This text is part of the special notebook Innovating for better care
Bring about change systemic and lasting in the health sector is the bet of the Ecocaregiver Journey. This training was offered this year to a first cohort of managers from the CIUSSS du Centre-Sud-de-l’Île-de-Montréal. The objective is to equip them to reduce the consequences of their practices on climate change.
In 2024, Laurence Sauvé-Lévesque was part of the first cohort of the Ecocaregiver Pathway (PEE). For six months, the one who occupies the position of senior advisor for patient-oriented financing (FAP) for the general physical health directorate of the CIUSSS du Centre-Sud-de-l’Île-de-Montréal (CCSMTL) benefited from a unique training of its kind.
Intended for managers like her, this innovative course aims to better equip them to encourage them to implement, in their services, ways of doing things that will reduce the effects on the climate and the environment. “We are the first to offer such a program in the health network,” explains the coordinator and main trainer of the PEE, Guillaume Moreau. Following the success of the first training, a second cohort is being created for this fall.
A systemic approach
Supported by the Environmental Health and Sustainable Development Office of the CCSMTL, the PEE lasts a total of fifteen hours, divided into five monthly sessions of three hours.
“During the training, we address, among other things, the different levels of the socio-ecological crisis, resource shortages and their impacts on people’s health,” explains the trainer.
The training approach is inspired by broader themes: regenerative design, planetary health, intersectional struggles, indigenous perspectives as well as knowledge from permaculture. It is not surprising to learn that Mr. Moreau did his master’s degree in environmental sciences, with the subject of permaculture and the regeneration of agricultural ecosystems.
A portion of the training is also provided by Camille St-Laurent, the equity, diversity and inclusion advisor. “We are opening up several fields to provide a more systemic vision of management and the environment,” says Mr. Moreau. Finally, during the last three-hour session, the Climate Fresco workshop is offered to eco-caregivers. This interactive card game allows them to deepen their knowledge of climate change.
First, do no harm
“Clinicians are very sensitive to taking care of the planet,” says Laurence Sauvé-Lévesque. Because, ultimately, taking care of the planet means taking care of the health of populations. » The executive advisor also recalls the clinicians’ premise: “ Primum non nocere »: first, do no harm.
Mme Sauvé-Lévesque is already seeing positive impacts from training between the different departments. “We often work on more local initiatives, the health establishment is so big! » she confides.
In addition to offering care and services to the population over an area of 46 km2the CCSMTL has service centers throughout the metropolis. With more than 20,000 employees, 930 specialists and more than 200 buildings, according to the organization’s latest 2022-2023 annual management report, it becomes essential to pool better adapted management tools, underlines Guillaume Moreau.
The objective is to sustain the changes at all levels of the CIUSSS. To better understand, Laurence Sauvé-Lévesque, who is also a nurse by training, explains that the tools provided as part of the PEE “allow us to take into consideration certain aspects of our work that take us out of our daily practice”.
Laurence Sauvé-Lévesque, who is also a trained nurse, believes that the tools provided as part of the PEE allow us to take a step back and think about certain important aspects of work organization. Talking to employees in the field led her to consider implementing “green” hemodialysis. This procedure, which filters the blood instead of the kidneys, is more environmentally friendly, because it notably reduces water consumption and the production of medical waste associated with the treatment. Mme Sauvé-Lévesque would like to integrate this new way of doing things and make it systematic through the CCSMTL.
Other projects already in place at CCSMTL make it possible to reduce the impacts of certain medical procedures. The Notre-Dame and Verdun hospitals, for example, obtained Transfuse with Care certification from Héma-Québec, an initiative that aims to reduce waste during blood transfusions. The trained nurse also recalls the idea of “right care, at the right time, for the right patient”. This vision, supported by convincing scientific data, is gaining more and more momentum in the Quebec health sector and is consistent with the objectives of the PEE.
Train the trainers
When it comes to climate action, efforts must be made “at all levels”, affirm the executive advisor and the trainer. Even if, for the moment, energies are focused on training managers, Laurence Sauvé-Lévesque recognizes the importance of listening to workers on the ground. Employed people also want to contribute, as they often already do on a daily basis, at home. “Staff want to be able to transpose this commitment into their workplace as well,” notes M.me Sauvé-Lévesque.
On this subject, Guillaume Moreau affirms that training for CCSMTL field staff will soon be given. Other health establishments in Quebec have expressed interest in the Ecocaregiver Pathway. A presentation of the project organized by the sustainable development advisor at the Ministry of Health and Social Services, Bénédicte Leclerc-Jacques, is planned for October. This is a condensed form of the PEE, in three sessions.
All people occupying a position similar to that of Mr. Moreau who in turn wish to offer training of this type in their region are invited to participate.
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