Emergency Department earns bronze status after green efforts

PICTURED: Members of the Emergency Department's GreenED team.

Morriston Hospital’s Emergency Department (ED) has earned bronze status for turning green in their approach to health care.

The department has made countless changes in the delivery of care for both patients and the planet following a review of its procedures.

Their efforts have been rewarded by being granted bronze status by GreenED - a framework developed by the Royal College of Emergency Medicine which encourages environmentally sustainable practices within the specialty of emergency medicine.

Led by ED Consultant Sue West-Jones, one of three Sustainable Clinical Leads in the health board, some subtle changes and innovative ideas have culminated in greener practices within the service.

PICTURED: ED Consultant Sue West-Jones.

Dr West-Jones said: “We are thrilled to have been granted bronze status – it’s reward for the efforts of everyone involved who have helped reduced our carbon and costs without impacting negatively on patient care.

“ED is a very busy department under immense pressure due to the number of patients seen each day. But the bottom line about GreenED is that we have proved we can save money, reduce carbon waste and simultaneously improve patient care whilst raising staff awareness.”

The starting point came via the creation of a group within ED, named Green ED By The Sea, which held bi-monthly meetings for staff to share their ideas and start projects.

As part of the recommendations of the group, all nurses starting in Swansea Bay – and those undergoing ED nurse mentor training - have an induction which now includes a section on sustainable health care delivered by Dr West-Jones and supported by Practice Education Facilitator Karen Edwards.

PICTURED: Foundation Doctor Giorgia Appolloni led an unnecessary cannulation project.

Following a Quality Improvement Project, fewer patients are now having cannulation after almost a third were identified as having them unnecessarily. The review has also reduced the risk of infections and inflammation from the procedure. It expects to save a minimum of £6,500 a year and reduce carbon emissions by the equivalent of 22 return trips from Swansea to London in a car.

ED has reviewed its use of pain relief, with oral paracetamol now given to patients – when possible – rather than intravenously as it reduces any form of harm to patients by avoiding an injection, which will also cut infection risks, and reduces waste.

A fun and creative project for paediatric patients was developed in the form of a sustainable sticker competition, which invited children to create stickers encouraging staff to make energy-saving changes like switching off lights and computers when not in use within the Children’s Emergency Unit.

Subtle, yet successful, changes were also made around the use of paper within the department, with ED only using recycled paper. Health information leaflets have been replaced by a QR code, which directed patients to a website with more detailed information, while lab reports are published digitally.

ED has also switched to using wooden cutlery and paper plates from plastic and polystyrene as they are less environmentally harmful.

The health board’s Pharmacy ED team also played a big part by swapping metered dose inhalers to dry powder inhalers, which deliver significant benefits for patients and the planet. The dry powder device doesn’t contain a propellant (hydrofluoroalkane) which is a potent greenhouse gas and has a significantly lower carbon footprint than metered dose inhalers.

The disposal of waste has also been addressed, with changes in bin bags which ultimately will be rolled out across the health board.

Dr West-Jones said: “The changes work when staff understand the cost, environmental and patient benefits.

PICTURED: A sticker competition promoting sustainable actions proved a success within the Children's Emergency Unit.

“Our team within ED has included staff in various posts, but we’ve also benefited from the efforts and enthusiasm of our pharmacy team along with the estates department. It’s really been a team effort.

“Staff who have really embraced the changes include Core Trainee 2 Doctor Ellie Harlow; Foundation Doctors Giorgia Appolloni and Bethany Smith; ED Stock Manager Margaret Armishaw; Physician’s Associate Ellie Cutforth; Senior E-Rostering Administrator Claire Richards; Reception Team Leader Heather Grice; ED GP Rebekah Brettle and Mark Poulden, Consultant Emergency Medicine.

“We are also grateful to Welsh Government for providing us with funding to assess and make these changes.

“With bronze status achieved, we now look to identifying further areas in which we can improve so that we can earn silver status.”

Dr Ian Higginson, Royal College of Emergency Medicine's President Elect, praised Morriston’s ED for their sustainable attitude.

He said: “On behalf of the College – a huge congratulations to the team at Morriston Hospital, who have implemented a range of environmentally sustainable practices within their Emergency Department through our GreenED programme.

“The accreditation awarded is a testament to their passion, innovation and drive to reduce emissions, waste and costs to tackle the climate crisis.

“By doing so, they are creating a greener future – not only for the health of our planet, but the health of our patients and we are proud to support them in their environmental mission.”