaster preparedness and response, procurement management, and information disclosure, allowing climate-related considerations to be progressively integrated into Hospital management and daily operations.
To strengthen data governance capabilities, the Hospital has completed a greenhouse gas inventory in accordance with ISO 14064-1:2018. Inventory results are used as the basis for identifying emission hotspots, analysing carbon-reduction potential, and establishing future targets.
In alignment with Taiwan’s 2050 net-zero policy and the TCFD disclosure framework, the Hospital will continue to enhance operational resilience and governance transparency through energy-efficiency improvements, low-carbon procurement, periodic assessments, and information disclosure mechanisms.
The Hospital promotes climate governance based on the four core pillars of the TCFD framework, linking governance responsibilities, strategic direction, risk management, and metrics and targets with existing operational management processes. Implementation is summarised below:
| Core Pillar | Governance | Strategy | Risk Management | Metrics and Targets |
| Disclosure Focus | Incorporate climate issues into Board oversight and establish cross-departmental governance mechanisms. | Promote energy-efficiency and adaptation actions and accelerate planning for the net-zero transition. | Identify risks, capture opportunities, and establish response and management mechanisms. | Establish targets, monitor performance, and disclose information based on greenhouse gas inventory results. |
| CSMUH Implementation | Under the Hospital’s sustainability governance framework, a governance hierarchy for climate-related issues has been established. The Board oversees major policy directions and implementation progress; the Superintendent coordinates sustainability initiatives; and the Sustainability Development Management Committee is responsible for strategy development, policy integration, and cross-departmental implementation. | The Hospital promotes energy transition and operational adaptation by evaluating solar photovoltaic systems, smart energy management, and replacement of high-energy-consuming equipment. Continuity of healthcare services, infrastructure resilience, and low-carbon procurement are incorporated into medium- and long-term strategies. | Standardised inventory and risk-identification procedures have been established to identify emissions and climate-impact hotspots related to energy, transportation, refrigerants, pharmaceuticals, and the supply chain, providing a basis for priority management and resource allocation. | Based on greenhouse gas inventory results and climate risk assessments, the Hospital continues to develop phased carbon-reduction targets, energy management indicators, and climate-resilience monitoring mechanisms, progressively improving disclosure transparency. |
Climate Change Risk and Opportunity Management
Based on the characteristics of healthcare services and the operational needs of its campuses, the Hospital has established a climate risk and opportunity management process covering inventory, identification, management, monitoring, and improvement.
The process is built on cross-departmental data collection and scenario-based discussion. Rather than assessing risk solely through individual environmental indicators, the Hospital simultaneously considers impacts on healthcare delivery, infrastructure, supply chains, patient safety, and financial performance. These assessments provide the basis for determining management priorities and allocating resources.
■ Climate Change Risk and Opportunity Management Process
| Step | Description |
| 1. Risk and Opportunity Inventory | Refer to the TCFD framework and IPCC guidance to identify physical risks, transition risks, and climate-related opportunities, covering infrastructure, healthcare processes, and supply chains across the main Hospital and branch campuses. |
| 2. Risk and Opportunity Identification | Consolidate cross-departmental input and evaluate factors including likelihood, magnitude of impact, vulnerability, onset speed, and financial impact to establish a comprehensive list of risks and opportunities. |
| 3. Risk and Opportunity Management | Develop management responses for high-impact items, including campus backup systems, disaster preparedness and response, energy-efficient equipment improvements, low-carbon procurement, digital healthcare, and telehealth. |
| 4. Monitoring and Improvement | Track implementation progress through energy management, internal audits, and the Sustainability Development Management Committee. Significant deviations or major risk and opportunity events are escalated for dedicated review, with management measures adjusted on a rolling basis. |
Scenario Analysis and Strategy
To enhance strategic resilience in responding to climate change, the Hospital has introduced scenario analysis tools to assess physical risks under a high-emissions pathway as well as policy, technology, market, and reputational risks under a net-zero transition pathway.
Scenario analysis is not treated as a single predictive forecast. Instead, it is used to help the Hospital identify potential stress conditions in advance and incorporate continuity of healthcare services, energy allocation, equipment maintenance, campus drainage, and disaster preparedness into medium- and long-term planning.
■ Scenario 1: SSP5-8.5 Physical Risk
The high-emissions scenario refers to the SSP5-8.5 pathway in the IPCC Sixth Assessment Report (AR6) and incorporates information from Taiwan’s climate change projection platform to examine trends in extreme temperatures, heavy rainfall, and typhoon-related precipitation.
The Hospital assesses near-, medium-, and long-term time horizons to evaluate the resilience of campus infrastructure and the ability to maintain healthcare services.
| Physical Risk | Parameter | 2021–2040 (Early 21st Century) | 2041–2060 (Mid-21st Century) | ~2100 (Late 21st Century) |
| Increasing Severity and Frequency of Extreme Weather Events | Number of typhoons | – | Decrease by 10% | Decrease by 50% |
| Proportion of intense typhoons | – | Increase by 105% | Increase by 60% | |
| Change in typhoon rainfall within 200 km of the typhoon centre | – | Increase by 20% | Increase by 35% | |
| Changes in Precipitation Patterns | Average change in total precipitation across Taiwan | Increase by 0.9% | Increase by 6.6% | Increase by 20% |
| Average change in rainfall intensity on rainy days across Taiwan | Increase by 1.9% | Increase by 7.4% | Increase by 27.9% | |
| Rising Average Temperature | Increase in average temperature across Taiwan | 0.8°C | 1.6°C | 3.5°C |
Note: Scenario parameters are based on the IPCC AR6, the Taiwan Climate Change Projection Information and Adaptation Knowledge Platform (TCCIP), and publicly available information from Taiwan’s Climate Change Administration, Ministry of Environment.
■ Scenario 2: NZE + NDCs Transition Risk
The transition scenario refers to the International Energy Agency’s Net Zero Emissions by 2050 Scenario (NZE) and the direction of countries’ Nationally Determined Contributions (NDCs).
The Hospital evaluates the potential impacts of carbon pricing, energy-efficiency requirements, low-carbon supply chains, and healthcare-service transformation on operating costs, capital expenditure, procurement decisions, and public trust.
These assessments serve as a strategic reference for energy-efficiency investment, renewable energy evaluation, digital healthcare, and responsible procurement.
Climate Risk and Opportunity Assessment
Based on the scenarios above and cross-departmental assessments, the Hospital categorises climate-related issues into three areas: transition risks, physical risks, and climate-related opportunities.
The following tables summarise the main risks and opportunities, their categories and drivers, their relevance to Hospital operations, and their expected time horizons. These results provide a basis for subsequent management targets and action planning.
■ Transition Risks
| Risk Type | Risk Item | Risk Driver | Relevance to CSMUH | Time Horizon |
| Policy and Regulation | Carbon tax / carbon fee | Introduction of carbon pricing mechanisms, including the potential future inclusion of healthcare institutions in carbon-fee schemes | The Hospital operates a large building footprint with high energy demand. If carbon pricing mechanisms are expanded to healthcare institutions, operating costs and pressure for energy-efficiency investment may increase. Early greenhouse gas inventories and carbon-reduction planning can help mitigate potential financial impacts. | Short term |
| Technology | Insufficient adoption of energy-efficient equipment | Failure to introduce high-efficiency equipment or green building technologies in a timely manner | Some Hospital buildings have been in use for extended periods. Delays in equipment replacement may reduce overall energy efficiency and sustainability performance and may also limit future opportunities to obtain subsidies or certifications. | Medium term |
| Market | Procurement constraints arising from low-carbon requirements | Increasing expectations for low-carbon supply chains affecting healthcare procurement | If suppliers lack low-carbon capabilities or sufficient environmental information, the Hospital’s choices of medical supplies, equipment, or pharmaceuticals may be constrained, potentially affecting healthcare processes and service quality. | Long term |
| Reputation | Inadequate climate risk management | Failure to respond proactively to climate risks may affect public trust and institutional reputation | Hospitals are public-service institutions that carry a high degree of public trust. Inadequate preparedness for extreme climate events may result in operational disruption or patient-care risks, thereby affecting public confidence. | Short term |
■ Physical Risks
| Risk Type | Risk Item | Risk Driver | Relevance to CSMUH | Time Horizon |
| Acute Physical Risk | Typhoons / Flooding | Natural disasters such as typhoons and flooding may disrupt healthcare operations, reduce asset value, and potentially contribute to emerging infectious disease risks. | The Hospital is located in an urban area, with some equipment and facilities located underground or within existing building structures. Short-duration heavy rainfall or flooding may affect mechanical rooms, diagnostic and treatment equipment, emergency services, and inpatient care, while also increasing infection risks. | Short term |
| Chronic Physical Risk | Extreme climate conditions | Increasing extreme rainfall and climate instability may raise facility-maintenance pressure, increase vector-borne disease risks, and affect energy allocation and operational planning. | More frequent extreme rainfall and high-humidity conditions require the Hospital to maintain stable air-conditioning, drainage, and infection-control systems over extended periods. Failure to do so may affect equipment lifespan, quality of care, and operational burden. | Long term |
■ Climate-Related Opportunities
| Opportunity Type | Opportunity | Description | Relevance to CSMUH | Time Horizon |
| Products and Services | Digitalisation | Improve operational processes, enhance resource efficiency, and optimise energy and workforce allocation. | The Hospital has introduced smart healthcare, electronic medical records, and energy management systems to improve administrative and clinical efficiency while reducing energy and labour costs. | Medium term |
| Resource Efficiency | Optimised Energy Management | Improve equipment and management practices to continuously reduce energy consumption and operating costs. | Replacing ageing equipment and introducing energy-efficient air-conditioning and lighting systems can help continuously reduce energy expenditure. | Short term |
| Products and Services | Renewable Electricity Adoption | Introducing solar power installations can increase the share of renewable energy use and strengthen energy autonomy and resilience. | The Hospital has assessed the feasibility of installing solar energy systems on available building spaces. Future adoption of renewable electricity may strengthen the Hospital’s sustainability profile and improve preparedness for carbon-pricing policies. | Long term |
| Resource Efficiency | Sustainable Healthcare | Promoting low-carbon healthcare and waste-reduction initiatives can enhance resource efficiency and strengthen sustainable healthcare capabilities. | The Hospital promotes green outpatient services, digital medical records, and paperless services to reduce material consumption and healthcare waste in alignment with low-carbon trends. | Medium term |
| Products and Services | Telehealth | Developing telehealth services supports low-carbon healthcare delivery while improving access to care and expanding healthcare coverage. | The Hospital continues to expand telehealth services for patients in rural areas and those requiring long-term care, while reducing carbon emissions associated with travel for medical visits. | Short term |
| Resilience | Increase in Climate-Related Diseases | Climate change may increase the incidence of climate-related diseases, strengthening the role of healthcare institutions in public health protection and emergency response. | By integrating emergency and critical care, infection control, and public health capabilities, the Hospital can provide care and response services for climate-related health risks and serve as an important regional hub for climate-health risk management. | Medium to long term |
| Resilience | Building a Sustainability Culture | Develop diverse ESG expertise and promote organisation-wide sustainability culture and cross-departmental collaboration. | The Hospital has established a sustainability governance and learning framework and promotes green healthcare and sustainable management through collaboration across departments. | Medium term |
| Resilience | Enhancing Sustainability Influence | Strengthen ESG practices, expand domestic and international collaboration, and enhance institutional influence and international visibility. | The Hospital actively participates in healthcare sustainability initiatives and related collaborative platforms, strengthening its institutional brand and public influence. | Long term |
■ Climate Risk and Opportunity Scoring Factors and Assessment Thresholds
To ensure consistency and traceability in climate risk and opportunity assessments, the Hospital has established scoring factors and assessment thresholds to evaluate both the significance and potential financial impact of each climate-related risk and opportunity. The results serve as the basis for matrix analysis and management prioritisation.
| Assessment Category | Risks | Opportunities | Scoring Method |
| Significance Factors | • Likelihood • Impact • Onset Speed • Vulnerability | • Feasibility • Impact • Timeliness & Window of Opportunity • Strategic Alignment with CSMUH | Four dimensions are used to form a composite risk/opportunity factor. Each dimension is scored from 1 to 5, and the four scores are summed to determine the overall risk/opportunity significance score. |
| Financial Impact | • Level IV: Major financial benefit (NTD 2 million or more) or an extremely significant positive reputational impact – 20 points • Level III: Financial benefit of NTD 1.51–1.99 million or a highly significant positive reputational impact – 15 points • Level II: Minor financial benefit of NTD 1.01–1.50 million or a moderately significant positive reputational impact – 10 points • Level I: Very minor financial benefit of NTD 1 million or less or a minimal positive reputational impact – 5 points | Each risk/opportunity is assigned the corresponding score according to its level of financial impact. |
Threshold for Significant Risks and Opportunities
Following discussion by the Sustainability Development Management Committee, and taking into account management effectiveness and resource allocation, the Hospital defines an item as requiring priority management when both its risk/opportunity significance score and financial impact score exceed 12 points out of a maximum of 20.
Items meeting this threshold are incorporated into formal management processes, assigned targets, and subject to regular monitoring and review.
- Red zone: High-priority risks or opportunities requiring active management and target-setting.
- Yellow zone: Items included on the watch list, with management priority adjusted as circumstances change.
- Green zone: Low-level risks or opportunities included on the monitoring list and reviewed periodically.
After completing the scoring process based on the factors above, the Hospital plots risk/opportunity significance against financial impact in a matrix. This allows the Hospital to identify high-priority risks and opportunities requiring greater resource allocation and provides a basis for establishing management objectives, implementing action plans, and regularly monitoring performance.
■ Climate Change Risk and Opportunity Matrix
Assessment results are presented in the Hospital’s Climate Change Risk and Opportunity Matrix to determine management priorities for climate-related issues.
The assessment indicates that key priority risks include policy and regulatory risks, typhoon and flooding risks, and reputational risks. Key high-potential opportunities include telehealth, optimised energy management, and responses to climate-related diseases. These findings serve as important references for future action targets, resource allocation, and climate resilience management.
Climate Governance Key Metrics and Targets
To extend climate governance from risk identification to action management, the Hospital has established climate-related key metrics and management targets based on the TCFD framework and the results of its climate risk and opportunity assessment. These cover risk identification and response, the capture of climate-related opportunities, and an additional dimension of sustainability governance and culture, serving as references for annual planning and resource allocation.
| Management Dimension | Risk / Opportunity Item | Management Target | Current Status and Plans at CSMUH |
| Risk Identification and Response | Inadequate climate risk management | Conduct an annual review of climate risks and impact factors and incorporate them into hospital management | Establish a climate risk assessment process, strengthen institutionalised management, and integrate it into the Hospital’s sustainability governance framework |
| Carbon tax / carbon fee | Advance greenhouse gas inventory management | Complete greenhouse gas inventory work in line with policy developments and continue strengthening the foundation for greenhouse gas management and carbon reduction actions | |
| Replacement of energy-consuming equipment across campuses to reduce risk and energy use | Upgrade high-energy-consuming equipment on an ongoing basis | Continue promoting upgrades of high-energy-consuming equipment to enhance energy efficiency and improve operational cost management | |
| Typhoons / flooding | Strengthen operational resilience in response to short-duration heavy rainfall and flood risk | As the Hospital’s campuses are located in urban areas with significant disaster-preparedness needs, the Hospital will continue to develop disaster response plans to improve operational continuity | |
| Capturing Climate Opportunities | Optimised energy management | Optimise equipment and management to continuously reduce energy use and operating costs | By replacing ageing equipment and introducing energy-efficient air-conditioning and lighting systems, the Hospital can continue reducing energy expenditure |
| Telehealth | Reduce carbon emissions generated by patient travel through remote services while improving access to care | Continue promoting telemedicine and the application of electronic medical records, thereby balancing carbon reduction benefits with accessibility to medical services | |
| Increase in climate-related diseases | Become an important regional hub for climate-healthcare services | Leverage the Hospital’s teaching and public health functions to enhance its overall capacity to respond to climate-related health risks | |
| Sustainability Governance and Culture | Building a sustainability culture | Strengthen the functions of the Sustainability Development Management Committee and integrate resources and implementation capacity | The Sustainability Development Management Committee coordinates cross-departmental resources to promote green healthcare and carbon management |
| Enhancing sustainability influence | Actively participate in net-zero alliances and healthcare sustainability dialogue platforms | Join the Taiwan Alliance for Climate and Health and participate in healthcare sustainability exchange platforms to strengthen the practical linkage between the net-zero transition and climate-health governance |
The Hospital will continue to review the effectiveness of climate risk and opportunity management through annual assessments, committee tracking, and cross-departmental improvement mechanisms. These efforts will also be linked with data on energy use, greenhouse gas emissions, waste, and water resource management, thereby progressively enhancing the resilience of low-carbon healthcare and sustainable operations.
3.3 Energy and Greenhouse Gas Emissions
As a healthcare institution, the Hospital has a certain degree of rigid energy demand due to the need to maintain stable operation of medical equipment, inpatient care, emergency and critical care services, and air-conditioning environments in order to ensure patient safety and uninterrupted healthcare delivery. In response to the pressures of low-carbon transition and energy cost management, the Hospital continues to monitor energy use and emission sources based on its greenhouse gas inventory.
Management priorities focus on adjustable items such as purchased electricity, air-conditioning, lighting, refrigeration units, and administrative and general-use equipment. The Hospital progressively promotes electricity efficiency management, inventories of high-energy-consuming equipment, energy-saving improvements, and advocacy for low-carbon behaviour. Following the completion of its first greenhouse gas inventory in 2024, the Hospital continued in 2025 to inventory the energy use and greenhouse gas emissions of the Main Hospital (Daqing and Wenxin Campuses) and the Chung Hsing Branch in accordance with ISO 14064-1:2018, and established a traceable emissions inventory for regulatory reporting, providing a foundation for subsequent energy-saving, carbon-reduction, and low-carbon healthcare management.
Greenhouse Gas Inventory
To align with national greenhouse gas management policy and reporting requirements of the competent authority, the Hospital continues to establish an ISO 14064-1 greenhouse gas inventory system, with 2024 designated as the base year, and updates emissions data and management boundaries on an annual basis. The 2025 inventory maintained the organisational boundary covering the Main Hospital (Daqing and Wenxin Campuses) and the Chung Hsing Branch, and improved the accuracy and transparency of carbon management information through internal data consolidation, identification of emission sources, and external verification procedures.
To ensure consistency and comparability, the Hospital quantifies emissions using either the emission factor method or the mass balance method, depending on the characteristics of the emission source, and discloses all activity data in carbon dioxide equivalent (CO₂e). Inventory activity data cover energy use, transportation, medical gases, refrigerant leakage, and products used by the organisation. Data sources include procurement records, billing statements, accounting ledgers, issue records, Taipower electricity bills, water and electricity consumption statistics, and equipment nameplate information. Emission factors are selected in accordance with announcements of the competent authority and relevant international standards. The 2025 inventory results indicate that indirect greenhouse gas emissions from imported energy remain the Hospital’s primary source of emissions, showing that management of purchased electricity is the priority area for energy saving and carbon reduction. The increase in Category 3 emissions was mainly due to the addition this year of Category 3: Indirect greenhouse gas emissions from transportation, while Category 4: Other indirect emissions also continued to be included. Therefore, comparisons of total emissions between the two years also reflect differences in inventory items and reporting boundaries. Category 4 emissions are also significant from a management perspective and will be further addressed through procurement management, supply chain communication, and evaluation of alternatives. The Hospital also includes emission sources specific to healthcare institutions in its inventory management, including medical gases, refrigerant leakage, and use of related pharmaceuticals, reflecting the diverse and specialised carbon management challenges faced by healthcare services while maintaining patient safety and quality of care.
Energy Use and Electricity Efficiency
Energy use statistics were consolidated based on the principle of operational control, covering the major operating activities of the Main Hospital and the Chung Hsing Branch. To clearly present the Hospital’s energy use, managed energy sources are divided into two categories: electricity and fuel oils/gases. The statistics disclose usage by purchased electricity, petrol, liquefied petroleum gas, natural gas, and diesel.
Because healthcare institutions must maintain stable operation of inpatient care, emergency and critical care services, air-conditioning environments, and medical equipment, purchased electricity remains the Hospital’s primary source of energy use. In 2025, the Hospital completed one energy use inventory, and total electricity consumption decreased by 2.42% compared with the previous year. The overall reduction in electricity use was mainly attributable to optimised management of the monitoring software for the chilled water host system at the Main Hospital. The Hospital monitors and manages key power-consuming equipment and areas to understand energy use patterns and identify major energy hotspots, plan equipment replacement, and evaluate low-carbon alternatives.
Improvements to High-Energy-Consuming Equipment
The Hospital focuses its electricity efficiency management on adjustable lighting, air-conditioning, and administrative/general-use equipment. Through operational management, electricity-use monitoring, and equipment inventories, the Hospital progressively reduces non-essential energy consumption unrelated to clinical care. In 2025, the Hospital completed one inventory of high-energy-consuming equipment, covering a total of 12 items, of which the four chilled water host units in the Ju-Chuan Building were identified as priority improvement items. Replacement work is currently underway and is expected to be completed in 2026.
Because healthcare services must remain uninterrupted, the Hospital adopts a phased approach to inventory, assessment, and replacement of high-energy-consuming equipment. During the year, no material operational abnormalities occurred due to ageing equipment or energy consumption issues, and clinical services were not affected. Going forward, improvement priorities will be determined based on energy-saving benefits, equipment condition, and the impact on healthcare services, and the Hospital will progressively introduce high-efficiency equipment, smart controls, or energy-saving designs without affecting medical operations.
Low-Carbon Actions and Employee Participation
Low-carbon healthcare depends not only on equipment improvements, but also on the active participation of employees in their daily work. Through advocacy activities on low carbon, energy saving, electricity saving, paper saving, and low-carbon commuting, the Hospital extends carbon-reduction awareness into employees’ work and daily lives. In 2025, the Hospital held 6 related advocacy activities, with 934 participant attendances. In addition, 11 low-carbon or sustainability culture promotion activities were organised to encourage employees to practise low-carbon actions in areas such as electricity use, paper use, commuting, and resource use.
The Hospital also encourages employee participation in environmental improvement through its proposal mechanism. In 2025, employees submitted 34 proposals related to carbon reduction or environmental improvement, of which 18 proposals were adopted for implementation. In the same year, 378 employees participated in Car-Free Day, representing 11.5% of employees. Through education and advocacy, low-carbon commuting, Car-Free Day surveys, and employee proposals, the Hospital continues to extend carbon reduction actions from facilities management to hospital-wide culture. In addition to energy-saving management and employee proposals, the Hospital also continues to deepen employees’ understanding of low-carbon healthcare and climate-health issues through benchmarking visits, sustainability lectures, and exchange activities, thereby extending low-carbon action from equipment management into everyday workplace culture.
Energy Saving, Carbon Reduction, and Continuous Improvement
Based on energy use and greenhouse gas inventory results, the Hospital has promoted two energy-saving improvement measures: the Emergency Department Renovation Project and air-conditioning schedule control in the Administrative Building. In the Administrative Building, through cross-departmental collaboration, the operating schedules of air-handling units and supply fans were adjusted according to the usage requirements of each floor. Timer installation and testing were completed in November 2025. As 2025 focused primarily on equipment installation and trial operation, electricity savings were estimated based on differences in operating hours, equipment power, and the number of operating days throughout the year. After formal operation begins in 2026, the Hospital will track energy-saving performance based on actual electricity consumption and operating records.
Relevant targets and tracking results will be fed back into energy management, equipment replacement, behavioural advocacy, and annual reduction planning, thereby progressively forming a low-carbon management cycle of annual inventory, management feedback, cross-departmental collaboration, and continuous improvement. Going forward, while ensuring uninterrupted healthcare services, the Hospital will continue to strengthen purchased electricity management, improve high-energy-consuming equipment, enhance employee participation in low-carbon actions, and track reduction targets, so that low-carbon healthcare becomes not only an environmental management requirement, but also an important foundation supporting healthcare resilience and sustainable operations.
3.4 Waste Management
Healthcare services generate different types of waste, including general domestic waste, recyclables, food waste, infectious medical waste, and chemical waste. Among these, medical waste is closely related to infection control, workplace safety, and regulatory compliance. In accordance with the Waste Disposal Act and relevant waste classification and management regulations, the Hospital has established mechanisms for waste classification, temporary storage, collection and transport, recordkeeping, and outsourced treatment. Clearly labelled recycling bins and dedicated containers are set up in operational areas such as meal distribution rooms, treatment rooms, and nursing stations to guide employees, patients, family members, and outsourced personnel in proper disposal, thereby reducing the risk of mixed waste and misclassification at source.
The Hospital also incorporates waste classification into orientation training for new employees and outsourced cleaning personnel and promotes waste segregation policies to patients and their families during admission orientation. In this way, waste management is not merely a downstream disposal process, but a routine management practice jointly implemented across clinical, administrative, logistics, and public-use settings.
Waste Classification and General Treatment
The Hospital manages waste according to its nature and treatment method. General domestic waste is collected after classification and sent to qualified contractors for incineration. Recyclables such as paper, metal cans, glass, and plastic containers are collected centrally for recycling and reuse. Food waste is handled in accordance with the food waste recycling procedure. Through clear classification, regular collection, and compliant outsourced treatment mechanisms, the Hospital ensures that all waste streams comply with regulatory requirements while improving resource recovery and reuse efficiency.
| Waste Category | Management Method | Treatment Method |
| General domestic waste | Classified and centrally collected in accordance with regulations | Off-site treatment / incineration |
| Recyclables | Sorted and collected, including paper, metal cans, glass, and plastic containers | Recycling / reuse |
| Food waste | Collected according to the food waste recycling procedure | Treated by qualified contractors |
| Hazardous medical waste (infectious medical waste) | Sorted into combustible and non-combustible categories and sealed in dedicated red or yellow containers | Treated by qualified contractors |
| Hazardous medical waste (chemical or chemotherapy waste) | Managed through leak-proof, spill-proof, ventilated, and secure temporary storage | Treated by qualified contractors |
Source Control of Pharmaceuticals and Collection of Waste Pharmaceuticals
(1) Source Reduction: Reducing Pharmaceutical Waste through Procurement and Inventory Management
Pharmaceutical management is an important part of source reduction for medical waste. The Hospital addresses this through procurement, inventory, shelf-life, and supplier management. Procurement plans are formulated based on historical usage and demand forecasting to avoid over-purchasing. Through regular inventory checks and expiry-date control, the risk of medicines being discarded after expiry is reduced. At the same time, suppliers are carefully selected to ensure stable pharmaceutical quality and traceable sources. By moving pharmaceutical management upstream to procurement and inventory control, the Hospital reduces pharmaceutical waste and waste generation at source, ensuring that management of waste pharmaceuticals begins even before medicines reach the point of use.
(2) Public Return Service: Providing Waste Pharmaceutical Collection Services
To prevent pharmaceutical misuse, reduce environmental risks, and improve public awareness of proper medication use, the Hospital has established a mechanism for the inspection, collection, and recycling of waste pharmaceuticals. A public pharmaceutical disposal drop-off service is available in the waiting area for medications on the first floor, enabling the public to return unused or expired medicines to the Hospital for centralised treatment. Pharmacists assist with classification, sealing, and documentation to ensure that waste pharmaceuticals do not re-enter use and are handled in accordance with regulations governing infectious and chemical waste. In this way, public return, professional inspection, and subsequent treatment form a complete management process.
(3) High-Risk Pharmaceuticals and Sharps: Centralised Handling to Reduce Environmental and Infection Risks
For common household pharmaceutical waste such as antibiotics, hormones, immunosuppressants, addictive medicines, liquid medicines, and sharps, the Hospital advises the public to return them to the Hospital for centralised treatment. This helps prevent improper disposal or release into the environment and reduces the potential impact of pharmaceutical residues on water bodies, soil, and ecosystems. Within the Hospital, clinical units such as nursing stations also provide designated collection areas for infectious sharps. These items are placed in puncture-resistant containers in accordance with regulations, and the principle of replacement when 80% full is strictly followed to reduce the operational risks posed by infectious sharps and ensure personnel safety.
(4) Recordkeeping and Tracking: Ensuring Transparent and Auditable Flows of Waste Pharmaceuticals
The Hospital has also established recordkeeping and treatment mechanisms for expired medicines, waste pharmaceuticals, and controlled drugs. Depending on the type of pharmaceutical, items are classified, sealed, stored, and treated through outsourced contractors. Through pharmaceutical recovery record forms and controlled drug recovery registers, information such as the medicine name, quantity, recovery date, and treatment method is recorded to establish a tracking mechanism for the flow of waste pharmaceuticals. This ensures clear, traceable flows in compliance with regulatory requirements and further strengthens the transparency and auditability of waste pharmaceutical management.
(5) Management Benefits: Extending Medication Safety to Environmental and Public Health
Through source control of pharmaceuticals, public return services, in-hospital classification and inspection, and record tracking, the Hospital continues to reduce pharmaceutical waste and the potential environmental risks associated with discarded medicines, while also helping the public develop proper medication use and recycling practices. Guided by the principles of source reduction, classification and inspection, record tracking, and environmental stewardship, the Hospital extends pharmaceutical management beyond medical care into environmental safety and public health.
Note to Designer: Please design a flowchart titled “Source Control of Pharmaceuticals and Collection of Waste Pharmaceuticals” as the main visual for this section, illustrating the Hospital’s management logic from source reduction to flow tracking. The process should be:
Source Control → Public Return → Pharmacist Inspection → Classification and Sealing → In-Hospital Safe Collection → Record Tracking → Compliant Treatment
Infectious and Special Waste Management
To ensure safe classification and regulatory treatment of medical waste, the Hospital has established a comprehensive management system. Biological and chemical waste are subject to graded classification, storage, and strict operational standards, as detailed below:
(1) Biological Medical Waste Management
■ Combustible items:
- Use leak-proof, rupture-resistant red plastic bags clearly labelled “Biological Waste”.
- Waste stored above 5°C must be limited to one day; waste refrigerated below 5°C may be stored for up to seven days.
- Items include animal carcasses, specimens, vaccines, plastic laboratory apparatus, and gloves.
■ Non-combustible items:
- Use sturdy, puncture-resistant yellow containers with appropriate labels attached.
- Items include needles, blades, glass culture dishes, and test tubes.
(2) Chemical and Chemotherapy Waste Treatment
- For safety reasons, priority is given to procuring pharmaceuticals supplied with recovery containers.
- Expired pharmaceuticals are sealed and stored in their original containers to avoid mixed reactions.
- Combustible liquids are stored centrally in areas equipped with fire-resistant building materials and ventilation facilities, together with fire-fighting equipment.
- Relevant containers must be durable, leak-proof, unbreakable, and made of materials compatible with the waste characteristics; containers must not be filled beyond two-thirds of their capacity and must be kept sealed and clean.
- Genotoxic waste and sharps are placed in puncture-resistant containers and labelled accordingly.
(3) Personnel and Operational Protection Management
- All personnel involved in operations wear personal protective equipment (PPE), including gloves and protective goggles.
- Work is carried out in accordance with standard operating procedures and container labelling requirements to reduce cross-contamination and operational risks.
Note to Designer: Please design a visual titled “Safe Management of Infectious and Special Waste”, structured into three sections: Biological Medical Waste, Chemical / Chemotherapy Waste, and Personnel Protection Management, accompanied by icons for red bags, yellow puncture-resistant containers, and PPE.
Recycling and Reuse of Medical Waste
To reduce the final incineration volume of medical waste, the Hospital launched medical waste recycling and reuse operations in 2025. After completing the amendment to its industrial waste treatment plan and signing contracts with waste removal and treatment contractors in February, the Hospital first introduced recycling in the dialysis room for recyclable plastic items such as artificial kidneys, infusion tubing, and dialysis solution bags. From March onwards, the programme was expanded hospital-wide to include the recycling of plastic IV hard bottles and soft bags, progressively incorporating reusable medical waste into routine management processes.
In 2025, there were 2 categories of medical waste recycling and reuse, with an annual recycled and reused volume of 18.94 tonnes, accounting for approximately 4.53% of total medical waste. This initiative redirected part of the waste that would otherwise have been incinerated towards reuse, enabling waste management to move beyond proper treatment towards resource circularity.
| Item | 2025 Result |
| Number of recycling and reuse categories | 2 categories |
| Weight recycled and reused | 18.94 tonnes |
| Percentage of total medical waste | 4.53% |
| Implementing unit / scope | Dialysis room and hospital-wide recycling of plastic IV hard bottles / soft bags |
| Recycled items | Artificial kidneys, infusion tubing, dialysis solution bags, plastic IV hard bottles / soft bags, etc. |
Note to Designer: Please highlight 18.94 tonnes, 4.53%, and 2 recycling categories in an enlarged visual format, and use a simple diagram to show the implementation pathway from the dialysis room pilot to hospital-wide expansion.
Waste Generation and Treatment Performance
In 2025, total waste generation was 768.85 tones, an increase of 39.65 tones compared with 2024, mainly due to the increase in recyclable materials and the addition of new medical waste reuse items. Looking at different waste flows, both general domestic waste sent for incineration and hazardous medical waste sent for incineration declined compared with the previous year, while the volumes of recyclables, food waste recycling, and hazardous medical waste reused increased. This indicates that the Hospital continues to promote waste segregation management and resource circularity, progressively improving waste reuse performance.
Table 3.4-3 Waste Statistics, 2022–2025
3.5 Water Management
As a healthcare institution with high water demand, the Hospital depends on a stable water supply for patient care, medical procedures, cleaning and disinfection, air-conditioning cooling, and equipment operation and maintenance. Therefore, water resource management is directly related to patient safety, healthcare quality, and operational resilience. The Hospital continues to promote stable, safe, and efficient water management from three perspectives: replacement of water-saving equipment, water quality and safety monitoring, and compliant wastewater treatment.
Water-Saving Equipment and Water Use Efficiency
The Hospital replaces old taps and bathroom fixtures on a phased, zone-by-zone basis, prioritising public areas and spaces with high frequency of use. In 2025, replacement works in inpatient ward areas were completed. By 2025, the Hospital had completed phased replacement in public areas and ward areas across its campuses, with a cumulative total of 205 sets of water-saving equipment replaced. These are estimated to save approximately 30% of water use compared with older equipment, while maintaining uninterrupted patient care and hospital operations.
In addition to hardware improvements, the Hospital also uses water-saving signage, admission guidance, and employee education and training to remind staff, patients, and family members to cherish water resources and put water-saving actions into practice in everyday healthcare services and daily life.
Water Quality and Safety Management
To ensure the safety of medical and domestic water use, the Hospital regularly conducts tests on drinking water and medical-related water. It also carries out planned cleaning of water tanks, management of water supply spaces, and equipment inspections to ensure stable water quality. Through routine testing and maintenance, the Hospital reduces the risks posed by abnormal water quality to patient care, staff safety, and healthcare operations.
Wastewater Treatment and Regulatory Compliance
The Hospital’s wastewater treatment system has been established based on the planning of environmental engineering professionals and has obtained a discharge permit issued by the Taichung City Government. The Hospital regularly conducts wastewater testing and equipment maintenance to ensure that discharged water quality complies with regulatory standards. In 2025, the Hospital continued to implement wastewater treatment monitoring and compliance management, maintaining a balance between healthcare operations and environmental protection.