Practical tips for making healthcare systems more sustainable

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Cutting nitrous oxide waste in hospitals, switching to reusable vaginal speculums for cervical screening, and prescribing tablets over intravenous drugs are just some of the practical steps doctors can take to reduce the carbon footprint of healthcare.

If global healthcare were a country, it would rank fifth in the world for greenhouse gas emissions. A new series launched by The BMJ offers a range of ideas, including practical tips, to make healthcare systems more sustainable today.

Each article describes an action or project that frontline clinicians can implement to reduce the carbon footprint of their work, supported by a rapidly growing evidence base.

Readers can use a linked interactive tool to find actions relevant to their own roles and workplaces.

“The climate crisis is a health crisis, and health care professionals are on the front lines,” Florence Wedmore and colleagues wrote in an editorial to launch the series. “Physicians want to know how they can help slow this crisis, and we want to demonstrate solutions that are within the power of individuals.”

Previous studies show that switching asthma patients to dry powder inhalers, replacing single-use masks with reusable options of equivalent protection, and changing prescribing habits, saves money and reduces harm to patients.

Other achievable actions associated with lower greenhouse gas emissions include:

    • Using smaller or fewer pre-packed surgical trays during operations to avoid re-sterilizing unused instruments 


    • Changing from single use plastic speculum to reusable stainless steel version for cervical screening 


    • Choosing oral over intravenous drugs to reduce the impact of manufacturing, using and disposing of equipment and packaging 


    • Changing the dose and frequency of iron supplementation in line with the latest recommendations to help benefit patients and reduce environmental harm 


    • Reviewing nitrous oxide losses and waste to help reduce hospital costs 


“The BMJ has long recognized the seriousness of the climate emergency and campaigned to reduce carbon emissions in healthcare and beyond,” Wedmore and colleagues said. “This campaign is now moving towards concrete steps that healthcare professionals can and must take in response to this emergency.

“We hope the new series will help many more physicians realize the benefits of more sustainable healthcare for patients and the planet.”

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