Education first

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 was education.

When Dr. Kenneth Barker, consultant anaesthetist at Raigmore Hospital, learnt about the detrimental impact of the 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.

Overcoming obstacles

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 resistance from colleagues, with some individuals 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.” He says, “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 retain 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 education and support to encourage sustainable decision-making amongst clinicians and patients. It can nudge clinicians to choose clinically safe alternatives whenever appropriate and patients to opt in for sustainable pathways where unnecessary patient travel and paper are eliminated, for example.

An important feature of SurgiCare is its end-to-end architecture, which enables the system to capture all the information with granular SNOMED-CT coding along with its carbon weight value. With this, the platform automatically inputs all the captured data in real-time into its carbon matrix, displaying the information on a green dashboard that showcases all carbon emissions and reflects the positive impact of behavioural changes in reducing the carbon footprint.

The beauty of SurgiCare lies in its seamless automation. Rather than needing to constantly keep 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.”