Wiser Carbon Neutral
We aim to develop an evidence base that can assist clinicians and policy makers to safely decarbonise healthcare, while maintaining high quality patient care.
This is an emerging area of research for Wiser Healthcare for which we are currently seeking funding
The problem
Healthcare accounts for 4-5% of global greenhouse gas emissions (7% in Australia). Around 40% of the footprint of healthcare comes from buildings (including energy, water and waste, catering and non-medical equipment). Greening hospitals by using renewable energy is vital, but alone will be insufficient as 60% of the footprint of healthcare is due to clinical care itself i.e. the tests and treatments that result from clinical decisions in relation to each individual patient. The UK leads the world in decarbonising healthcare; the NHS has cut its footprint by 26% compared to 1990 emissions. Almost all of that gain, however, has been achieved by less reliance on fossil fuels and decarbonising the UK electricity grid. Changing clinical care itself is the next, critically important challenge as further carbon footprint reductions will not be achieved without it.
Environmental sustainability is often described as a hierarchy of waste reduction: reduce (or recycle), reuse, and replace, with most attention to date being focused on reuse (or recycle) strategies. In some areas of healthcare, opportunities for reuse are limited (e.g. by infection control requirements) and replacement with lower carbon options is currently limited and will rely on future technical innovation. A major opportunity for reduction, therefore, lies in avoiding or reducing unnecessary or low value care.
Low value care confers little or no benefit and risks iatrogenic harm. As a result, it generates carbon emissions without improving health. CI Glasziou et al have shown that ~30% of healthcare is low value and 10% is harmful. CIs Barratt, Bell, Semsarian, Glasziou and AI Morton have shown low value care is widespread in cancer and heart disease. CI Buchbinder and AI Harris have found the same in the musculoskeletal (MSK) field. Research by CIs on this team is leading to practice change. Accelerating this change can significantly reduce healthcare’s carbon footprint without negatively impacting quality of care.
Recent publications
A Randomized Noninferiority Trial to Compare Enteral to Parenteral Phosphate Replacement on Biochemistry, Waste, and Environmental Impact and Healthcare Cost in Critically Ill Patients With Mild to Moderate Hypophosphatemia – Chinh D Nguyen et al.
Hypophosphatemia occurs frequently. Enteral, rather than IV, phosphate replacement may reduce fluid replacement, cost, and waste. Our primary outcome was serum phosphate at 24 hours with a noninferiority margin of 0.2 mmol/L. Secondary outcomes included cost savings and environmental waste reduction and additional [...]
Single-use synthetic plastic and natural fibre anaesthetic drug trays: a comparative life cycle assessment of environmental impacts – Stephen J. Lightfoot et al.
Single-use drug trays are widely used in anaesthesia procedures performed in Australia; however, their environmental impact has not been carefully assessed. A life cycle assessment was used to compare the carbon emissions resulting from the use of 10 types of single-use anaesthetic drug [...]
How many carbon emissions are saved by doing one less MRI? – Scott McAlister et al.
Different methods to quantify the carbon impact of health care produce different answers. The top-down method, environmentally extended input output (EEIO) analysis, uses financial data to track money flows of products and services between sectors within an economy. Knowing both the direct emissions [...]