Co-benefiting people and planet: stewarding health resources to reduce waste and improve health.

Abstract

The health sector contributes 4-5% of global greenhouse emissions, with direct and indirect harms to people and the planet. Reducing health sector waste by stewarding health resources can reduce emissions, improve preventive and clinical services, reduce costs, and deliver numerous population health co-benefits. Sources of waste include overuse of energy and products (such as diagnostics, medications, consumables, devices), waste related to models of care (including over-diagnosis, unwarranted variation, and excess bed-days from avoidable admissions or not preventing disease or progression of disease), and human factors-related waste (such as duplication, delays, teamwork failure, adverse events and safety shortcuts). A health resource stewardship program commenced in our large regional referral health service (6500 staff) in Ballarat, Victoria, Australia in 2018. Staff commence training having identified a source of waste warranting attention, and receive mentoring over a four-month period to implement their solution; more than 300 have been trained to use improvement methods to reduce or eliminate wasteful practices. Successful initiatives include that removing a blood tube (for a test rarely required but often done) from a trolley halved its use and saved half the salary of the nurse who took the action. Training staff to recognise early sepsis halved admissions to the Intensive Care Unit and saved lives. Implementing pharmacist-led care via telehealth before a person's in-person cardiology appointment saved 16,275Kms and 4.5tonnes of carbon dioxide. People and the planet benefit from modest or broad action such as reducing printing, assuring prevention program quality and efficacy by co-designing with consumers, optimising effective screening in a high-risk population, and investment in programs such as telehealth or digital health records. Health resource stewardship can be done anywhere any day by anyone, and is a key climate action for health by the health sector. Key messages • The health sector produces greenhouse emissions which harm people and the planet. • Stewarding health resources can reduce emissions, reduce costs, and deliver numerous population health co-benefits.