Climate conscious clinical specialties
Practitioners across clinical specialties can take meaningful steps to reduce the environmental impacts of their practice and safeguard patient and population health.
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Kidney Care
CASCADES Contact
Implementation resources on sustainable kidney care
Upcoming training and events
Sustainable Kidney Care Playbook
A step-by-step guide to change ideas that address perioperative care in the Canadian context.
Explore key actions in sustainable kidney care
More resources on sustainable kidney care
External initiatives in sustainable kidney care
The Canadian Society of Nephrology’s Sustainable Nephrology Action Planning (‘SNAP’) committee is a pan-Canadian group of providers dedicated to advancing patient care within a framework of environmental sustainability.
Radiology
CASCADES Contact
Resources on sustainable radiology
Environmental Sustainability in Radiology
Explore strategies for low carbon, high quality medical imaging with mitigation and adaption opportunities in radiology in Canada.
Implementation of a program to reduce the environmental impact of the radiology department
This project aims to reduce the environmental impact of medical imaging. Radiology, or medical imaging, has a significant environmental impact, including through energy consumption, and the production of medical waste like contrast media. The project aims to address these impacts by increasing awareness among health professionals and implementation of sustainable practices.
Sustainable radiology event recordings
Internal Medicine
CASCADES Contact
Resources on internal medicine
Climate Conscious Inhaler Practices in Inpatient Care
A step-by-step guide to more sustainable inhalers in inpatient care
Clinical Order Set Redesign
Prioritizing Inhaler Wardstock
Tamper Sealing the Inhaler Cap
Low-Volume versus High-Volume HFA Inhaler Procurement
Hospital Formulary
Multidose Medication Discharge Policy
Inpatient provider-specific information
- Inpatient Pharmacists poster
- Inpatient Pharmacy Technicians poster
- Nurses poster
- Respiratory Therapists poster
- Physician and Trainee infographic
- Trainee video
Outpatient provider-specific information
Patient information
Embedding Planetary Health Education into the Medical Teaching Unit
This package of resources supports embedding formal education on planetary health within medical teaching units (MTU).
PI: Nabha Shetty, Associate Professor, Division of General Internal Medicine, Dalhousie University
Laboratories
CASCADES Contact
Implementation resources for sustainable laboratories
Integrating Environmental Sustainability into Clinical Laboratories
Recommendations and resources for appropriate testing, resource use, procurement practices and enhancing a culture of environmental sustainability.
Sustainable Anatomical Pathology
Information for Anatomical Pathology (AP) lab teams on sustainable lab practices and actions specific to AP.
- Exemption of specimens from routine submission to pathology laboratories: recommendations in the Canadian context
- Recommendations on practices related to tissue exemption and release
- Serous cavity fluid/bronchial washings/sputum submission guidelines
- Anatomical pathology expired immunohistochemistry antibody use procedure
- Anatomical pathology sustainability checklist
Emergency rooms
CASCADES Contact
Resources on emergency rooms
Reducing single-use plastics in Laurentian emergency departments
Tens of thousands of disposable thermometers, absorbent pads and shoe covers are used every year in the Saint Jérôme Hospital emergency department.
For several months now, CISSS des Laurentides has been working to reduce the waste generated in its emergency departments at source, by eliminating the use of these single-use items and replacing them with multi-purpose alternatives.
Sustainable emergency room projects in development
Sustainable asthma care in the pediatric emergency department
This project will adapt sustainable inhaler prescribing principles and practices for the pediatric emergency department. The project is based on the four principles of sustainable practice, focusing on educating and encouraging use of the lowest impact MDIs for younger patients and increasing pediatric providers’ comfort in considering dry powder inhalers when appropriate. The project aims to develop a tool for rapid assessment of readiness to use a DPI that can be easily applied in the ED setting.
PI: Katie Gardner, Physician (Pediatric Emergency Medicine), IWK Health
Radiotherapy
Resources on radiotherapy
Sustainable, Socially Responsible Health Care: A Toolkit for Radiotherapy Professionals
Guide created by the Canadian Coalition for Green Health Care.
Kassam, Z., Gabara, A., Rozanec, N., Comsa, D., Lefresne, S., Wong, P., Sergeant, M., Kandasamy, S., Kaminski, J., Sypus, A., and Waddington, K. (2024). Sustainable, Socially Responsible Health Care: A Toolkit for Radiotherapy Professionals. Canadian Coalition for Green Health Care.
Dentistry
CASCADES Contact
Sustainable dentistry projects in development
Greenhouse gas emissions estimations and reduction opportunities in dental clinics
This project will develop and distribute an open access tool that will estimate the greenhouse
gas emissions of dental clinics in Canada. A prototype playbook to support the dissemination of the tool will offer practical guidance and considerations for understanding GHG emissions in community dental clinics and explore opportunities to practice more sustainable oral health care through changes to clinical pathways and operations.
PI: Christophe Bedos. Associate professor & Researcher. McGill University, Montreal
Ophthalmology
Contact
Sustainable ophthalmology projects in development
Vision for a Sustainable Future in Ophthalmology: A Toolkit for Professionals
The Canadian Ophthalmological Society (COS), with support from Choosing Wisely Canada, is developing a sustainability toolkit for eye care delivery across Canada. The toolkit, Vision for a Sustainable Future in Ophthalmology: A Toolkit for Professionals. For further information, contact Kim Tytler.
This Toolkit will provide ophthalmologists and eye practitioners across Canada with extensive, up to date and highly referenced information and guidelines to improve sustainability in eye care delivery. The Toolkit is practical, detailed, and contains many links and resources, as well as examples of successful sustainability initiatives across Canada and globally. It will be a living document updated on an ongoing basis to educate, to raise clinician awareness, and to inform attitudes with the goal of implementing sustainable eye care practices Canada wide.
We want to hear from you
Materials created by CASCADES are shared under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License (CC BY-NC-SA 4.0).
While it is not a requirement under the license, we would be grateful if you would let us know where and how you use, share or adapt our materials.
Other action areas
Care pathways
Key actions can minimize the environmental harms of medications throughout their lifecycle and address increased medication-related risks due to climate change.
Many opportunities exist to address the resource intensity of perioperative care while ensuring and promoting high quality care.
Comprehensive person-centered primary and community care can support health and wellbeing and reduce the need for more resource intensive services.
Practitioners across specialties can take meaningful steps to reduce the environmental impacts of their practice and safeguard patient and population health.
Health services can promote health, including by delivering healthy food, effective chronic disease management, and climate-adapted clinical care.
System enablers
Sustainability is intrinsically linked with both quality care and patient safety and can be embedded within these efforts.
Leadership and good governance are needed to develop and deliver effective climate and sustainability strategy.
The shift to climate resilient and sustainable health systems requires accurate assessment of healthcare’s environmental impacts.
Health systems can leverage their purchasing power to influence vendors and shape markets for sustainable and resilient health sector products and services.
Healthy food, digital innovation and effective waste management are among the key enablers of low-carbon, sustainable and climate-resilient health systems.