Advancing Sustainability in Perioperative Practice - a milestone publication by ESAIC

Climate change has emerged as one of the defining challenges of our time, impacting every facet of our lives. It is imperative that every sector, including healthcare, contributes to reducing its carbon footprint. A recent study revealed that clinical practice accounts for a significant 4.7% of European greenhouse gas emissions, with the European Union ranking as the third largest contributor to global healthcare industry emissions. Recognising the urgency of this issue, the ESAIC took a significant step forward in June 2023 by launching the Glasgow Declaration on Environmental Sustainability in Anaesthesiology and Intensive Care. This marked a pivotal moment for ESAIC, aligning sustainability with its mission and vision. 

ESAIC’s Vision of Sustainability 

ESAIC’s mission and vision extend beyond clinical excellence; they encompass a commitment to the holistic well-being of patients, healthcare professionals, and the environment. In adopting the Glasgow Declaration, ESAIC reaffirmed its dedication to sustainable healthcare practices. The declaration emphasises the importance of integrating sustainability into the core of healthcare delivery. Building upon this commitment, the ESAIC Sustainability Committee has now released a ground-breaking publication that solidifies the society’s dedication to sustainability. 

The publication titled “European Society of Anaesthesiology and Intensive Care Consensus Document on Sustainability” is a testament to ESAIC’s unwavering commitment to sustainability in perioperative care. Authored by a consortium of experts and endorsed by Sustainability National Representatives from 24 countries, this document presents a comprehensive framework for achieving a more sustainable practice in anaesthesia and intensive care. 

Four Key Scopes for Sustainable Practice:

The document explores sustainability in four pivotal areas, acknowledging that sustainability encompasses not only environmental concerns but also broader dimensions: 

1. Direct Emissions: Recommendations in this area focus on reducing the carbon footprint of anaesthesia procedures through measures such as very low fresh gas flow and the selection of eco-friendly anaesthetic drugs. 
2. Energy: This section highlights strategies for conserving energy and water resources within healthcare facilities. 
3. Supply Chain and Waste Management: It offers insights into sustainable procurement practices, responsible disposal of plastics, and the adoption of “5R” policies. 
4. Psychological and Self-Care of Healthcare Professionals: Recognising the vital role of healthcare professionals in delivering sustainable care, this section emphasises the importance of maintaining a healthy work environment and addressing issues like fatigue and burn-out. 

A Path Forward 

To develop these recommendations, 13 sustainability experts in anaesthesia laid the foundation in March 2023. The document underwent a rigorous validation process involving 36 experts from 24 different countries through a two-step Delphi validation process in May and June 2023. Remarkably, all recommendations surpassed the 80% agreement threshold in the first round, with 88 recommendations achieving an agreement rate exceeding 90% in the second round. 

Furthermore, to facilitate the practical application of these recommendations, executive summaries for areas 1, 2, and 3 have been made available as cognitive aids for quick reference in the operating room. 

In the face of an escalating climate crisis and the significant carbon footprint of clinical practice, ESAIC’s commitment to sustainability is commendable. The ESAIC Sustainability Committee’s publication is a monumental step toward realising this vision, offering actionable recommendations for healthcare professionals to adopt more sustainable practices in anaesthesia and intensive care. 

As we move forward, this publication not only bolsters ESAIC’s mission but also stands as a testament to the society’s dedication to improving patient care, protecting the environment, and fostering the well-being of healthcare professionals. It serves as a valuable resource and a catalyst for change, as ESAIC leads the way in promoting sustainability within the healthcare sector. 

Authors

• Prof. Patricio Gonzalez-Pizarro – Chair of the ESAIC Sustainability Committee
• Ms. Arta Leci (MA) – Marketing and Communications Manager at the ESAIC