Peering through the hourglass

Environmentally sustainable emergency medicine

Emergency clinicians worldwide are demonstrating increasing concern about the effect of climate change on the health of the populations they serve. The movement for sustainable healthcare is being driven by the need to address the climate emergency. Globally, healthcare contributes significantly to carbon emissions, and the healthcare sector has an important role to play in contributing to decarbonisation of the global economy. In this article, we consider the implications for emergency medicine of climate change, and suggest ways to improve environmental sustainability within emergency departments. We identify examples of sustainable clinical practice, as well as outlining research proposals to address the knowledge gap that currently exists in the area of provision of environmentally sustainable emergency care.

BET 1: The clinical impact of policies aimed at reducing the carbon footprint of emergency departments

A short-cut systematic review was carried out to establish if strategies to reduce greenhouse gas emissions in the ED could succeed while maintaining comparable care standards. Of 2914 papers found in the searches, 40 were selected for full-text review and none were eligible for inclusion. The main reason for exclusion was article type. Given the wide-ranging proposals for reducing greenhouse gas emissions in healthcare, there is a dramatic paucity of evidence on the pragmatic effects on patient care.

Science Policy Training for a New Physician Leader: Description and Framework of a Novel Climate and Health Science Policy Fellowship

The accelerating health impacts of climate change are undermining global health, and the roles of the health sector in addressing the many challenges of climate change are being articulated by governments, multilateral institutions, and professional societies. Given the paucity of physician engagement on this issue to date, there now exists a clear need for health professionals to meet this new challenge with the development and cultivation of new knowledge and skill sets in public health, environmental science, policy, and communication. We describe a novel GME fellowship in climate and health science policy, designed to train a new generation of clinicians to provide the necessary perspective and skills for effective leadership in this field. This fellowship identifies available university resources and leverages external collaborations (government, medical consortiums, affiliate institutions in public health, and environmental science), which we describe as being replicatable to similar training programs of any number of medical specialties and likewise bring meaningful opportunities to their respective training programs and academic departments. The creation of this novel fellowship in climate and health policy provides a roadmap and potential path for similar programs to join us in addressing the defining health issue of this generation and many to follow.