ENVIRONMENTAL SUSTAINABILITY
Clinicians lead climate health action in WA In a major development for the delivery of anaesthesia in Australia, WA Health has become the first state to remove desflurane from all public hospitals. The campaign to reduce and then remove desflurane has been a carefully constructed path over several years. It began with a few enthusiastic clinicians from different health services, coming together to drive change. Inspiration came from our anaesthesia trainees through TRA2SH and their “Ditch the Des” campaign. From the earliest stages, this project was data-driven – tracking volatile and propofol usage at individual sites across the state to guide interventions and demonstrate progress, including financial savings. Thanks must go to Dr Chris Mitchell for his invaluable work with this. Alongside the data, we used consistent education in as many forums as possible to align views and bring our colleagues with us on the journey. We spread the word state-wide via the WA Green Theatres Network, sharing resources such as posters and putting the data into the hands of local staff so that they could enact change. It soon became clear that the tide had turned on desflurane usage in WA, with very few public hospitals using it at all by late 2022. We felt it was likely that the remaining use was only related to habit or easy availability. We also knew that positive local changes could be transient unless there was a system-wide commitment to the cause.
De-listing desflurane from the state formulary was a logical next step, but first we needed to unite clinical staff and their existing action with the appropriate governing bodies. Consultation with multiple stakeholders occurred and was centrally coordinated by the Sustainable Development Unit (SDU) in the WA Department of Health. Written submissions were obtained from multiple heads of departments of anaesthesia, surgeons, pharmacists, climate health leads and sustainable anaesthesia networks. The evidence was submitted to the WA Therapeutics Advisory Group and subsequently to the WA Drug Evaluation Panel (WADEP) who agreed that this was an obvious step to reduce our carbon footprint. We thank Dr Emma-Leigh Synnott and Dr Sarah Joyce of the SDU for their facilitation of this process. This achievement clearly demonstrates the potential for clinicians to lead positive system-wide action and reduce the impact of healthcare on the environment. A “clinical community” organising approach means that the people who best know their clinical area are facilitated and supported to enact change. In this instance, anaesthetists have identified one of their biggest contributors to declining planetary health and corrected it. Linking enthusiastic people together in sustainability networks spreads these messages and shares the workload. Dr Adam Crossley, Member, ANZCA Environmental Sustainability Network (ESN) Executive, WA Green Theatres Network Committee Dr Archana Shrivathsa, Chair, ANZCA ESN Executive, WA Green Theatres Network Committee
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