How an Audit-and-Feedback-Based Educational Program Contributed to a Reduction in Environmentally Harmful Waste...

Area of Science:

• Environmental Science
• Medical Education
• Anesthesiology

Background:

• Waste anesthetic gases (WAGs) are significant contributors to greenhouse gas emissions.
• Current anesthesiology residency programs lack comprehensive education on mitigating WAG-associated environmental impact.
• A novel electronic audit-and-feedback system was developed to educate residents on reducing fresh gas flow (FGF) and subsequent WAG emissions.

Purpose of the Study:

• To evaluate the efficacy of an electronic audit-and-feedback program in reducing FGF and WAG emissions among anesthesiology residents.
• To assess resident engagement and motivation regarding practice changes prompted by the educational program.
• To extrapolate the potential annual environmental impact reduction based on resident performance.

Main Methods:

• Anesthesiology records from 2020-2021 were analyzed to extract resident case data, FGF, and anesthetic choices.
• Forty residents across three training years received weekly personalized FGF data and WAG emission reports.
• Resident FGF was benchmarked against a low-flow standard (≤1 LPM) and peer performance, with post-rotation surveys assessing attitudes.

Main Results:

• Residents achieved a significant 22% reduction in mean FGF from their first to last rotation week (1.83 to 1.42 LPM).
• The program demonstrated a statistically significant decrease in FGF (P<.0001).
• Individual performance feedback was the primary motivator for practice change, cited by 56% of surveyed residents.

Conclusions:

• The audit-and-feedback educational model effectively promoted climate-conscious anesthetic practices among residents.
• This intervention successfully reduced fresh gas flow and, consequently, waste anesthetic gas emissions.
• The findings support the integration of such programs into anesthesiology training to foster environmental responsibility.