Blue planet, green ideas | The CISSS de Laval is tackling its carbon footprint

Up to 5% of greenhouse gas (GHG) emissions come from the healthcare system. To reduce its carbon footprint, the Integrated Health and Social Services Center (CISSS) of Laval carried out a detailed estimate, a first in Canada.

Six times less material and 67% fewer bags of solute: the figures speak for themselves, but the sight of disposable products is even more so.

Six trays, three IV bags, various accessories and lots of packaging…

This is what the Cité-de-la-Santé hospital used until recently for the three weekly hemodialysis sessions – the treatment that purifies the blood when the kidneys fail – for each of its patients. Even well-strung, this disposable material takes up two-thirds of a large table.

Last summer most of the solutes were removed, replaced with a purified water system. And since this year, the hospital has been placing connectors, similar to small plugs, on the patient’s catheter. With these connectors installed for the week, you no longer need six trays; one is enough.

With these connectors, “the cost of treatment has gone down by about 50%,” calculated Sven Kutschera, Nursing Advisor, Supply. On 20,000 annual treatments, the CISSS will save nearly $45,000. This is without counting the reduction of more than 20,000 bags of solute in six months. And the reduction of GHG emissions?

This is what remains to be measured, indicates the head of the sustainable development committee (CDD) and deputy director of the CISSS’s technical services department, Benoit Lalonde. “We have a race of 90,000 tonnes. Where will we go this year and how far will we have progressed? »

These 90,000 tonnes of carbon dioxide equivalent (t eq. CO₂) represent the annual footprint of the CISSS de Laval. Staff purchases and travel, which are part of a category called “scope 3”, are included in the calculation, a first in the Canadian health system. The CISSS thus discovered that 90% of its emissions fell under scope 3.

“I never would have thought it would have been so important! It’s a great awareness,” says Mr. Lalonde.

The CISSS now wants to measure the real effect of the actions it is considering and already taking (hemodialysis, planting trees, etc.). “We have more and more ideas, how do we choose? Every dollar we invest, how do we prioritize it? »

Eco-anxious doctors

It is not the ideas that are lacking.

“We are about twenty doctors who all suffered from eco-anxiety. Getting involved, putting time and energy into finding solutions has been our way of self-treating,” says Dr.^r Mark-Andrew Stefan, vice-president of Eco-CPDP, an independent committee formed before the pandemic.

Use less desflurane anesthetic gas (886 kg CO eq.₂ per bottle) has in particular made it possible to reduce emissions from the operating room. For several operations, doctors use another less harmful gas, sevoflurane (44 kg eq. CO₂ per bottle). They also do general anesthesia with intravenous medication, and many more regional anesthesia, all without gas.

Further reductions are possible, says the D^r Stefan. He gives the example of pumps used by patients with asthma or emphysema. They contain a powerful GHG (hydrofluoroalkane, or HFA), which several medical associations are calling for the removal. Not to mention the roughly 30% of tests, procedures and treatments used in the healthcare system that Canada’s Choosing Wisely Canada campaign says are potentially unnecessary.

Telemedicine, telework and transport

Staff travel between home and the workplace generates more than a quarter (26.1%) of CISSS emissions. “I did the math: in terms of CO₂ generated, that represents 150 round trips by car from Earth to the Moon. It’s huge, “said the D^r Stefan, who is also responsible for the sustainable mobility sub-committee at CDD.

Telework and even telemedicine, when appropriate, can be put to use. All consultations of the D^r Stefan for smoking cessation are now done remotely. “Before, patients didn’t show up for appointments. Now we have them on the line, so they don’t fall between two chairs. »

The CISSS is also discussing with the City and the Société de transport de Laval for the development of the cycling network and bus schedules.

“The City is beginning to develop a strategic plan for sustainable mobility. Considering that the CISSS is the largest employer in Laval, we are an almost essential partner,” says Guillaume Charest-Hallée, planning, programming and research officer at the CISSS. A carpooling system is also planned.

“Employees are becoming more and more aware. We have demand, but also a lot of ideas,” says Mr. Lalonde. “The sustainable development committee is not there to provide all the solutions, but to provide a reflex. If we can imbue that in the culture of the organization, we will have come a long way. »