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Collaborative Care for the Planet

BC Children's Hospital and Women's Hospital + Health Centre Perioperative team members: Samantha Thompson, Lesley Martinez and Drea Newman

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BC’s cooperative push towards sustainable clinical practices

While the health care sector has always been dedicated to promoting health and well-being, the system also has significant environmental costs. Health care contributes up to 5 per cent of global greenhouse gas emissions. Recognizing the urgent need to reduce this carbon footprint, BC’s Low-Carbon, High-Quality Care Collaborative is tackling emissions with a focus on perioperative care and respiratory medicine. Led by Health Quality BC (HQBC), in partnership with CASCADES Canada, Vancouver Coastal Health’s Planetary Health Department, and several BC Health Organizations, this initiative aims to lower the carbon impact of health care while improving patient care.

The collaborative launched in 2023:

  • mobilizing 18 Action & Improvement Teams,
  • composed of 100 participants
  • across 23 sites throughout the province.

Their goal is to reduce the carbon emissions from clinical practices by 10 per cent by November 2024. To accomplish this, the collaborative is focused on practical changes in clinical settings, such as optimizing anesthetic gas use, curtailing unnecessary pre-operative testing, and transitioning to reusable medical items.

A notable aspect of this work is its provincially coordinated, patient-centered approach. Leveraging HQBC’s partnerships with patients and communities, care providers, health leaders, policymakers, senior executives, and academics, it is responsive to the unique dynamics of BC’s health care system and builds capacity where it is needed the most.

At PHSA, the collaborative is most active at BC Children’s Hospital, where several clinical teams are implementing changes to reduce emissions and enhance the quality of patient care.

BC Children’s Hospital and Women’s Hospital + Health Centre Perioperative team members: Kynna Sorg, Carmina Gogal, and Stephanie Harding.

One multidisciplinary team — comprised of respiratory therapists, nurses, physicians, and pharmacists from the pediatric ICU and emergency departments — is focusing on reducing unnecessary use of metered-dose inhalers (MDIs), which have a high carbon footprint. They are using patient labels to ensure that inhalers remain with the patients throughout their hospital stay, and collaborating with the pharmacy to monitor progress. Their efforts also include an education and awareness campaign to highlight the importance of reducing MDI use and loss, while monitoring the impact on asthma-related emergency visits.

In the perioperative setting, another team at BC Children’s is working to cut down on waste by transitioning from single-use items to reusable alternatives. They are evaluating reusable items, such as light handle covers and sterile wraps, and assessing their impacts on workload, costs and clinical care. This initiative involves a collaborative effort from nurses, quality and safety leads, educators, and program managers, all dedicated to integrating environmental sustainability into their practice.

While the initiative has a clinical focus, one of the best outcomes thus far is the community of practitioners, clinicians, and other contributors who share a purpose and passion. As Andrea Wnuk, Leader of Health System Improvement at HQBC, notes,

It’s been extremely inspiring to be a part of this work. I’m in awe of the excitement, engagement, and dedication to reduce the carbon footprint of clinical care while maintaining high-quality care for patients across BC.”

As the project heads towards its conclusion in November 2024, the focus will shift to the tangible results and future possibilities of this climate-conscious approach to health care. This initiative will serve as a blueprint for sustainable clinical practices across Canada and beyond.