An unexpected benefit from the forced move to digitized healthcare has been an opportunity to address carbon emissions in healthcare. Mask mandates and fear of unwittingly transferring germs into one’s mouth caused a whole new form of garbage in the use of civilian disposable medical face masks. Fast food chains and restaurants everywhere reverted back to the use of exclusively disposable food packaging and drive-thru only food options. Many products began to be served in single use packaging. Airlines, a worst offender in the waste department, somehow managed to create more opportunities for trash on board through the addition of cleaning kits and single use hand sanitizer containers. Although surface transmission proved to be an insignificant contributor to the pandemic, a newfound fear of germs has permeated society resulting in more single use products and excessive wet wiping. However, the move to telehealth has opened up an opportunity to provide healthcare without the commute, space, and materials that traditional healthcare requires. This move has also opened up healthcare providers eyes to the many ways that CO2 emissions make their way into everyday care.
To begin to address carbon emissions in the healthcare sector, we need to understand the scope and where they are coming from. In the United States, 10% of carbon emissions come from the healthcare industry (Hays, 2019). Like all institutions, healthcare requires a physical building and with it water, heating, cooling, and electricity. The often sterile nature of healthcare has historically required the use of single use plastics and other petroleum based products such as syringes, gloves, catheters and IV ports, as well as vast quantities of cleaners and sanitizers. The constant flow of patients requires huge laundry capabilities, eating up water and energy. There is medication, carefully and wastefully packaged, which at some facilities is provided in single use plastic baggies. Additionally, there is the paper trail still required in many healthcare settings, or a similar computer based model of charting and all the technology that follows it. Most healthcare facilities are a complex and highly bureaucratic web, where direct patient care, medications, waste and laundry are all handled by different agents within a massive system. It is difficult for individual healthcare providers to understand how best to serve other departments to lower waste, and difficult for waste collection facilities to handle the sheer quantity of waste exiting a hospital. There is also the consideration of biomedical and toxic waste from bodily functions and medications.
While important to a nation’s overall wellbeing, healthcare offers many opportunities to lower carbon emissions through waste and excess. As increased carbon emissions are tied to increased hospitalizations, this should be prioritized by the healthcare system and the bodies that govern it. The alternative is that as climate change worsens health outcomes and pushes more patients into the system, the system creates more carbon emissions, feeding the problem.
The RNAO, an organization representing nurses in Ontario, has identified patient safety as a priority in providing optimal care (RNAO, 2004). They go so far as to illustrate that patient safety goes further than just physical safety and in fact includes psychological safety and safe environments, with the goal of moving to a culture of systemic changes that support patient safety. Given this, it is not unreasonable to extend the responsibility of multilevel healthcare providers, like hospitals and governments, to include preventing unnecessary injury, illness, and death resulting from CO2 emissions that the healthcare system itself is producing. However, these changes to lower emissions will need to be balanced with current patient safety initiatives. Many of the processes mentioned above have increased in waste as they have improved in safety, from medications being individually packaged, preventing errors, to the much more robust charting that is now expected.
The pandemic has demonstrated how fragile our systems are to a spike in need and how quickly they can be destabilized. This is a concern moving forward for how climate change will impact our ability to provide care and keep up with potentially large portions of the population suffering environment related chronic disease and injury. The concepts that govern healthcare from “do no harm,” to broader values like fairness, respect for life, and client well being need to move from the bedside into the larger sphere, providing cause for the healthcare system as a whole to address its role in climate change.
HAYS, B. (2019). Healthcare industry responsible for 10 percent of U.S. carbon emissions. UPI NewsTrack (Consumer Health).
RNAO. (2004). Position Statement: Patient safety. Retrieved March 24th, 2022 from https://rnao.ca/policy/position-statements/patient-safety
The Avery Spectacle 