Photo (left to right): Members of the BC Cancer Planetary Health Unit, led by diagnostic radiologist Dr Maura Brown, radiation oncologist Dr Shilo Lefresne, and medical oncologist Dr Caroline Mariano.
Medical oncologist Dr Caroline Mariano and the BC Cancer Agency's Planetary Health Unit have eliminated exam table paper waste across four regional outpatient centers.
The project has saved $3,974 annually in health care costs, while reducing carbon emissions by 32,501 kilograms. That translates to driving about 130,000 kilometres in a gas-powered car.
The low-barrier change can be used in many health care settings. Instead of table paper, disinfectant wipes are used to clean tables between patients, while effectively maintaining infection control standards.
Promoting environmental sustainability in health care
The BC Cancer Agency (BCCA) Planetary Health Unit is a clinician-led initiative that promotes low-carbon, low-waste, and high-quality sustainable health care practices.
Sessional funding for medical staff involvement is provided by the BC Cancer Medical Staff Engagement Society through Facility Engagement, an initiative of the Specialist Services Committee and joint partnership of Doctors of BC and the Government of BC. The work is further supported by BC Cancer's senior leadership team.
The group notes that health care contributes to about five percent of global greenhouse gas emissions; with the production, transport, and disposal of medical goods making up 60 to 80 per cent of health care emissions.
Challenging outdated practices
The use of thin white paper that covers examination tables is a common practice entrenched in outpatient clinics and other health care facilities.
A roll of paper attached to the table is changed after each patient, and although it may be recyclable, it is typically discarded in the regular garbage due to concerns about microbial contamination.
Despite giving the impression of a sterile environment, the paper does not protect the surface from microbial contamination.
Instead, infection control guidelines suggest that disinfecting surfaces is more effective.
Engaging for change
Dr Mariano engaged with a multidisciplinary team at BCCA’s largest outpatient facility in Vancouver to implement a new protocol where exam tables are cleaned with disinfectant wipes between patients instead of using table paper.
They used quality improvement methodology to plan, test, standardize, and validate the change in Vancouver’s 80 exam rooms and three additional clinics in Kelowna, Victoria, and Surrey.
For patient comfort, information posters were placed in examination rooms, and table paper is still available upon patient or health care provider request.
The initiative is one of many examples of BCCA medical staff and physicians across BC who are engaging as leaders in planetary health with environmentally-sustainable daily practices.
"We did want to put it out there so that other organizations could take this and say, listen, this is an organization that has a big cancer population, immunocompromised patients, and we were able do this in prevention and save both carbon and money.” – Dr Caroline Mariano
READ MORE
- BC Medical Journal – July-Aug 2024: Eliminating the routine use of examination table paper in outpatient oncology clinics
- CBC – July 12, 2024: BC Cancer eliminates exam paper, saves 32 tonnes of emission
- BC Cancer Agency Planetary Health Unit
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