KA BARRACLOUGH 1,2, A GLEESON 2, SG HOLT 1,2, JWM AGAR 3
1Department of Nephrology, Royal Melbourne Hospital, Parkville, Victoria; 2Victorian Clinical Network, Department of Health and Human Services, Melbourne, Victoria; 3Department of Renal Medicine, University Hospital Geelong, Barwon Health, Geelong, Victoria.
Aim: The GREENS survey aimed to 1) establish a baseline for environmental sustainability (ES) in Victorian renal healthcare, and 2) guide future initiatives to reduce its environmental impact.
Background: The recurrent, per capita resource consumption and waste generation profile of dialysis is second to none in healthcare. The environmental and financial costs are high and unsustainable.
Methods: Nurse unit managers of all Victorian public dialysis facilities received an online link to the survey, which asked 107 questions relevant to the ES of dialysis services.
Results: Responses were received from 71/83 renal facilities in Victoria (86%), representing 628/660 dialysis chairs (95%). Low energy lighting was present in 13 facilities (18%). Only 18 (25%) recycled reverse osmosis water while 7 (10%) reported use of renewable energy. 56 facilities (79%) performed comingled recycling but only 27 (38%) recycled polyvinyl chloride plastic. A minority educated staff in appropriate waste management (n=30;42%) or formally audited waste generation and segregation (n=19;27). There was limited use of tele- or video-conferencing to replace staff meetings (n=19;27%) or patient clinic visits (n=13;18%). 44 facilities (62%) provided secure bicycle parking but only 33 (46%) provided shower and changing facilities. A minority (n=28;39%) considered ES in procurement decisions. Only 33 (46%) reported any level of preparedness to cope with climate change. Only 39 services (49%) confirmed an ES policy and few had ever performed an ES audit (n=14;20%), formed a green group (n=14; 20%), or were currently undertaking a green project (n=8;11%). Only 15 facilities (21%) made any formal effort to raise awareness of ES.
Conclusions: The need for practice and culture change is urgent if the ongoing delivery of high-quality care is to be ensured.