Pediatric Hospital Consortium Achieves Dramatic Reductions In Anesthesia-Related Greenhouse Gas Emissions

Sets Even More Ambitious Sustainability Goal and Calls for All Hospitals to Join Initiative

Seattle, WA /PRNewswire-PRWeb/ - Project Spruce, an international consortium of 9 leading pediatric hospitals, today announced a major milestone in its mission to reduce the environmental impact of healthcare. Through collaborative efforts to improve anesthesia protocols, increase knowledge of the environmental impact of anesthesia, and provide data-driven feedback, the consortium has successfully cut greenhouse gas emissions from inhaled anesthetics by over 50% across its 9 founding institutions. Across the Project Spruce consortium hospitals, these efforts have already prevented over 3,900 metric tons of carbon dioxide equivalents (CO₂e) from entering the atmosphere – equivalent to driving a gas-powered car about 10 million miles (or Seattle to New York 3,500 times).

"The healthcare sector is a significant contributor to climate change, generating 2 gigatons of carbon dioxide equivalents each year," said Elizabeth Hansen, MD, PhD, anesthesiologist at Seattle Children's, associate professor at University of Washington, and founder of Project Spruce. "Inhaled anesthetic agents used during surgeries are particularly concerning, with global warming impacts hundreds to thousands of times greater than carbon dioxide. Our consortium has demonstrated that substantial emissions reductions are achievable through the implementation of evidence-based practices and a collaborative, data-driven approach. I am amazed by the power of our collaboration to make these dramatic reductions, and I'd like to extend an invitation to all hospitals to join in these efforts."

The critical impact of Project Spruce's work is also being commended by The Joint Commission and Joint Commission International. These organizations offer U.S. and international certification programs to recognize healthcare organizations accelerating their sustainable practices. "Project Spruce continues to show leadership in its mission to reduce the environmental impact of healthcare," said Jonathan B. Perlin, MD, PhD, president and chief executive officer of The Joint Commission and Joint Commission International. "The Joint Commission applauds the milestone that Project Spruce achieved through its consortium with children's hospitals around the world to reduce greenhouse gas emissions from inhaled anesthetic gasses."

"Our collaborative, data-driven approach has been instrumental in achieving our emissions reduction goals and fostering a culture of sustainability across our member hospitals," said Diane Gordon, MD, pediatric anesthesiologist of Children's Hospital Colorado and principal investigator of Project Spruce. "We are now extending our goal to a 75% reduction. We know that this target is ambitious, but hospitals in the Project Spruce consortium are making such rapid progress on their emissions reductions that we believe this aggressive goal is achievable. Given the critical importance of addressing the climate crisis from all angles, anesthesiologists must work together to continuously improve our practices to reduce our environmental impact."

According to Health Care Without Harm's 2019 Climate Footprint report, healthcare accounts for 8.5% of U.S. greenhouse gas emissions and 4.4% globally. The operating room is a major emissions hotspot, responsible for up to 40% of a hospital's emissions, largely due to the use of long-lasting anesthetic gases like nitrous oxide.

Launched in 2021, Project Spruce has implemented practice improvements and guidelines around inhaled anesthetic selection and delivery by using a unique data-driven, collaborative methodology. By leveraging real-world data from electronic medical records in partnership with AdaptX, the consortium has had dramatic success in not only identifying but also implementing and sustaining best practices.

Seattle Children's, the founding site, has reduced its anesthesia emissions tenfold by eliminating over 500,000 kg of CO2e annually. Critically, these reductions were accomplished without compromising patient care or outcomes, as consortium institutions were able to use AdaptX's self-serve clinical management solution to continuously assess not just the emissions impact but also the care quality effect of anesthesia protocols.

Project Spruce members have also realized significant cost savings. At Seattle Children's, for example, cost savings are approximately $180,000 per year by increasing inhaled anesthetic efficiency and reduced waste – resources that can now be reinvested into critical patient services.

With healthcare facing increasing pressure from climate change – including spread of disease, heat events, and cardiac and respiratory complications of poor air quality – the Project Spruce consortium aims to drive broader adoption of greener anesthesia practices worldwide. Project Spruce has established a model that brings sustainability considerations into clinical decision-making and developed methods to implement and maintain the clinical practice changes needed to reduce anesthesia's environmental impact. These are significant contributions to the transition toward environmentally sustainable healthcare that is required to tackle this era's greatest public health challenge.

The founding members of the Project Spruce consortium are Akron Children's, Boston Children's Hospital, BC (British Columbia) Children's Hospital, Children's Hospital Colorado, Dayton Children's, Johns Hopkins Children's Center, Nemours Children's Health, Seattle Children's, and The Children's Hospital at Westmead, Australia. Recently, several additional institutions have joined the consortium, and Project Spruce invites all interested hospitals and surgery centers who wish to participate.

Critically, the success of Project Spruce reflects the commitment of both institutional leadership and frontline clinicians across the consortium's member institutions.

"Reducing our environmental footprint is both an ethical imperative and a strategic priority at Akron Children's," said Tarun Bhalla, MD, MBA, FAAP, chief clinical officer of Akron Children's Hospital. "Project Spruce demonstrates that sustainable practices can be quickly implemented at scale without compromising quality or safety."

"Patients and communities are looking to healthcare institutions to lead on sustainability," said Simon Whyte, MBBS, FRCA, FRCPC, head of anesthesia of BC Children's Hospital. "With our established culture of using total intravenous anesthesia, our CO2e was already an order of magnitude lower than many anesthesia departments even before joining this initiative. Nevertheless, involvement has driven us to even further reductions. Our participation in Project Spruce reflects our deep commitment to environmental stewardship."

"Knowing that healthcare is one of the biggest contributors to climate change, it is imperative that we do everything we can to help mitigate these effects," said Nina Deutsch, MD, division chief, perioperative anesthesiology of Boston Children's Hospital. "Our participation in Project Spruce reflects our deep commitment to environmental stewardship."

"The Project Spruce collaboration exemplifies how data and teamwork drive transformative change," said Tom Majcher, DO, clinical director pediatric anesthesiology of Children's Hospital Colorado. "We're proud to be part of this group, showing how data feedback informs and accelerates practice changes that reduce our environmental impact."

"Caring for the children in our community means providing high quality care in our hospitals and clinics, while also being good stewards of our environment and resources," said Katherine DeMasie, MD, chief of pediatric anesthesiology of Dayton Children's Hospital. "Project Spruce proves we can deliver outstanding clinical outcomes while drastically reducing carbon emissions."

"As we bolster resilience to climate change impacts, decarbonizing our operations is mission-critical," said Sapna Kudchadkar, MD, PhD, anesthesiologist-in-chief of the Johns Hopkins Children's Center. "The solutions pioneered by Project Spruce get us closer to net zero healthcare while providing the best perioperative care for children."

"As pediatric anesthesiologists, our mission is to improve the life of our small patients. Project Spruce Forest allowed us to continue this mission by protecting the environment where our patients are going to live," said Judit Szolnoki, MD, anesthesiology chair of Nemours Children's Health, Florida. "Practicing in a sustainable way may be the most profound thing we can do for the future generations."

"As the largest Australian Paediatric Healthcare provider, we have a moral imperative to lead the way in reducing our carbon emissions to ensure a sustainable future for our children and young people who are disproportionately impacted by the effects of climate change," said Kathryn Asher, associate director of strategy and innovation of the Sydney Children's Hospitals Network - Children's Hospital at Westmead. "Project Spruce demonstrates the power of global collaboration in significantly reducing our emissions and maintaining excellent care."

"We are proud to support the work of Project Spruce by enabling participating clinicians to leverage their own anesthesia and outcome data so that they can continuously assess and improve clinical practice," said Warren Ratliff, chief executive officer of AdaptX. " The amazing success of this initiative demonstrates that a highly-collaborative, data-driven approach can quickly transform clinical practice to improve healthcare."

About Project Spruce
Project Spruce (Saving the Planet by Reducing Carbon Emissions) is an international consortium dedicated to reducing greenhouse gas emissions from anesthesia in healthcare. Its member institutions collaborate to develop and share best practices, protocols, and data-driven feedback for minimizing the climate impact of surgery while maintaining exceptional patient care. For more information, visit projectspruceforest.com.