NIHR Global Health Research Unit on Global Surgery, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
Department of Surgery, Obafemi Awolowo University, Ile-Ife, Nigeria.
BMJ Glob Health. 2024 Nov 7;9(Suppl 4):e015066. doi: 10.1136/bmjgh-2024-015066.
Surgeons, anaesthetists, wider surgical teams and hospital managers are a large global group that has the capacity and power to play a leadership role to contribute to change. Hospitals are a good target for improvement since they are centres of communities, linking together surrounding healthcare facilities and influencing wider determinants of the environment. District and rural hospitals are good sites to start since they serve large populations, have the least sustained energy and clean water supplies and will benefit most from quality improvement. Within hospitals, surgeons and surgical pathways are the ideal places to start decarbonising healthcare. Surgery is a high-resource activity, but it focuses on one patient at a time, allowing measures to be introduced, and their effects closely monitored. Through a mass movement, surgical teams should be able to influence policy-makers for healthcare and industry supply chains, amplifying their effect. This article describes how we can make personal, professional and organisational changes to start creating impact. Change can be hard, especially in healthcare, so this new community needs to blend carbon literacy and behavioural change techniques for success. The article is focused on the front-line team and written by clinician experts in behavioural change and sustainable practice. As such, it will not tackle the technicalities of sustainability and carbon accounting. It intends to challenge individual readers to start making changes now, and to challenge systems leaders to start making larger-scale changes urgently.
外科医生、麻醉师、更广泛的外科团队和医院管理人员是一个庞大的全球群体，他们有能力和权力发挥领导作用，为变革做出贡献。医院是改善的一个很好的目标，因为它们是社区的中心，将周围的医疗设施联系在一起，并影响更广泛的环境决定因素。地区和农村医院是一个很好的起点，因为它们服务于大量人群，能源和清洁水供应最不可持续，将从质量改进中受益最多。在医院内，外科医生和外科路径是实现医疗保健脱碳的理想起点。外科手术是一项高资源活动，但它每次只关注一个患者，允许引入措施，并密切监测其效果。通过大规模运动，外科团队应该能够影响医疗保健和行业供应链的政策制定者，放大他们的影响。本文描述了我们如何能够做出个人、专业和组织上的改变，从而开始产生影响。改变可能很困难，尤其是在医疗保健领域，因此这个新的社区需要将碳素养和行为改变技术融合在一起，才能取得成功。本文侧重于一线团队，由行为改变和可持续实践方面的临床专家撰写。因此，它不会解决可持续性和碳排放核算的技术细节。它旨在挑战个别读者现在就开始做出改变，并挑战系统领导者紧急做出更大规模的改变。
