Department of Family Medicine, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada.
Fam Pract. 2023 May 31;40(3):473-485. doi: 10.1093/fampra/cmad006.
There is a pressing need for healthcare to respond to the climate crisis. Family physicians, given their central role in community healthcare provision, are strategically placed to lead, support, and promote sustainable healthcare, yet guidance on how to do this is fragmented.
To identify and evaluate toolkits and aids on sustainable healthcare to act as a curated resource for family physicians and their care teams interested in delivering evidence-based sustainable healthcare in their clinical practices.
A scoping review was completed of the published and grey literature across 4 databases and 2 search engines to identify articles and aids/toolkits from 1990 to present. Toolkits were subsequently evaluated for purpose, evidence-base, implementation process, adaptability to family medicine, and outcome measures.
The search identified 17,751 articles. Screening resulted in 20 published articles and 11 toolkits. Most articles presented simple checklists to support greening clinic initiatives, 3 studies focussed on partial carbon footprint analyses, and 4 on educational initiatives. Toolkits ranged in sustainability topics and degree of depth covered, and adaptability and outcome measures. None of the resources identified have been formally evaluated for effectiveness.
A range of aids exist to support greening of clinic operations; however, there is a significant gap in the literature for greening clinical care. Two toolkits were found to be comprehensive, one requiring tracking and reporting of sustainability initiatives. This scoping review provides a starting point for motivated family doctors and community clinics to initiate change and support more sustainable healthcare.
医疗保健迫切需要应对气候危机。家庭医生在社区医疗服务中发挥着核心作用，他们具有战略性地位，可以领导、支持和促进可持续的医疗保健，但关于如何做到这一点的指导意见却很零散。
确定并评估可持续医疗保健工具包和辅助工具，为有兴趣在临床实践中提供基于证据的可持续医疗保健的家庭医生及其护理团队提供一个精选资源。
对 4 个数据库和 2 个搜索引擎中的已发表文献和灰色文献进行了范围综述，以确定 1990 年至今发表的文章和辅助工具/工具包。随后，对工具包的目的、证据基础、实施过程、对家庭医学的适应性和结果衡量标准进行了评估。
搜索共确定了 17751 篇文章。筛选后得到 20 篇已发表文章和 11 个工具包。大多数文章提供了支持绿色诊所倡议的简单清单，3 项研究侧重于部分碳足迹分析，4 项研究侧重于教育计划。工具包涵盖的可持续性主题和深度范围以及适应性和结果衡量标准各不相同。没有一个确定的资源已被正式评估其有效性。
有一系列辅助工具可用于支持诊所运营的绿化；然而，在绿化临床护理方面，文献中存在着显著的差距。发现了两个全面的工具包，其中一个需要跟踪和报告可持续性倡议。本范围综述为有积极性的家庭医生和社区诊所提供了一个起点，以启动变革并支持更可持续的医疗保健。
