| Abstrakt: |
Healthcare systems are major emitters of greenhouse gases that contribute to climate change. The resulting climate crisis harms human and planetary health and increasingly impacts lives on Earth. Because of their status as high emitters and their social role in society, healthcare systems have a clear obligation to decarbonise. This study investigates how healthcare systems worldwide can lower their greenhouse gas emissions and thereby contribute to global climate action. We performed a systematic literature review, searching PubMed, GreenFILE, Business Source Complete and CINAHL for relevant empirical studies, non-research papers and grey literature published between 1 January 2018 and 28 March 2023. The Greenhouse Gas Protocol applied to healthcare systems guided thematic and descriptive analyses to explore interventions targeted at scope 1, 2 and 3 emissions. The PRISMA guidelines were followed for reporting and synthesising the results. A total of 742 publications were initially identified, 230 of which were included in the systematic literature review, comprising 96 empirical studies, 132 non-research papers and two governmental reports. Numerous conventional and unique decarbonisation actions related to healthcare have been reported in the literature. Eight themes were identified: transportation, anaesthesia, energy, travel, supply chain, clinical practices, planetary health literacy and system changes. This study shows the abundant potential for healthcare decarbonisation while highlighting key uncertainties around decarbonisation in healthcare and providing ambitious recommendations to lower emissions globally. Decarbonisation actions are needed at the personal, organisational and system levels. The health workforce is vital in driving transformative change but needs to be adequately trained and educated about the importance of low-carbon solutions in healthcare. Countries worldwide must exchange knowledge about successful decarbonisation interventions and best practices to push global progress. Looking forward, action plans and audits at the local level combined with large-scale measures and policies are needed to influence the system as a whole. Plain English summary: Climate change caused by greenhouse gases, which are mainly emitted via the burning of fossil fuels and biomass in the form of carbon dioxide but also include methane, nitrous oxide and fluorinated gases, harms both human and planetary health. Health effects can be direct and indirect and range from infectious to chronic diseases, mental health impacts, malnutrition and forced displacement. Highly developed healthcare systems are crucial for meeting the rising demand for health services related to the climate crisis. However, healthcare systems worldwide have a large climate footprint, and they themselves contribute to this problem. They emit greenhouse gases directly (scope 1) and indirectly (scopes 2 and 3)—most greenhouse gases are emitted through the global healthcare supply chain (scope 3). We reviewed the literature for possible actions that healthcare workers and decision-makers can take to lower the climate footprint of healthcare systems. We found that healthcare system emissions have abundant potential to decrease, for example, by reducing emissions from transportation, anaesthesia, energy, travel, the supply chain and clinical practices. Practical actions at the personal and organisational levels can be supported by promoting the planetary health literacy of healthcare workers, patients and their caregivers and system changes that need to be implemented at a higher level. The health workforce is vital in driving transformative change but needs to be adequately trained and educated about the importance of low-carbon solutions in healthcare. We recommend that countries worldwide exchange knowledge about successful decarbonisation interventions and best practices to push global progress. Future research is needed to substantiate these decarbonisation efforts. However, the time for action is now—and through this research, we hope to empower everyone to take the necessary steps towards a climate-friendly healthcare system. [ABSTRACT FROM AUTHOR] |
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