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Area of Science:

  • Environmental Health
  • Medical Education
  • Quality Improvement

Background:

  • Engaging healthcare trainees in climate change mitigation within clinical settings presents significant challenges.
  • Limited research exists on institution-wide graduate medical education (GME) initiatives to involve residents in sustainability projects.
  • The need for practical, scalable solutions to reduce the environmental footprint of healthcare is increasingly recognized.

Purpose of the Study:

  • To pilot a novel, institution-wide, pay-for-performance (P4P) sustainability quality improvement (SusQI) program.
  • To incentivize residents across all GME programs to implement practice-changing SusQI projects.
  • To evaluate the feasibility and impact of integrating sustainability into GME quality improvement efforts.

Main Methods:

  • Residents identified SusQI problems and collaborated with stakeholders to achieve monthly environmentally friendly improvement goals.
  • A financial incentive of $400 was offered to eligible residents who met their monthly goals for six months.
  • Four SusQI projects were approved, with project leaders guiding implementation and monitoring progress.

Main Results:

  • Three of four piloted SusQI projects remained active after six months, despite one stalling due to institutional barriers.
  • Two hundred and ten residents participated, leading to significant environmental improvements: increased low anesthetic gas use (25% to 53%), improved waste sorting (20% to 58%), and increased instrument recycling (9% to 24%).
  • A total of $84,000 was allocated to residents upon successful completion of their SusQI goals.

Conclusions:

  • An institution-wide P4P SusQI program effectively integrated sustainability into GME quality improvement initiatives.
  • The program successfully motivated residents to develop and implement environmentally sustainable clinical practice projects.
  • This model demonstrates a viable approach to fostering environmental stewardship among future healthcare professionals.