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Assessing the environmental impact of an anastomotic leak care pathway

BACKGROUND: The healthcare sector faces increasing pressure to improve environmental sustainability whilst continuing to meet the needs of patients. One strategy is to lower the avoidable demand on healthcare services, by reducing the number of surgical complications, such as anastomotic leak (AL)....

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Autores principales: Bischofberger, Stephan, Adshead, Fiona, Moore, Keith, Kocaman, Mesut, Casali, Gianluca, Tong, Cindy, Roy, Sanjoy, Collins, Michael, Brunner, Walter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388196/
https://www.ncbi.nlm.nih.gov/pubmed/37528919
http://dx.doi.org/10.1016/j.sopen.2023.07.001
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author Bischofberger, Stephan
Adshead, Fiona
Moore, Keith
Kocaman, Mesut
Casali, Gianluca
Tong, Cindy
Roy, Sanjoy
Collins, Michael
Brunner, Walter
author_facet Bischofberger, Stephan
Adshead, Fiona
Moore, Keith
Kocaman, Mesut
Casali, Gianluca
Tong, Cindy
Roy, Sanjoy
Collins, Michael
Brunner, Walter
author_sort Bischofberger, Stephan
collection PubMed
description BACKGROUND: The healthcare sector faces increasing pressure to improve environmental sustainability whilst continuing to meet the needs of patients. One strategy is to lower the avoidable demand on healthcare services, by reducing the number of surgical complications, such as anastomotic leak (AL). The aim of this study was to assess the environmental impact associated with the care pathway of AL. METHODS: An environmental impact assessment was performed according to the Sustainable Healthcare Coalition (SHC) guidelines. A care pathway, describing the typical steps involved in the diagnosis and treatment of AL was developed. Activity and emission data for each stage of the care pathway were used to calculate the climate, water and waste impact of the treatment of AL patients. RESULTS: The environmental impact assessment shows that AL is associated with an average climate, water and waste impact per patient of 1303 kg CO(2)-eq, 1803 m(3) of water and 123 kg waste, respectively. Grade C leaks are associated with the greatest environmental impact, contributing to 89.3 %, 79.4 % and 97.9 % of each impact, respectively. A breakdown of the environmental impact of each activity shows that stoma home management is the largest contributor to the total climate (46.6 %) and waste (47.3 %) impact of AL patients, whilst in-patient hospital stay contributes greatest to the total water impact (46.7 %). CONCLUSIONS: The treatment of AL is associated with a substantial environmental impact. This study is, to our knowledge, the first to assess the environmental impact associated with the treatment of AL.
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spelling pubmed-103881962023-08-01 Assessing the environmental impact of an anastomotic leak care pathway Bischofberger, Stephan Adshead, Fiona Moore, Keith Kocaman, Mesut Casali, Gianluca Tong, Cindy Roy, Sanjoy Collins, Michael Brunner, Walter Surg Open Sci Research Paper BACKGROUND: The healthcare sector faces increasing pressure to improve environmental sustainability whilst continuing to meet the needs of patients. One strategy is to lower the avoidable demand on healthcare services, by reducing the number of surgical complications, such as anastomotic leak (AL). The aim of this study was to assess the environmental impact associated with the care pathway of AL. METHODS: An environmental impact assessment was performed according to the Sustainable Healthcare Coalition (SHC) guidelines. A care pathway, describing the typical steps involved in the diagnosis and treatment of AL was developed. Activity and emission data for each stage of the care pathway were used to calculate the climate, water and waste impact of the treatment of AL patients. RESULTS: The environmental impact assessment shows that AL is associated with an average climate, water and waste impact per patient of 1303 kg CO(2)-eq, 1803 m(3) of water and 123 kg waste, respectively. Grade C leaks are associated with the greatest environmental impact, contributing to 89.3 %, 79.4 % and 97.9 % of each impact, respectively. A breakdown of the environmental impact of each activity shows that stoma home management is the largest contributor to the total climate (46.6 %) and waste (47.3 %) impact of AL patients, whilst in-patient hospital stay contributes greatest to the total water impact (46.7 %). CONCLUSIONS: The treatment of AL is associated with a substantial environmental impact. This study is, to our knowledge, the first to assess the environmental impact associated with the treatment of AL. Elsevier 2023-07-11 /pmc/articles/PMC10388196/ /pubmed/37528919 http://dx.doi.org/10.1016/j.sopen.2023.07.001 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Bischofberger, Stephan
Adshead, Fiona
Moore, Keith
Kocaman, Mesut
Casali, Gianluca
Tong, Cindy
Roy, Sanjoy
Collins, Michael
Brunner, Walter
Assessing the environmental impact of an anastomotic leak care pathway
title Assessing the environmental impact of an anastomotic leak care pathway
title_full Assessing the environmental impact of an anastomotic leak care pathway
title_fullStr Assessing the environmental impact of an anastomotic leak care pathway
title_full_unstemmed Assessing the environmental impact of an anastomotic leak care pathway
title_short Assessing the environmental impact of an anastomotic leak care pathway
title_sort assessing the environmental impact of an anastomotic leak care pathway
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388196/
https://www.ncbi.nlm.nih.gov/pubmed/37528919
http://dx.doi.org/10.1016/j.sopen.2023.07.001
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