The healthcare sector stands at a critical juncture in addressing climate change, balancing its mission to improve health with the urgent need to reduce its carbon footprint. Hospitals, and particularly surgical departments, are among the largest contributors to healthcare’s greenhouse gas emissions. In this blog, we focus on our recent publication that underlines the relevance of applying business knowledge in other industries. We can show the main sources of carbon emissions related to surgery in a hospital setting, and we can make suggestions to improve carbon reduction initiatives.

Understanding the Challenge

Globally, healthcare accounts for approximately 4-5% of total carbon emissions, with hospitals contributing a significant share. The healthcare sector must navigate the challenge of caring for individuals affected by climate change while being a significant emitter of carbon emissions. Within hospitals, operating rooms (ORs) emerge as hotspots, generating carbon emissions three to six times higher than other departments. Factors such as the use of anesthetic gases, sterilization processes, single-use supplies, and habitual practices drive this impact. Recognizing these sources is the first step toward targeted interventions.

Analyzing emission sources

Our research applied the Congruence Model to categorize and analyze emission sources across the four key elements of the model: People, Work, Structure, and Culture. This showed us:

• People: Addressing behavioral resistance and enhancing environmental awareness among surgical staff is critical. Training and education programs can empower individuals to adopt more sustainable practices.
• Work: Surgical tasks, including the choice of anesthetics and the handling of surgical supplies, were identified as major emission sources. Switching to less harmful anesthetic agents and optimizing supply use can significantly reduce emissions.
• Structure: Policies promoting waste segregation, recycling, and the use of reusable materials are structural strategies that can drive change at an organizational level.
• Culture: Building a culture that values sustainability requires aligning organizational values, communication patterns, and informal practices with environmental goals.

Our study revealed not only the sources of emissions but also the interplay of misalignments across elements of the model. For example, while policies might encourage sustainability, entrenched cultural norms or a lack of staff training might hinder their implementation. By addressing these incongruences, healthcare organizations can foster a more holistic approach to reducing their carbon footprint.

What should be done?

Decarbonizing surgical care is both a challenge and an opportunity. Hospitals can lead by example, demonstrating that it is possible to reduce emissions without compromising patient care quality. Our study underscores the importance of a systemic approach—one that integrates organizational change with individual responsibility. As we strive to meet climate targets, the healthcare sector has the potential to not only heal individuals but also contribute to the health of our planet. This is a pivotal moment for healthcare. Together, we can transform surgical care into a model of sustainability, ensuring that future generations inherit a healthier, more resilient world.

If you’d like to learn more, you can read the full research report (for free!) via: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-024-11929-6

 Author: Oskar Roemeling - o.p.roemeling@rug.nl

Reference:

Kloevekorn, L., Roemeling, O., Fakha, A. et al. Decarbonizing surgical care: a qualitative systematic review guided by the Congruence Model. BMC Health Serv Res 24, 1456 (2024). https://doi.org/10.1186/s12913-024-11929-6