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INTEGRATED SUSTAINABILITY REPORT 2023

Business model

sdg:

  • SDG 3 : Good Health and Well-Being
  • SDG 8: Decent Work and Economic Growth
  • SDG 12: Responsible Consumption and Production
  • SDG 13: Climate Action
  • SDG 16: Peace, Justice and Strong Institutions

sdg:

  • 3

  • 8

  • 12

  • 13

  • 16

  • 3

    SDG 3 : Good Health and Well-Being

  • 8

    SDG 8: Decent Work and Economic Growth

  • 12

    SDG 12: Responsible Consumption and Production

  • 13

    SDG 13: Climate Action

  • 16

    SDG 16: Peace, Justice and Strong Institutions

Commitment to sustainability

GRI,2-2, 2-28, 3-3, 308-1, 308-2, 414-1, 414-2

We devote our efforts to adopting the best sustainability- related practices, which has been a multidisciplinary topic for Rede D’Or for many years. The soundness of our strategy, a result of continuous progress on this journey, is attested to by the main corporate sustainability recognitions and assessment tools.

We are signatories to the United Nation’s Global Compact and committed to UN’s 2030 Agenda and World Bank’s Ethical Principles in Health Care (EpiHC). We are members of the Ethos Institute for Social Responsibility and the Healthy Hospitals Project (PHS, in Portuguese), which represents and coordinates the activities of Health Care Without Harm and the Global Green and Healthy Hospitals Network in Brazil. We have a goal to zero our net carbon emissions by 2050, as part of the Race to Zero initiative.

We are included in important sustainability and governance indexes and ratings, which reaffirms our commitment to sustainability management and to an efficient and successful journey.

  • FTSE4 Good Index Series
  • Corporate Sustainability Index (ISE B3) B3’s
  • Efficient Carbon Index (B3’s ICO2) Institutional
  • Shareholder Services (ISS) ESG
  • Standard&Poors’s (S&P) The Sustainability Yearbook 2023 Carbon Discloure
  • Project (CDP)

In 2016, we prepared our first Greenhouse Gas (GHG) emissions inventory, initially as a pilot project. Since 2020, we began to submit our inventory to external assurance and publish it in the Public Emissions Registry. We have been awarded the Gold Seal by the Brazilian GHG Protocol Program, in recognition of our complete and audited information, which attests to our efforts to reduce environmental impacts.

One of our most important commitments is to provide quality care for our patients, seeking to improve their experience with us every day, based on empathy and compassion and a team trained in Patient-Centered Care concepts and definitions, for example. Some programs reinforce our commitment to sustainability, namely, the Energy Efficiency Programs, aimed at promoting the efficient use of electricity and, therefore, reducing Greenhouse Gas emissions; the Water Efficiency Program, which sets out strategies to increase water use efficiency in the hospital units; and the Diversity Program, through which we carry out awareness-raising and engagement initiatives on the subject.

In 2023, we revised our ESG Strategic Planning, which includes the SDG Program and was approved by Senior Management, and we committed to new targets by prioritizing more sustainable development goals, increasing them from five to eight, according to our revised SGD Program (see more information here).

We also aim to increase the number of hospital kitchens with the Green Kitchen, sustainable seal, which adopts sustainability criteria for food services.

ESG Strategic Planning

Our ESG strategy was based on the ESG Strategic Planning, approved by the Board of Directors on June 30, 2022, for the 2022-2030 period [GRI 2-14]. This planning is an internal document designed to guide our sustainable management processes, based on the Environmental, Social and Governance pillars.

The Planning which was revised in December 2023, and approved by the Board of Directors on 21/03/2024, materialized our governance on the topic [GRI 2-14]. This document presents the main processes structured to underpin our strategy, aligning social, environmental and governance goals with our business model. It was updated based on the maturity of our sustainability governance, broken down into robust processes that have been in place since 2015, and takes into account the materiality principle. The main objective of the ESG Strategic Planning is to transparently present our sustainability management to both internal and external stakeholders, as well as to maintain our position as one of the main ESG practice benchmarks in our main industry.

1 For strategic reasons, we have chosen not to publish the ESG Strategic Planning in its entirety.

SDG Program

The Sustainable Development Goals (SDG) are important tools for strengthening the culture of sustainability, as well as making business more efficient, responsible, transparent and competitive. By implementing a methodology to comply with the SDGs, we take on our responsibility in mitigating and contributing to the solution of major social and environmental problems in the contemporary world.

That is why, in 2022, we developed the D’Or SDG Program, which is a structured program in which we defined five priority SDGs, considering the material topics established in the Materiality Matrix prepared in 2020. With a new Materiality Matrix and a review of material topics, in this reporting cycle, we revisited the D’OR SDG Program and added SDGs 9, 12 and 16 as priorities. For prioritization, we also considered the B Impact Assessment, which uses the SDG Action Manager tool, made available by the UN Global Compact. For each priority SDG, we set related goals, targets, metrics and indicators, in order to contribute to the priority SDGs.

Priority SDGs

ESG Goals

One of the ESG Strategic Planning’s main processes is developing structured programs for strategic topics, which have been identified as recurring themes from 2015 to 2023, namely: the Integrity Program; Corporate Water Efficiency Program; Corporate Energy Efficiency Program; Corporate Waste Management Program; Corporate Program on Adaptation to Climate Change and Greenhouse Gas Emissions Management; and SDG Program, in which the SDGs are prioritized and aligned with the material topics in a comprehensive manner [GRI 3-3].

We set ESG targets through these programs, and we consider the deadline set in the ESG Strategic Planning – 2030 – to be in line with our commitment to the 2030 Agenda. These programs are maintained internally, and their results are overseen by the responsible departments and the Sustainability Committee.

As provided for in the ESG Strategic Planning through the “ESG transparency” process, we carried out a quantitative assessment of the current status, compared to the previous year; presented the final status when considering the target deadline; and carried out a qualitative analysis of the target’s progress. It is important to note that, in accordance with our internal regulations on roles and responsibilities in ESG management, there is a department responsible for each of these targets, which establishes an action plan and provides resources for achieving the goals.

Material topic Target1 Target’s main indicator 2022 2023 Final status2,3,4 Prioritized SDG
Economic Performance By 2023, set out an assessment process for suppliers in the ESG high-risk categories for direct and indirect supplies. % of the task completed 0% 100% Completed ODS 08
R&D, Innovation and Education Restructure the organization of Academia Rede D’Or’s knowledge management content by December 2022. % of the task completed 100% 100% Completed ODS 04
Increase the number of young people impacted by corporate programs* by 20% until 2030.
*Internship and trainee programs; (reference year 2021).
Percentage change (%) of young people impacted 17.1% 92.2% In progress ODS 04
Integrity, Risk and Anti-corruption Train 90% of active employees and contractors (those holding leadership positions in the hospital units) on integrity-related procedures by 2025. N/A 77.2% In progress ODS 16
Energy Establish a committee to set out analyze and approve energy and water efficiency measures by 2022. 0% 100% Completed ODS 12
Maintain at least a 10% annual reduction in electricity consumption at the cold-water centers (CAGs, in Portuguese) of all units included in the project by 2024. % of the task completed -21% -16.9% In progress ODS 12
By 2025, migrate 74 consumer units to the Free Energy Market, using renewable energy. Number of consumer units 44% 71 In progress ODS 12
Use high-performance LED lamps (A-rated lighting efficiency) in at least 90% of the specifications in each project completed each year*.
*Application stage: project.
% of the specifications in each project 0% 100% In progress ODS 09
Water and effluents Standardize a procedure for monitoring effluent water quality at units with an STP by December 2023. % of the task completed 0% 100% Completed -
Maintain at least a 10% annual reduction in water consumption for all units included in this project by 2024. % annual reduction in consumption
Use low-water-consumption hydraulic system equipment in at least 90% of the specifications in each project completed each year*.
*Application stage: project.
% of the task completed 0% 100% In progress ODS 09
Waste By 2030, achieve a 30% recycling rate. Percentage composition (%) of waste 11.3% 12.8% In progress ODS 12
Health and Safety By 2025*, reduce by 20%, the lost-time injury frequency rate **
*Considering the base of 47 legal entities (units), in 2021.
**Lost-time Injury frequency rate: LTI = No. lost-time accidents x 1,000,000 / person-hour (Source: NBR 14280.
Percentage change (%) in the lost-time injury frequency rate -23.3% -1.8% In progress ODS 03
Patient-centered care Disseminate health-related topics through Rede D’Or’s 7 Care Program campaigns, adapted with offices and the Diagnostic and Therapeutic Support Service (SADT), to carry out preventive digital media and Out of Home (OOH) campaigns, seeking brand visibility until the end of 2023. Number of campaigns 0.0 7.0 Completed ODS 03
Use educational and health prevention videos in at least 50% of our 64 Medical Centers (CEMEDs, in Portuguese) for the local population, as well as publicizing them on social media*, by the end of 2023. These videos can be made available to companies in the area surrounding the hospitals and CEMEDs, depending on their interest and availability for publication.
*Rede D’Or’s social media are Instagram, Facebook, Twitter and LinkedIn.
% of Medical Centers (CEMEDs) that received campaign material 0.0% 0.0% 71.9% Completed ODS 03
Achieve NPS zone of excellence* performance in all Star hospitals by 2030.
*Excellence: NPS between 76 and 100; Quality: NPS between 51 and 75; Improvement: NPS between and 50; Critical: NPS between -100 and 0.
% of Star hospitals in the excellence zone 100% 100% In progress ODS 03
Achieve NPS quality zone* performance in the hospitals (except Star line) by 2030.
*Excellence: NPS between 76 and 100; Quality: NPS between 51 and 75; Improvement: NPS between and 50; Critical: NPS between -100 and 0.
% of hospitals (except Star) in the quality zone 63.0% 76.0% In progress ODS 03
Climate Change Develop a Climate Risk Matrix and its scenarios by 2023. % of the task completed 0.0% 100.0% Completed ODS 13
Formal adherence to the Task Force on Climate-Related Financial Disclosures (TCFD) by 2025. % of the task completed 54.2% 83.3% Canceled ODS 13
Reduce GHG* emissions intensity by 36%** until 2030.
*In relation to reference year 2020 (0.056 tCO2e/pt.day).
**Includes scopes 1, 2 and 3.
Percentage change (%) in GHG emissions -27.3* -30.8%* In progress ODS 13
Net zero carbon emissions by 2050.
*In relation to the reference year 2020.”
Net carbon emissions (tCO2e) 110,770 107,896 In progress ODS 13
Socioeconomic impact Encourage employees and physicians to participate in social initiatives, e.g.: the renovation of nursing homes, activities at orphanages and distribution/collection of food items for the surrounding communities until the end of 2025. % of the task completed 100.0% 100.0% In progress ODS 16
Participate and sponsor committees and class events to discuss topics such as diversity, child labor, types of violence, capacity building for the first job, etc. until the end of 2025. % of the task completed 0.0% 0.0% Canceled ODS 16
Human Rights Maintain an annual Human Rights Campaign until 2024. Number of campaigns carried out 1 1 In progress ODS 16
Restructure and launch the Diversity and Inclusion program by December 2024. % of the task completed 50.0% 99.0% In progress ODS 08
Ensure that 50% of leadership positions (supervision, coordination, management and executive office) are held by women by December 2025. % of women in leadership positions 65.7% 67.6% In progress ODS 05

(1) Targets established in the ESG Corporate Programs and/or the ESG Strategic Planning’s SDG Program.

(2) Final status: refers to the achievement of the target in relation to the quantitative value achieved. The status “completed” means that the target was achieved before or after the deadline; the status “in progress” means that the deadline has not yet been reached and that an action plan is in progress; the status “delayed” means that the target is in progress but has not been met by the established deadline; the status “canceled” means that the target had to be discontinued for specific reasons, such as, but not limited to: the target not being viable due to a change in the business model; Senior Management decision; and force majeure.

(3) Targets with a “completed” status have been finalized. As a deployment of the revised SDG Program Action Plan, we intend to quantitatively measure our impact on the prioritized SDGs by using the “SDG Action Manager” tool from B Impact Assessment. As a result of this assessment, we expect to identify gaps and set new targets for these SDGs and/or our material topics, which will be validated by the responsible departments to ensure that they are also aligned with our business model.

(4) The progress assessment for each target is kept in an internal document, as provided for in the ESG Strategic Planning.

Green Kitchen Program

We began our journey as members of the Green Kitchen Program in 2020, with three hospital units eligible for the Green seal. The seal is a quality certification that recognizes the ongoing improvement of the Nutrition and Dietetics Service, taking into account sustainability criteria throughout the production process and encouraging healthy eating habits in the hospital environment. In order to obtain and maintain the seal, technical criteria and concrete actions linked to air, water, food and waste quality parameters, among others, are assessed annually by the Program.

In 2023, the Central do Tatuapé, Morumbi, São Marcos, Villa Lobos and viValle units were awarded their first Green Kitchen seal, increasing the number of hospitals recognized by the program to 22 (20 owned units and two under management).

Hospital units recognized by the Green Kitchen Program:

  • Anália Franco
  • Assunção
  • Barra D'Or
  • Caxias D'Or
  • Central do Tatuapé*
  • Cinco de Outubro
  • Copa D'Or
  • Copa Star
  • DF Star
  • Itaim
  • Jabaquara
  • Morumbi*
  • Niterói D'Or
  • Norte D'Or
  • Osasco
  • Quinta D’Or
  • São Caetano
  • São Marcos*
  • Vila Nova Star
  • Villa Lobos*
  • Vivalle*
  • Yutaka Takeda

*First seal in 2023.

22

5

38.5%

50%

*Reference year 2020 (52 owned hospitals).

In line with its purpose, the Green Kitchen program encourages the continuous improvement of nutrition services, and establishes categories (PIN) within the program by using scores. In 2023, the kitchen at Copa Star Hospital was recognized with 50 points during the seal maintenance process, and thus became part of the select group of kitchens awarded PIN 5. This is Rede D’Or’s first hospital to achieve the certification’s top score. The Hospital São Marcos’ kitchen was the first in the Northeast region to receive the seal and the first in the entire program to be certified in the state of Pernambuco.

We have a Green Kitchen-related target, which can be seen in the "ESG Goals" chapter.

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