Award-winning Green team putting the planet at the centre of critical care
Unafraid to question how things are done and to drive change that values both their patients and the planet, the award-winning Green ICU Team are successfully reducing waste, conserving energy and making financial savings.
Each year around 1,200 critically ill patients are admitted to the Adult Critical Care Unit at University Hospital of Wales. Often on ventilators, being fed through a tube and requiring round-the-clock monitoring, the resources required to care for some of the sickest patients in the hospital are considerable.
In this setting it would be easy to give up on eco-friendly concerns. But a team of clinicians and managers called ‘The Green ICU Team’ are seeking to put environmental sustainability at the centre of critical care. By steadily implementing a whole raft of changes over the past five years, plastic waste within the unit has reduced by around 2 tonnes per year with tens of thousands of pounds in expenditure saved.
Globally Responsible Wales Award
In June, the seventeen members of the Green ICU Team were rewarded for their efforts winning the Globally Responsible Wales Award in the NHS Welsh Sustainability Awards. Talking about the award, the Chair of the Green ICU Team Jack Parry-Jones, Consultant in Adult Intensive Care Medicine said: “The competition was stiff but I think the judges liked that we’d implemented a range of things and it was a team, rather than individual effort.”
Jack said: “There is that thing in athletics called the ‘accumulation of marginal gains’. That is what we do. You could argue ‘what’s the point?’, but if we all said that nothing would ever change. We all need to add those little gains together. When you add them up, they do make a difference.”
These marginal gains include
unplugging machines that aren’t being used once they’ve reach full charge
not disposing of ventilation bags that are unopened in the treatment of a patient
arranging for the recycling of bottles used to feed patients
patients now drinking tap water instead of sterile water
follow up clinics being run virtually
installing LED lighting
standardising the amount of ventilation tubing provided for each bed space.
Jack said: “There is a culture you need to change, so it’s not as quick as putting a policy in place and expecting it to change overnight. It will take time. The thing about sustainability is that people want to do the right thing, but either they don’t know how or there are disincentives to doing it. I think some of it is around education, some of it is just making it easier to do the right thing and some of it is just banging on and on and on about it!”
The Green ICU Team’s strength is in their diversity of roles, from nurses to pharmacists, dietitians and doctors. Jack said, “A really useful thing about having a multidisciplinary team is that we have a number of projects on the go at the same time.”
The involvement of the unit’s Procurement Manager Ian Sidney has been key. Jack explains. “At least 60% of sustainability is related to procurement.” Critical Care Nurse and Quality and Safety Lead Hayley Valentine has also made a big difference. Jack said: “Most of our workforce are nurses. There are over 300 critical care nurses. Sensible policy and implementation can make a big difference but it does need someone high up who is respected and can lead the change.”
Gloves Off campaign
One of the changes being piloted is the Gloves Off campaign, which aims to reduce the amount of non-sterile gloves worn. During the pandemic the use of these gloves increased as did the cost. While the gloves are useful when staff are at risk of coming into contact from bodily fluids or chemicals, they are not needed in many other interactions. Counterintuitively wearing the non-sterile gloves can increase the risk of infection as they deter hand washing.
Jack said, “People wear gloves and don’t wash their hands. There is the tendency to think the more you do the better but actually it’s not. During COVID we were spending nearly £400k a year on non-sterile gloves. Now it’s around £110k. We looked at how often we should be wearing them, and we wear them about 50% more than we should. With the Gloves Off campaign we should be able to save around £50k.” This equates to a plastic saving of around 30 pairs of gloves per patient per day.
Beyond the unit
The Green ICU Team is active in sharing its learning and recently encouraged the Critical Care Network in Wales to adopt sustainability as one of their top priorities for the year in the hope that changes will be rolled out across the country.
As well as looking at changes to practices in the unit, the Green ICU team are also inspiring colleagues to look wider, such as how they travel to work, car-sharing and involvement in a tree planting project.
Jack said: “I wanted to commemorate the staff, patients and relatives during the pandemic so we raised money in conjunction with the charity Stump Up for Trees. We raised £5,000 and used that money to plant 1500 trees, five native species, in the Brecon Beacons. We planted the trees and look after the trees, and the charity looks after the land.”
For Jack, who grew up in the countryside, biodiversity in Wales is a motivating passion. “We are ruining biodiversity – our rivers, our sea and the countryside. We want people to survive critical illness in a country worth living in.”