How to Decarbonise a Care Pathway With Your Findings

Utilising a care pathways approach allows us to appraise the entire patient journey to identify areas where meaningful carbon savings can be made.

Once you have utilised the carbon calculator to calculate the carbon footprint, you can interpret the results and identify any likely carbon hotspots within the pathway. For the worked example in the downloadable PDF, elective laparoscopic cholecystectomy pathway, the hotspot area appears to be the surgical procedure. This may be where you choose to identify carbon saving initiatives to implement.

This section takes a focus on some of the key pathway modules and outlines some actions which can be taken towards decarbonisation with a clinical focus.

Each module has useful resources and example case studies located in the Resources section. This section will be launched soon.

How to decarbonise primary care?

Below are example strategies for healthcare staff:

Focus on disease prevention and health promotion.
Address significant carbon footprint associated with prescribing i.e. avoid medicines wastage, over-prescribing and unnecessary polypharmacy.
Focus on medicines optimisation and consider greener alternatives where available.
Adopt greener inhaler prescribing.
Avoid over-diagnosis and unnecessary testing. Focus on patient-centred care.
Manage waste appropriately ensuring that this is segregated and disposed of appropriately in the least-carbon intensive method possible.
Encourage active or communal travel by cycling, walking or taking public transport – both for staff and patients.
Reduce travel through the use of telephone or video clinics where clinically appropriate.

How to decarbonise the emergency department?

Below are example strategies for healthcare staff:

Address significant carbon footprint associated with prescribing i.e. avoid unnecessary prescribing, reduce use of carbon-intense medicines such as Entonox, review discharge medication.
Avoid unnecessary referrals, tests and invasive procedures such as cannulation and venepuncture.
Utilise a paper-free environment where possible.
Turn off equipment when not in use.
Reduce use of unnecessary consumables (e.g. non-sterile glove use) and use reusable items where available.
Manage waste appropriately ensuring that this is segregated and disposed of appropriately in the least-carbon intensive method possible.
Encourage active or communal staff travel by cycling, walking or taking public transport

How to decarbonise an outpatient clinic?

Below are example strategies for healthcare staff:

Avoid unnecessary referrals, tests and imaging requests.
Reduce use of unnecessary consumables (e.g. non-sterile glove use) and use reusable items where available.
Utilise a paper-free environment where possible.
Turn off equipment when not in use.
Encourage active or communal travel by cycling, walking or taking public transport – both for staff and patients.
Reduce travel through the use of telephone or video clinics where clinically appropriate.
Provide streamlined and efficient patient care to enable same-day outpatient clinic/diagnostic tests/pre-operative assessment clinics to minimise travel.
Manage waste appropriately ensuring that this is segregated and disposed of appropriately in the least-carbon intensive method possible.

How to decarbonise the operating theatre?

Below are example strategies for healthcare staff:

Switch off theatre equipment and lighting when not in use.
Utilise a paper-free environment where possible.
Use local, regional or intravenous anaesthetic where possible. Avoid use of desflurane or nitrous oxide.
Avoid additional unnecessary clinical interventions when not required e.g. catheterisation, additional access lines and histology samples.
Reduce the use of single-use consumables – switch to reusable products where available including instruments and textiles.
Rationalise instrument trays and use of additional instruments.
Manage waste appropriately ensuring that this is segregated and disposed of appropriately in the least-carbon intensive method possible.

How to decarbonise inpatient admissions?

Below are example strategies for healthcare staff:

Address significant carbon footprint associated with prescribing i.e. avoid unnecessary prescribing, regular medication review, antimicrobial stewardship, prompt conversion to oral medication where appropriate, review of discharge medication.
Avoid unnecessary referrals, tests and invasive procedures such as cannulation and venepuncture.
Perform operations as day-case procedures where clinically safe to do so.
Avoid unnecessary use of high-dependency or intensive care unit.
Reduce use of unnecessary consumables (e.g. non-sterile glove use) and use reusable items where available.
Manage waste appropriately ensuring that this is segregated and disposed of appropriately in the least-carbon intensive method possible.
Utilise a paper-free environment where possible.
Encourage active or communal staff travel by cycling, walking or taking public transport.