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Location

Emilia-Romagna region, Italy

Organization and entities

Azienda Unita Sanitaria Locale di Bologna (AUSL, the local public health authority), covering Bologna and 45 surrounding municipalities. Facilities include Ospedale Maggiore (Bologna), Ospedale Bentivoglio, and several community health centers. 

 

AUSL Bologna’s Technical Department (with a designated Energy Manager) leads the projects, in coordination with Emilia-Romagna Region and EU bodies. Funding was mainly from the European Regional Development Fund (ERDF) via the POR FESR 2014–20 program (~70% of costs), supplemented by AUSL’s own budget and regional contributions.  

Initiation date

Projects rolled out in phases from 2020 through 2024–25, aligned with EU/ERDF funding cycles.

Sector setting

Healthcare system in Emilia-Romagna

Mitigation initiative

The AUSL Bologna Health Authority launched a decarbonization strategy to modernize its healthcare infrastructure while advancing climate goals. The initiative targeted outdated energy systems across hospitals and community health facilities, integrating energy-efficiency retrofits, smart technologies, renewable energy generation, and sustainable transport solutions. Its objective was to systematically cut energy consumption and greenhouse gas emissions across the health authority’s estate, and reduce costs at the same time. [1] [2] [3] 

A core feature of the initiative was the combination of technical upgrades and behavioral change. This included replacing legacy HVAC equipment with high-efficiency chillers and air-handling units, optimizing cooling infrastructure at Maggiore Hospital to match actual needs, and transitioning to electric mobility through the “Care Sharing” fleet programme. The scheme pools vehicles across services through a booking system, supporting more efficient use and replacing older, more polluting vehicles with electric and methane cars, backed by EV charging infrastructure in hospitals and community centres. [3] [4] 

Investments in tri-generation, cogeneration, solar PV, and solar-thermal systems allowed facilities to produce part of their own electricity, heat, cooling, and hot water, reducing dependency on external energy sources and lowering emissions. The approach draws inspiration from the broader AUSL Romagna model, prioritizing replicable and cost-effective climate mitigation actions. Backed by national and EU recovery funding, the initiative improved environmental performance while also supporting operational efficiency, lowering utility costs and increasing patient comfort. [1] [2] [3] [4] [5] [6] 

GHG emission reduction measures  

Scope 1

N/A

Scope 2 - Reducing emissions from energy

The initiative reduces electricity use through energy-efficiency retrofits and smarter energy management across healthcare facilities. The Maggiore Hospital upgrade is projected to save ~436,286 kWh/year, lowering indirect CO₂ emissions from grid electricity.

Scope 3

N/A

Key learnings

 Bologna’s experience shows the value of having an Energy Management Plan and a full-time energy manager. This enabled coordinated scheduling of retrofits, phased by building, and continuous tracking of savings. 

Retrofitting active hospitals is challenging because work needs to avoid disrupting care. AUSL addressed this through careful staging (“stralci” of works) and by choosing technologies, such as variable-speed pumps and modular chillers, that integrate smoothly with existing systems. Documentation, such as bidding specifications, referenced regional green procurement criteria, ensuring consistency with existing policies. 

The mix of ERDF/PNRR grants and company funds proved critical. By capturing regional/EU co-financing (typically 70% of costs), AUSL made large upgrades feasible. Importantly, initial savings are being reinvested into new measures, creating a self-financing cycle.  

Initiative outcomes

Evidence of Success  

The emissions from the buildings diminished by 14%, despite a total building size rising by 15%. [7] Other numbers in this report are given as projections established in the planning phase of the project. 

Co-benefits 

Beyond energy savings, the initiative delivers airquality and health benefits: the EV fleet cuts local pollution, helping meet urban air standards. Replacing internal combustion engine vehicles with EVs removes tailpipe emissions of CO, NOₓ, PM and other pollutants. AUSL reports ~90% reduction in NOₓ and 60% in CO (virtually eliminating particulate/benzene) from the new fleet. 

There are economic co-benefits: reduced utility bills (e.g. ~€6K/yr at one site) and new revenue streams (white certificates/incentives). Resilience is enhanced as well, ashospitals gain more reliable power/cooling (e.g. supporting surge capacity during health emergencies). Finally, there are organizational gains: the project raises staff awareness of sustainability through training and mobility programs, and aligns the health authority with regional/national climate goals. 

 

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This translation is generated by eTranslation, a machine translation tool provided by the European Commission.