Consultant anaesthetist Matt Jenks first developed an interest in sustainability in health care when he saw the amount of waste that went into rubbish bags after every anaesthesia case.

“I was slightly horrified,” he says. “I started off looking at waste reduction in the operating theatre, but I soon realised that the biggest threat to population health is climate change. Health care is a huge contributor to that problem – it’s responsible for up to 4-9% of a country’s greenhouse gasses.”

In 2018, Matt calculated SDHB’s carbon footprint, and since then has been working with others in the organisation to improve high carbon areas. One of the biggest is medical gases like nitrous oxide, at about 12%.

While nitrous oxide is a safe and effective anaesthetic, analgesic agent and sedative, it is also an ozone-destroying greenhouse gas. It is 265 times as potent a greenhouse gas as carbon dioxide and remains in the atmosphere for over 100 years.

In collaboration with the Project Management Office, Matt has been working on a more sustainable way to deliver nitrous oxide within the new hospital.

Currently, Dunedin Hospital has a bank of large nitrous cylinders with pipes reticulating it to where it’s used. However, reticulation requires significant monitoring and maintenance to minimise wastage.

“In the new hospital, only the maternity unit will retain a reticulated system, while other areas will use nitrous oxide cylinders,” Matt explains. “As far as I’m aware, we’re the first major hospital build that hasn’t reticulated operating theatres. It’s a fairly innovative thing to do – we are at the forefront.”

Because nitrous oxide can result in negative health impacts to staff who are regularly exposed to it, the new hospital will also utilise a process called scavenging.

“Scavenging involves the use of masks or nose pieces to collect exhaled gas and vent it,” Matt says. “This will make it safer for staff as there will be less nitrous oxide in rooms.”

There is emerging technology that separates the gas into oxygen and nitrogen so it can be safely released into the air. These units are now widespread in Scandinavia, are being introduced in the UK and trialled in Australia.

“Including a scavenging system in the new hospital means we can use one of these units when they become available in New Zealand, which is really exciting,” says Matt.

When he isn’t championing sustainable initiatives in health, Matt enjoys the collegiality of working within operating theatres, which allows him to interact with a broad group of people and specialties.

“I really enjoy working with the people here at SDHB,” he says. “It’s great to work with people who are really good at their jobs and dedicated to looking after people.”

With that in mind, it makes sense that Matt’s favourite SDHB value is kind / manaakitanga.

“When you see kindness demonstrated to patients – and when you can deliver that yourself – it’s the most important thing,” he says.

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