Shaping a sustainable future in healthcare

The statistics are confronting: healthcare in Australia contributes to seven per cent of all national carbon emissions.

The climate emergency is truly a health crisis, but thanks to small actions from teams across the Network, we are putting sustainability on the agenda and doing our part to create the best possible future for our kids.

At last month’s Innovation Forum at Sydney Children’s Hospital, Randwick (SCH), the Kids Cancer Centre’s (KCC) Dr Felicity Wright and Professor Tracey O’Brien shared how their Decarbonising Paediatric Cancer Care program is helping reduce their team’s carbon footprint, through small scale projects such as sensible blood, CMV @ Home and Stock Wisely.

“Our main drive is a commitment to protecting the lives of children and curing cancer – it’s up to us to not only deliver a cure but also a world that’s worth surviving for,” Dr Wright said. 

“We need to be responsible for the impact health care has on climate change. It’s all about what we can do to choose our care better and have less of a carbon footprint in those choices.” 

The Sensible Blood program aims to reduce the burden of low-value care by reducing the frequency of ordering routine pathology tests in SCH’s oncology ward. Across 18 months, the team:

  • reduced blood test ordering by 37 per cent and liver function tests by 52 per cent
  • calculated $300,000 in savings
  • saved 15,000 vacutainers and 1.5 tonnes of carbon. 

CMV @ Home allows patients with virus reactivation to be treated in their home post stem-cell transplant. Hospital in the Home and oncology nurses deliver treatment at home instead of a 14-day admission to a transplant bed. Across 18 months, this program:

  • saved 73 inpatient transplant bed days
  • seven less nights in hospital per patient
  • calculated $275,000 in savings, and
  • saved 500kg of single-use plastics and 0.1 tonnes of carbon

Stock Wisely has been running for six months and is an initiative that asks ward and pharmacy staff in oncology to rethink their management of stock. KCC developed an algorithm based on seasonal usage to set limits on ward stock holdings. They also changed the way that ward stock was ordered, bringing in pharmacy staff to stock the ward in place of night duty nurses.  The program:

  • reduced monthly ward stock ordering by 17 per cent on average
  • reduced shelf cost holdings by 24% per cent and
  • removed 37 unused line items

The program also promotes reuse of medications by coordinating large volume of returns to pharmacy for low use stock. 

But the work doesn’t stop here.  

“Across all the domains of work within KCC, we strive to look for innovative ways to reduce environmental impact and build this into research or practice change design. No effort is too small, and all staff can play a role.  Once you start measuring the impact, small changes can make, it drives the enthusiasm to do more,” Professor O’Brien said. 

At The Children’s Hospital at Westmead (CHW), Research Lead at the ChiPLab, Justin Skowno, says the Department of Anaesthesia is working to actively shrink their carbon footprint too.

“It turns out some anaesthesia agents such as Nitrous Oxide and the volatile agents used every day have surprisingly big greenhouse gas footprints. For example, one hour of anaesthesia with Desflurane and Nitrous Oxide has the same carbon dioxide footprint as driving 800km,” A/Prof Skowno said.

“Our Department has recently done the work to continuously collect gas usage data from every anaesthetic at CHW. That's continuous information from over 20,000 hours of anaesthesia every year.

“With this information we can make a real difference. Our department has recently stopped using Desflurane because of this. This real time data will give the team information that helps them make more sustainable choices during every anaesthetic, every day.”

The whole operating suite is focussed on trying to make a difference every day. Simple measures like making sure that only clinical waste goes in the yellow bins, to recycling surgical equipment, plastics and fluid bags - hundreds of tonnes of material has been kept out of landfill.

“Healthcare has been part of the problem and now we're making sure we are part of the solution. We are part of the wave of change needed to get to Net Zero Healthcare emissions and beyond,” Dr Andrew Weatherall, co-Head of Department, added.

As a Network, we’re investing in the development of a sustainability framework, which will include our action plan for halving our carbon emissions by 2030 and achieving net zero carbon emissions by 2050 - consistent with the NSW Health Climate Policy Change Framework. Every action, big or small, can make a difference.