Measuring environmental impact

On this page

When measuring your project’s environmental impact, focus on data that shows both the benefits and any unintended consequences. You don't need to collect every type of data, only what gives you a clear picture.

Choosing what to measure

The simplest way to measure environmental impact is to count the resources used in a set timeframe, before and after the change.

You can include environmental measurements for any of your family of measures:

  • Outcome measures: progress towards your overall goal.
  • Process measures: steps in the process; is the improvement being implemented as planned?
  • Balancing measures: unintended consequences or knock-on effects on other parts of the service.

When you map the process you want to improve, identify where resources are used. You may need resources at different stages, and extra resources to transition to the change.

When low value care is prevented or reduced

Environmental impact can be measured by tracking resources when low-value and unnecessary care is prevented and appropriately reduced.

ResourceMeasurement options

Procedures

Number of procedures appropriately avoided (For example, 35 spinal surgeries/year)

Diagnostic tests and monitoring

Number of tests appropriately reduced/avoided (For example, 129 MRIs/year, 22 blood and other pathology tests/week)

Appointments

Number of clinic appointments (For example, 87 physiotherapy appointments/year)

Hospital stays

Bed days (For example, 5 ICU bed days/patient)

Medical supplies not included in any of the above

Number of items required (For example,10 medications/week)

When high value care is required

Environmental impact can also be measured by tracking resources used during high-value care.

Resource

Measurement options

Medical supplies

  • Number of items required, such as 20 cannulas/day
  • Financial cost, for example $300/month
  • Weight of supplies, for example 1kg/month

Non-medical supplies

  • Number of items required, for example uniforms/year
  • Financial cost, for example $200/week
  • Weight of supplies, for example 2kg of paper/month

Waste disposal

  • Bags of waste, for example 2 bags of waste/day

Travel (staff, patients, carers)

  • Km of travel (state mode of travel), for example 200km/week by car

Energy

  • kWh electricity (maintenance departments can often provide this information)

Water

  • Litres of water (maintenance departments can often provide this information)

Carbon footprinting

Everything we use in every part of healthcare contributes to greenhouse gas (GHG) emissions, which cause global warming. A carbon footprint measures the total GHG emissions of a product, process or organisation, reported in kilograms of carbon dioxide equivalent (kg CO2e).

Carbon footprinting accounts for every input that contributes to emissions. This gives a more accurate picture of environmental impact than the resource counts above. It is also more time-consuming and complex.

Most local quality improvement projects do not need this level of detail. For complex carbon footprinting or to join the NSW Health Sustainability Network, email moh-netzero@health.nsw.gov.au

Measurement examples

Keep our communities healthy

Prevention initiatives have a positive environmental impact by reducing illness and avoiding the environmental costs of care. Examples include:

Reduce low-value and unnecessary care

Reducing low-value care avoids the environmental impact associated with that care.

  • Reusable sterilised holloware in operating theatres (South Eastern Sydney LHD): A pilot project introduced reusable polypropylene bowls, kidney dishes and gallipots to replace single-use holloware. It saves around 7 tonnes of CO₂e and diverts more than 4 tonnes of waste from landfill annually.
  • Blister pack recycling program (Western NSW LHD): A ward-based education program at Bathurst Hospital improved pharmaceutical waste segregation, increasing staff knowledge and capability to manage blister pack waste.

Reduce emissions in high-value care

Reducing resource use when providing high value care is another way of reducing environmental impact.

The Kneed to Succeed project aimed to reduce waiting times in a physiotherapy outpatient department by moving from individual appointments to group-based therapy for patients after knee replacement surgery. To fit group classes, all patients were treated at a single site rather than two. Equipment did not change. Environmental measures included:

  • Number of appointments required before and after the change (process measure)
  • Approximate travel of patient and staff before and after the change, measured in kilometres and mode of travel (balancing measure). A random sample of patients could be selected before and after the change to calculate average travel distance.

Average patient travel is likely to increase after the change, while appointments and wait times decrease. Travel could be monitored as the program grows, with planning to deliver similar classes at the second site so more patients can access care closer to home.

Documenting your measures

Include environmental measurements in your project documentation, in both the description of the problem and the results.

Document the three cost dimensions together (financial, environmental and social) alongside your clinical outcomes. This combined view, sometimes called the triple bottom line, ensures gains in one area are not at the expense of another.

Find your local sustainability lead

For support with environmental sustainability in your quality improvement project, contact your local sustainability lead. If your local team is not listed, email the Climate Risk and Net Zerot team at moh-netzero@health.nsw.gov.au for more information.

 
Back to top