Implementing leaner, more streamlined patient care pathways can help to reduce the carbon footprint of knee surgery, according to a new study.
A team of GIRFT researchers* analysed data for all 648,861 primary total knee replacements conducted in England between April 2013 and March 2022 for a new study recently published in The Annals of The Royal College of Surgeons of England, entitled Carbon savings associated with changing surgical trends in total knee arthroplasty in England: a retrospective observational study using administrative data.
Over the nine-year study period a number of changes were observed that align with GIRFT recommendations – average length of stay reduced from four to three days, the proportion of patients undergoing knee arthroscopies in the year prior to knee surgery fell from 6% to 0.5%, and the number of early revisions and emergency readmissions also fell.
As well as the benefits of these changes to patient outcomes and improved service efficiency, an association with lower carbon footprint was also noted, with the per-patient carbon footprint reducing from 379kgCO2e to 295kgCO2e over the same period. If all patients in the study had the same carbon footprint as the average patient in 2021-22, 32.4kilotons CO2e would have been saved – enough to power 29,509 UK homes for a year.
These three elements together are often referred to as the green ‘triple bottom line’.
The study concluded that a move to more streamlined care pathways, where unnecessary time and resource waste is minimised, can help support both the NHS’s commitment to reach net zero by 2045 and elective recovery following the COVID-19 pandemic.
* The study was carried out by:
- Elizabeth Ojelade: GIRFT clinical fellow
- Jacob Koris: GIRFT clinical fellow
- Maria van-Hove: GIRFT clinical fellow
- Hasina Begum: NHS England data scientist
- Professor Tim Briggs: GIRFT chair and NHS England’s National Director for Clinical Improvement and Elective Recovery
- William Gray: GIRFT’s academic content lead
