Cardiology Can Become More Environmentally Sustainable While Maintaining Quality Patient Care
Cardiology can become more environmentally sustainable through targeted interventions that reduce carbon emissions and waste without compromising patient outcomes, and in many cases, these changes may actually improve quality of care and reduce costs. 1, 2
Current Environmental Impact of Cardiovascular Care
Cardiovascular disease is the leading cause of morbidity and mortality worldwide, consuming substantial healthcare resources for diagnosis and management. The environmental footprint of cardiology practice includes:
- High energy consumption from imaging equipment and facilities
- Significant waste production from single-use items and packaging
- Water pollution from contrast media and pharmaceuticals
- Carbon emissions from patient travel and supply chains
Evidence-Based Sustainability Strategies
Diagnostic Testing
- Prioritize lower-emission imaging modalities: Echocardiography produces only 1-20% of the carbon emissions of cardiac MRI or SPECT scanning when clinically appropriate 2
- Implement focused imaging protocols to reduce scan time and energy consumption 3
- Power down equipment when not in use rather than leaving it in standby mode 4
- Develop iodine contrast media recycling programs for cardiac CT 3
Patient Care Models
- Implement patient-centered medical homes for cardiovascular care (PCMH-CVD) that reduce unnecessary hospital visits and readmissions through coordinated care 5
- Utilize remote monitoring for pacemaker devices and teleconsultations when clinically appropriate 2
- Develop electronic communication systems between care team members and patients to increase access and reduce travel-related emissions 5
Procedural Sustainability
- Minimize reliance on single-use items where clinically safe alternatives exist 4
- Implement rinsing of bypass circuitry after cardiac surgery to reduce waste 2
- Collaborate with industry partners to reduce excessive packaging 4
- Establish recycling programs for appropriate medical waste 4
System-Level Changes
- Incorporate environmental sustainability as a quality metric in departmental quality improvement programs 4
- Develop standardized information systems to assess quality at the population level 5
- Foster organizational cultures that value sustainability alongside clinical excellence 5
- Consider environmental impact in procurement decisions for equipment and supplies 1
Co-Benefits of Sustainable Cardiology
Implementing environmentally sustainable practices in cardiology offers multiple co-benefits:
- Economic: Reduced costs through energy conservation, waste reduction, and more efficient care delivery 2
- Clinical: Improved coordination of care, reduced readmissions, and better patient outcomes 5
- Social: Less time away from work for patients and caregivers through more efficient care models 2
Barriers and Challenges
- Lack of awareness among healthcare providers about environmental impacts
- Financial considerations and initial investment costs
- Absence of regulatory frameworks and industry standards
- Resistance to changing established clinical workflows
Implementation Framework
- Assess: Conduct baseline environmental impact assessments of cardiovascular services
- Prioritize: Identify high-impact interventions that maintain or improve clinical outcomes
- Implement: Start with changes that offer clear co-benefits (cost savings, improved efficiency)
- Measure: Track environmental metrics alongside clinical outcomes
- Refine: Continuously improve based on data and emerging evidence
Conclusion
The evidence strongly suggests that cardiology can become more environmentally sustainable while maintaining or even improving patient care. By prioritizing lower-emission diagnostic modalities, implementing coordinated care models, reducing procedural waste, and fostering a culture of environmental responsibility, cardiovascular care can reduce its environmental footprint while continuing to deliver excellent clinical outcomes.