This paper aims to review the state of the art technologies for the energy efficiency within the hospitals sector. Hospitals are liable for an unstable amount of energy demand and joint emissions, because of their 24/7 nature of operation and hence resulting larger energy consumption than a typical commercial building. Additionally, they need high quality and warranted supplies of electricity. Due to increased energy demand and therefore the depletion of existing fossil fuel based sources, it is required to use the energy more efficient.

In 2009, the European Union adopted high-level goals for renewable energy, energy efficiency, and greenhouse gas reductions with targets set toward the year 2020. This was followed in 2012 by adoption of the Energy Efficiency Directive (EED) (2012/27/EU), which included as a major component a requirement for Member States to create Energy Efficiency Obligations Schemes (EEOSs) on energy companies or equivalent alternative measures, and those provisions have now been in effect for three years.

Ecosystem-based adaptation (Eba) uses biodiversity and ecosystem services as part of a larger adaptation strategy to climate change. While the conservation and sustainable development community considers EbA to be a strong method of addressing climate change and its associated challenges, there is still a tendency for policy makers to implement traditional engineering solutions for adaptation, rather than investing in EbA.