NYC Health + Hospitals has reduced annual anesthesia-related carbon emissions 52% systemwide by curbing the use of nitrous oxide — a common anesthetic and highly potent greenhouse gas.
The initiative began in 2022 at NYC Health + Hospitals/Bellevue with a pilot focused on reducing fresh gas flow through clinical education and monitoring. The hospital added best practice advisories to its EHR to prompt clinicians to lower gas flow after induction and transitioned from central piped nitrous oxide to portable tanks, reducing wasteful gas leaks.
The program expanded systemwide in early 2024. Four hospitals — including the system’s Bellevue, Jacobi, Elmhurst and North Central Bronx campuses — have now fully phased out central piped nitrous oxide systems. In total, the New York City-based health system estimates it has prevented more than 5,000 metric tons of carbon dioxide-equivalent emissions.
The initiative is part of NYC Health + Hospitals’ Climate Resilience Plan, which aims to cut overall carbon emissions by 50% by 2030.
“Together, we’ve proven that with small changes we can achieve huge results,” Leonard Golden, MD, chair of anesthesiology at NYC Health + Hospitals/Jacobi and North Central Bronx, said in an April 16 news release. “We will build off of the success of our work and share it with our peers across the city and country to demonstrate that you can shut down central nitrous oxide supply systems with very little change to clinical practices or impact to patient health.”
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