Morriston Emergency Department's role in saving the planet

PICTURED: Dr Kath Doran, Senior Clinical Fellow in ED; Daniel Greenwell, ED pharmacist; Sue West-Jones, ED Consultant and Dr Rebekah Brettle, GP in ED.

It is a department which saves lives, but now one of Morriston Hospital’s busiest services is also doing its bit to save the planet.

The Emergency Department (ED) uses a wide range of medication and equipment to treat the large volume of patients under its care each day.

But now a designated team within the service is looking at the carbon and cost implications of the methods and equipment currently used – to see if there are greener and better ways to deliver this care.

It has already identified a number of significant changes that could be made, such as a reduction in cannulation usage and utilising QR codes to cut down on paper leaflets where possible.

It also plans to swap the use of metered dose inhalers to dry powder inhalers, which will deliver significant benefits for patients and the planet. The latter doesn’t contain a propellant (hydrofluoroalkane) which is a potent greenhouse gas and has a significantly lower carbon footprint than metered dose inhalers.

Other proposals include switching the pain relief method of Entonox, commonly known as laughing gas, for an inhaler called Penthrox as it has a considerably lower impact on the environment without impacting patient care.

The efforts of the department are highlighted during Great Big Green Week - the UK’s biggest celebration of community action to tackle climate change and protect nature.

Sue West-Jones, Emergency Department Consultant, is among the staff leading a Green ED team that is exploring various ways of reassessing the service’s carbon, cost and care approach.

PICTURED: Sue-West Jones outside ED at Morriston Hospital.

Sue, who is one of three Sustainable Clinical Leads within the health board, said: “In emergency medicine we recognise that we carry a significant carbon load through the investigation and assessment process - a load which is increased by the prolonged stays in ED caused by intense pressure on the NHS.

“So ED is an excellent place to begin looking at all processes. The target is to show a real difference in cost and carbon reduction without impacting patient care.”

The department’s cause has been aided by funding from the Welsh Government to access a GreenED toolkit and framework developed by the Royal College of Emergency Medicine. The GreenED programme encourages environmentally sustainable practices within the specialty of emergency medicine.

The health board is working towards attaining a bronze status, which requires meeting a set number of criteria before looking to secure silver and then gold status.

Sue added: “We have 16 staff members who are on the GreenED team, so we’ve made a positive start. Engagement and enthusiasm are key elements driving our desire for change, and we’re targeting many approaches within our department which we feel can make a big difference.

“There is a lot of work ahead, but when you’ve got passionate staff in place eager to make a difference then you’re already moving in the right direction.

“There are little changes we can make that will add up to make a big difference. We wish to cut paper use, turn off electrical equipment not in use - especially computers and monitors overnight.

“We are looking at ways to reduce plastic by stopping use of bottled water. Plastic cutlery use has ended, which is great, but we must remember that single use plastic is not just the disposal toll it has on the planet, but the carbon cost of production and disposal.

“We are also looking into reducing intravenous paracetamol use when oral is perfectly acceptable. This is for two reasons. Firstly, we can reduce any form of harm to patients by avoiding an injection, which will also cut infection risks.

“Secondly, each cannula is plastic and comes in a plastic sleeve which is non-recyclable plastic waste. If they are disposed of incorrectly, then it is incinerated and carbon released to the atmosphere contributing directly to global warming.

“The early signs are that we are on the right path and have plenty of ideas which are innovative and others which are simple yet very effective.”