Better environmental stewardship improves patient safety

Pollution and Patient Safety: Saving Lives and Environmental Stewardship
Wednesday, 10:15 to11:15 a.m.
Upper 6A

Modern medicine has made dramatic strides in saving lives. Surgical infection rates, for example, have plummeted from nearly 90 percent in the early 19th century to about 5 percent today. At the same time, pollution from the health care industry continues to be a concern. Research suggests that health care-related pollution may be responsible for about as many deaths as medical errors, yet are currently unaccounted for.

“We are causing an indirect disease burden, likely in the same order of magnitude as those reported in the Institute of Medicine’s To Err Is Human report that sparked the formal patient safety movement,” said Jodi Sherman, M.D., Assistant Professor of Anesthesiology at the Yale School of Medicine, and Environmental Compliance Officer at Yale-New Haven Hospital. “Perioperative medicine is an enormously resource-intense specialty, and anesthesiologists are uniquely positioned to once again take a leadership role in this new area of patient safety.”

Dr. Sherman will present a professional issues session, “Pollution and Patient Safety: Saving Lives and Environmental Stewardship,” from 10:15 to11:15 a.m. today in Upper 6A. This refresher course will review the negative ecological impacts of anesthesia-related pollution and offer strategies for mitigating these impacts while continuing to deliver high standards of patient care.

“In our quest to protect ourselves and our patients against infection, for example, we are using more and more disposables and throwing more things away without evidence that we are improving safety, and without looking at the ways we are harming public health,” she said. “In addition to causing indirect harm, we are increasing the cost of health care. There are things we can do to prevent pollution simply by cutting waste. Cutting waste reduces pollution and reduces costs.”

One way to assess the environmental and financial costs of equipment decisions is to consider the life cycle rather than simply the acquisition cost, Dr. Sherman said. Life cycle analysis considers the entire impacts associated with an item, from the initial extraction of resources used to produce it, to manufacturing, transportation, purchase, maintenance, disposal and other factors.

Reusable items, such as blood pressure cuffs or laryngoscopes, are more time- and labor-intensive to use compared to disposable items. But reusable items can be significantly less costly over the entire life cycle depending on the item and hospital use practices. Doing the right thing environmentally can also be doing the right thing financially.

Environmental impacts alone cannot dictate clinical care, Dr. Sherman noted, but they can, and should, be factored into decision-making when choices exist. Seemingly small changes in how medical devices and drugs are used can have significant implications for resource use, emissions and public health when magnified over the entire health care system.

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