'%3e%3cline%20id='Line_151'%20data-name='Line%20151'%20x2='29.522'%20transform='translate(22.5%2022.368)'%20fill='none'%20stroke='%23fff'%20stroke-linecap='round'%20stroke-width='4'/%3e%3cline%20id='Line_152'%20data-name='Line%20152'%20x2='29.522'%20transform='translate(22.5%2032.443)'%20fill='none'%20stroke='%23fff'%20stroke-linecap='round'%20stroke-width='4'/%3e%3cline%20id='Line_153'%20data-name='Line%20153'%20x2='29.522'%20transform='translate(22.5%2042.519)'%20fill='none'%20stroke='%23fff'%20stroke-linecap='round'%20stroke-width='4'/%3e%3c/g%3e%3c/svg%3e)
'%20fill='%232c3e50'%20fill-rule='evenodd'/%3e%3c/svg%3e)
'%20d='M14,8a6,6,0,1,0,6,6A6,6,0,0,0,14,8Zm0,10.839A4.839,4.839,0,1,1,18.839,14,4.837,4.837,0,0,1,14,18.839Zm1.5-2.526L13.441,14.82a.292.292,0,0,1-.119-.235V10.613a.291.291,0,0,1,.29-.29h.774a.291.291,0,0,1,.29.29v3.428l1.616,1.176a.29.29,0,0,1,.063.406l-.455.627A.292.292,0,0,1,15.5,16.313Z'%20transform='translate(-8%20-8)'%20fill='%232c3e50'/%3e%3c/svg%3e)
'%20d='M4.1,11.944C.642,6.929,0,6.414,0,4.571a4.571,4.571,0,0,1,9.142,0c0,1.843-.642,2.358-4.1,7.373a.572.572,0,0,1-.94,0Zm.47-5.468a1.9,1.9,0,1,0-1.9-1.9A1.9,1.9,0,0,0,4.571,6.476Z'%20transform='translate(0)'%20fill='%232c3e50'/%3e%3c/svg%3e)
Carbon impact of anaesthesia consultation in a tertiary university hospital - evaluation and optimisation
Position du problème et objectif(s) de l’étude
Global warming is a public health concern. Transport has, just like in daily life, a significant part of the carbon impact generated. In the field of anaesthesia, some studies are beginning to evaluate the carbon footprint of different healthcare pathway, with particular focus on anaesthetic gases and their greenhouse effects, but no study have yet focused on the carbon footprint of pre-anaesthesia consultations. In this study, we assessed the carbon impact generated by the pre-anaesthesia consultation activity at the Nord hospital and modelled different care pathway scenarios that would make it possible to reduce this impact.
Matériel et méthodes
To carry out this observational study, we have prospectively collected data from patients, anaesthetists and secretaries conducting consultations for thoracic, vascular, neurosurgery and orthopaedic surgeries in the anaesthesia consultation service during the month of March 2023 and calculated the carbon impact generated by transport and the electricity consumption for lighting, telephony, heating and air conditioning. We then modelled different potential adaptations of the care pathway that would reduce carbon emissions. The different scenarios modelled are teleconsultation, remote consultations closer to the patient's home, grouping consultations during a day at the hospital, setting up a carpooling system and coming by public transport to the hospital. The impacts of current and optimized care pathways were compared and annualized.
Résultats & Discussion
Data from 213 patients, 11 anaesthetists and 13 secretaries were evaluated. 75% of the patients made the round trip to the hospital only for the anaesthesia consultation and the modes of transport is in 82% of cases by car The mean carbon footprint per patient from transport was 22.4 (95%CI 14.6-30.2) kgCO2, with the activities of anaesthetists and secretaries contributing a 0.56 (95%CI 0.52-0.59) kgCO2 and 0.31 (95%CI 0.30-0.32) kgCO2, respectively. Optimization of the care pathway could be achieved in 65% of cases and would reduce carbon emissions to 5.55 kgCO2 (IC95 0.13-10.87) which represent a reduction of 85% of carbon footprint. The most frequent adaptations would be to group consultations (27% of cases) and to carry out a teleconsultation (19% of cases). During the year 2023, 17,102 patients underwent an anaesthesia consultation at our hospital. According to our estimates, the carbon impact associated with travel amounted to 369,403 (95%CI 236,192-502,615) kgCO2. After optimising the patient care pathway, it should be possible to saving of 274,487 (95%CI 233,146-315,829) kgCO2 equivalent to 1.4 million kilometres driven by car. Sixty-four per cent of surveyed patients consider reducing the carbon impact a very important or important issue.
Conclusion
This study underscore different issues for diminishing the carbon footprint generated by pre-anaesthesia consultations, mainly through a reduction in transport. The adoption of certain scenarios, such as teleconsultation and relocated consultations, require the cooperation of anaesthesiologists and patients. Few studies have highlighted the value of the examination carried out remotely in comparison to the in-person clinical examinations. Further studies are needed to extend these results nationally and to define medical and socio-economic criteria that would allow us to best adjust the care pathway by adapting the proposed scenarios according to patients and clinical situations.
Auteurs
A. Villette, P. Mora, O. Saint-Aubin, E. Mace, A. Charvet, M. Leone, L. Zieleskiewicz