Staff at Whiston Hospital are working to reduce the environmental impact of their acute medical unit.
In 2019, NHSE’s carbon footprint in acute care was estimated to be 125 kg CO2 e per bed day and 76 kg CO2 per outpatient appointment, making acute care the most carbon-intensive clinical activity. Most of these emissions originate from the purchase of consumable goods and capital equipment, building energy consumption, food services and staff travel.
Staff at Whiston Hospital in the north-west of England, including three physicians, are delivering several projects to reduce the environmental impact of their acute medical unit (AMU). This work is led by an Acute Medicine Digital, Innovation, and Sustainability (DIS) Group, which promotes ideas and spearheads change on the AMU with members from medicine, nursing, pharmacy, pathology and IT, as well as administrative and managerial staff.
They identified performance of coagulation tests as a potential area to reduce the AMU’s carbon footprint, as well as operational costs. Initial scoping found that nearly half of the coagulation tests performed on the AMU were not necessary. Further quality improvement is being undertaken to collect detailed data on performing coagulation tests on AMU, aiming to align with NHSE’s best practice guidance on phlebotomy in secondary care.
Concurrently, a point of care INR testing machine has been purchased to obtain results in a timely manner (eg pre-procedure) and reduce the number of coagulation tests sent to the lab. This in turn will save on the use of plastic bottles, blood order print outs and packaging, as well as physical and human resources in the laboratory and waiting times for both patients and clinical staff. This is currently in a trial stage.
To achieve the cultural shift required to push forward this work, the DIS group is engaging with other cohorts of staff on their sustainability agenda. Whiston Hospital has undertaken a ‘sustainability on AMU’ staff survey, to allow for a comprehensive exploration of the topic and to identify gaps in knowledge and interest in education and resources on sustainability.
This exercise also aims to listen to concerns, find ideas and hopefully to gain support for projects which, when scaled, need to be adopted by staff. The survey is available for both healthcare and non-healthcare staff and has helped to improve staff’s interest in this topic and their willingness to be involved.
The hospital has received positive responses to their staff survey about sustainability on the AMU; many staff provided meaningful suggestions and the process has created a positive dialogue throughout the AMU, which the group feel has also improved morale.
'The work undertaken by staff, including physicians, at Whiston Hospital’s acute medical unit exemplifies the transformative potential that targeted sustainability initiatives can have within secondary care settings.
By addressing carbon-intensive practices, such as coagulation tests, and engaging staff in meaningful dialogues, Whiston is leading the charge towards greener healthcare. Their emphasis on collaboration across medical, administrative, and operational staff sets a precedent for others aiming to reduce their environmental footprint while maintaining high standards of patient care.'
Dr Mark Harber
Special adviser on healthcare sustainability and climate, RCP
- Contributors: Dr Natalie Beveridge, Dr Magda Nasher, Dr Ragit Varia
- Institution: Whiston Hospital