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Education was the first domino that fell and led to Scotland becoming the first country in the world to remove the volatile anaesthetic gas Desflurane from its national supply chain.
When Dr. Kenneth Barker, consultant anaesthetist at Raigmore Hospital, learnt about the detrimental impact of this default anaesthetic gas, he says he was “quite shocked, as many people are when they hear it for the first time." However, once armed with this knowledge, Kenneth helped push the first domino by discontinuing the use of the volatile anaesthetic gas in his own practice. He even convinced his colleagues to follow suit, stating that "after a little bit of education and persuasion, we agreed as a department to drop it as a default.”
Kenneth has since become the clinical lead for the National Green Theatres Programme at the Centre for Sustainable Delivery in Scotland, and he is also the Chair of the Environment and Sustainability Committee at the Association of Anaesthetists.
The discontinuation of the volatile gas was a significant step towards achieving NHS Scotland's sustainability objectives, but it was not without its challenges. According to Kenneth, there was some resistance from colleagues, with some voicing apprehension about patient safety with the alternative options.
They overcame this pushback with education. “For desflurane, [clinician engagement] has been relatively easy,” Kenneth says, because they had the carbon emission data for the anaesthetic gas and the evidence demonstrating there is no clinical advantage to using it rather than the alternative options. "When you present that figure on a slide, it's hard for people to argue against it," Kenneth notes. “Basically, it’s education; it’s spreading that message to people who haven’t heard it and backing it up with real life examples.”
But that is where the issue lies; while you need education, you don’t always have robust data to educate with. As Kenneth puts it, “We are working in the dark a lot. [...] We don’t have a lot of the basic data to do with the carbon footprint of both drugs and equipment. That’s one of the things that we have to get our procurement organisations to require from our suppliers.”
Unfortunately, even with an abundance of information, another obstacle remains: changing practices. Kenneth explains, “You actually have to persuade individuals to change their practices, but keep remembering to do that all the time.” Not only do you have to obtain engagement, you also need to maintain it.
Solution? Digital transformation
So what would a genuinely effective solution look like? It would need to facilitate data provision to avoid fumbling in the dark, and it would need to offer education and continuously promote safe and sustainable decision-making in a straightforward manner to truly change habits.
What could be more suitable for overcoming these obstacles than automated digital solutions?
Open Medical, a digital transformation scale-up, designed a sophisticated digital tool to address such challenges and promote a culture of sustainability in healthcare. Moreover, the company has been awarded a grant of £798,923 as part of the Small Business Research Initiative Phase 2 for their innovative solution, PathpointⓇ SurgiCare.
SurgiCare is a cloud-based, end-to-end digital workflow solution that covers everything from pre-admission care planning to post-discharge rehabilitation. In itself, SurgiCare delivers efficiency savings that contribute to carbon footprint reductions in surgical pathways. However, Open Medical is setting its sights higher by incorporating sustainable features into the platform to promote and facilitate sustainable choices, as well as providing carbon emission visibility through a carbon-reporting dashboard.
Sustainability made easy
SurgiCare offers a unique approach to promoting sustainable decision-making among both clinicians and patients. With a focus on education and support, the platform encourages clinicians to choose safe and sustainable alternatives whenever possible, while patients are encouraged to opt for sustainable pathways that, for example, eliminate unnecessary travel and paper usage.
The end-to-end architecture of the platform is a standout feature. It allows the system to capture all information throughout the entire pathway using granular SNOMED-CT coding and its corresponding carbon weight value. By processing this data in real-time, the system is able to automatically update its carbon matrix. This matrix is then displayed on a visually appealing green dashboard, providing a comprehensive view of all carbon emissions and highlighting the positive impact of behavioural changes on reducing the carbon footprint.
The beauty of SurgiCare lies in its seamless automation. Rather than constantly keeping in mind what is best for the environment, you can prioritise delivering the best care possible for patients while simultaneously helping the planet.
As Kenneth rightly points out, it is vital to “embed sustainability into every clinical and management decision so that it’s given a reasonable amount of importance alongside the effectiveness of the treatment and patient safety.”