WELCOME TO THE GREEN ANESTHESIA ROTATION AT STANFORD
Tackling Climate change is one of the most daunting challenges of the 21st century. As clinicians, we see its impact daily in our ERs in form of admissions due to air quality related diseases, weather related disasters, heat, flooding, vector borne diseases etc. Not only as health care professionals are we dealing with the effects of climate change on our health care system but our own actions also contribute to climate change leading us to become the part of the problem rather than solution. The healthcare sector produces 10% of GHG emissions in US and hospitals represent 36% alone. If the US health care is a country, it will rank 13th in the world for GHG emissions. Hospitals are the second most energy intensive and 3rd most water consuming buildings as compared to commercial building of similar size.
ORs are the financial hot spots for the hospital both in terms of the resources needed in providing care while also generating significant revenue for the hospital. ORs consume 40-60% of the organization total supply costs, drive up to 60% hospital revenue, produce more than 30% of total hospital waste and 2/3rd of regulated medical waste and consume 6 times more energy per square feet than anywhere in the facility.
Anesthetic gases are greenhouse gases, meaning that they contribute to both global warming and ozone depletion. Anesthetic gases make up around 5% of an organization’s GHG footprint. Generally there is lack of formal education among medical students and residents about how our own actions contributes to increase GHG emissions. Around 4000 tons of waste is generated in hospitals every day and around 30% comes from the OR. 70% of the waste is considered biohazardous even though it should not be more than 15% due to lack of education about what goes where in the trash bins.
The purpose of this rotation is to improve awareness, provide education and expose residents and students to the different initiatives Stanford’s anesthesia department has undertaken in addressing climate change in form of waste reduction, addressing anesthetic gas related emissions, encouraging recycling, decreasing hazardous waste etc. Our ultimate goal is to encourage residents to get involved in projects greening the OR to bring real change in our practice.
We are proposing a 2-week elective rotation for 1st and 2nd year residents under MSD where they will get an opportunity to work with faculty who are actively involved in these projects with dedicated teaching on this subject. This rotation will not take away any clinical experience from other specialty rotations but will complement it by allowing them to work with designated faculty.
Senior and junior level residents will rotate in the Green rotation under the MSD block. Attendance at the monthly green team meetings will be encouraged so that residents can get involved with sustainability projects. Clinical evaluations of residents during the GREEN rotation will occur at the end of 2 week period. Residents can request additional time if it aligns further with their interest. At any given time up to 2-3 residents can be assigned this rotation.
Learning objectives (for all levels of residents):
- Understanding pharmacology and physics of commonly used anesthetic gases from climate change point of view.
- How anesthetics affect global warming.
- Incorporate environmental friendly strategies in anesthesia- TIVA & regional anesthesia
- Understanding health care institutions role in contributing to climate change and how we can deliver climate smart health care.
- Understanding why sustainability is critical for the environment of health care delivery and how our own actions impact sustainability.
- Overview of the green projects taken at Stanford and lessons learned.
- Financial implications of going green and formulate a plan to make your OR greener.
List of faculty for Green Rotation in the MSD division
- Dr. Praveen Kalra (Founder of the GREEN team)
- Dr. Jean Louis Horn (Co-founder of the GREEN team)
- De. Brita Mittal
- Dr. Patrick Minot
- Dr. Victoria Fahrenbach
- Dr. Becky Wong
Faculty will be responsible for providing lectures on topics related to green anesthesia.