Green Anaesthesia Week: A Change Management Project

I’m often tempted to call it Future Tim’s problem. But of course, it’s not.

Affecting behavioural change at scale in the face of the intangible threat of climate change is the challenge of our lifetime. The choices we make now will last for decades.

One way of viewing the problem, is that healthcare already has a social mission. The fact that the carbon footprint of the healthcare industry is double that of the aviation industry doesn’t matter. Code-red doesn’t matter. We’re helping patients.

But what if we’re harming society in the aggregate? This can be explored in real terms. A recent paper published in Nature predicts one excess death for every 4,434 metric tons of carbon dioxide emitted. At Green Week, we learned that in Ireland in 2019, we emitted 19,481 metric tons (CO2 equivalent) worth of anaesthetic gases - mostly (86%) nitrous.

I wonder how many lives we saved with nitrous this year.

Of course, it’s more complicated than that. Which is exactly the issue. Climate change is a complex problem without a simple solution. This is one of the reasons we ran a week of talks on green anaesthesia this year.

MEP Grace O’Sullivan put it in simple terms when she asked that each of us consciously becomes a climate activist. Active, as opposed to passive, because people hate change.

Industry worked out how to affect behavioural change at scale over the past decades. Advertising executives, web designers and politicians are just some of the practitioners.

Green Anaesthesia Week was designed using a similar model – we’re trying to catalyse change. It was delivered by a diverse group of credible speakers, over a sustained period. Viewers were invited to participate and share their concerns, reducing the risk of a negative reaction. The costs of inaction were surfaced, education provided, and uncertainty alleviated.

On Minimising Monday, President George Shorten recommended that we be good ancestors. Dr Brian Kinirons explored the college’s foray into sustainability and called for grassroots changes. Dr Oscar Duffy presented his prize-winning national audit of anaesthetic gas emissions. Dr Ola Løkken Nordrum and Professor Kevin Clarkson described finding and fixing nitrous oxide leaks in Galway. MEP Grace O’Sullivan gave a fantastic overview of her astonishing achievements in Europe.

On TIVA Tuesday Dr Claire Nestor and Professor Mike Irwin extolled the virtues and lowered the barriers to intravenous anaesthesia. On No Waste Wednesday we learned of the astounding success of the Nitrous Oxide Mitigation Project from pharmacist Alifia Chakera. Dr Rob Burrell’s clear passion for nature and the environment has led to a variety of successful projects from which we can all learn something. His cats also made a cameo. These informative sessions were underscored with an open public discussion on Town Hall Thursday.

The videos will be available to view on the college website next month and will be an invaluable resource. If you’re inspired to act, start by doing some research and establishing a strong multidisciplinary team. A great resource is this article by Dr Forbes McGain, an Australian anaesthetist. A fantastic online course in sustainable quality improvement can also be found on the Centre for Sustainable Healthcare website. You’ll find likeminded people and help with your ideas.

With 250 registrants, Green Anaesthesia Week was well attended but it will we see any lasting behavioural change? As long as we don’t leave it up to Future Us I guess.