Call to action by SPA's Sustainability Special Interest Group
The Society for Pediatric Anesthesia has formed a Special Interest Group for Sustainability which brings together pediatric anesthesiologists with a passion for learning, teaching, and practicing ways to reduce the environmental impact of anesthesia and the wider operating room environment. I received this announcement and wanted to share it with all of you. Myron Yaster MD
We are thrilled to invite all of you to consider participating in a multi-institutional quality improvement project to reduce anesthesia green house gas (GHG) emissions called Project SPRUCE Forest. We will use implementation science methods to achieve or surpass our goal of 50% reduction in GHG emissions in each participating center over 12 months. We are pleased to share that Dr.Lynn Martin (Professor of Anesthesiology and Pain Medicine and former president of SPA) has agreed to serve as our mentor for this project. Working together we will use proven strategies that include:
Practice constraints (e.g. removal of desflurane vaporizer, disconnection of wall nitrous oxide)
Nudges and default choice changes to support conversion to low-flow induction and maintenance of anesthesia (lower default fresh gas flows, clinical decision support tools, EMR-based alerts)
Educational interventions (shared literature and departmental presentations)
Protocol changes to increase utilization of IV inductions and total IV anesthetics
Tracking and sharing results in real time
Participation in monthly virtual meetings to discuss implementation strategies, to track progress, and review barriers to implementation
Then we will:
Present and publish our findings as a consortium (more details to come later)
Celebrate the huge win for the planet!
To participate, you will need to:
Identify a local Principle Investigator (PI) for each center
Obtain support from your local QI leader(s) and chair/division chief
Allow the PI to participate in monthly virtual consortium report out meetings and semi-annual meetings (at SPA) for the duration of the project
Purchase AdaptXTM software solution (we have negotiated a discounted rate for this project and have applied for grant funding support)
Additional required support from each participating center may be identified as additional planning is completed
Technical and time requirements:
Use an EMR that captures data from the anesthesia machine (fresh gas flows) and monitors(exhaled anesthetic gas measurements)
Secure hospital IT support (approximately 30-35 hours initial work) to generate a flat file of OR data with specific data fields that will be automatically extracted to create a daily data feed. We will provide a list of needed data fields. Each institution’s data feed will be ingested by AdaptXTM , hosted on a HIPAA compliant cloud server (Amazon Web Services), accessible to the Consortium leaders and the anesthesia team members within their respective institution.
Data fields will be used to calculate generated kg CO2e/min (we will provide code for this). Automated analyses of CO2e displayed as continuously updated statistical process control charts, stratified by surgery specialty, type of procedure, anesthesiologist, etc will be available via AdaptXTM
PI must be able to devote 5-10 hours per month to this project
Monthly report out to the consortium on project status and progress via video calls
Please reply to Dr. Liz Hansen (elizabeth.hansen@seattlechildrens.org) and Dr. Diane Gordon (Diane.Gordon@childrenscolorado.org) with interest!
We will hold an informational Zoom call on October 3: 4pm PST/5 MST/6 CST/7 EST
We will also meet in person in New Orleans at SPA (10/22 or 10/23) to discuss the project further. October 23, 11:30-12:30 Westin Hotel
Please forward to anyone else who might be interested!
Liz Hansen & Diane Gordon