Hospital environmental audit and improvement tool: dental hospital case study

Hospitals carry a burden of responsibility for their contribution to climate change and pollution. The Hospital Environmental Audit & Improvement Tool (HEAIT) aims to provide comprehensive hospital-wide stakeholder engagement to mitigate the environmental impacts of hospital activity. HEAIT is a metric-based institutional advocacy tool for auditing, evaluating and improving environmental practice in hospitals. Method: HEAIT was implemented in the Department of Restorative Dentistry, Charles Clifford Dental Hospital (STHNHS Trust), Sheffield, UK. The SQUIRE guidelines have been used to provide a framework for reporting this quality improvement innovation. A thematic scoping review has identified all the environmental impacts arising from the practice of oral healthcare: 124 action statements across 16 specific theme categories. All action statements were coded and categorised according to: (i) Level of importance and environmental benefit (essential, important and aspirational) and (ii) Degree of implementation difficulty (easy, moderate and difficult). Activity in each activity area is audited and graded (point allocation) according to progress that identifies the status of activity, areas for improvement and measurable goals for year-on-year hospital improved performance. Results: The effectiveness of the toolkit was mapped against industry standard audit and improvement parameters. All parameters have been addressed, with identification of required further actions. The calculator was considered compliant against the audit criteria and provided a baseline level of environmental sustainability activity. Conclusion: HEAIT provides an effective and validated way of achieving real engagement of the whole workforce in a meaningful manner to achieve measurable goals as part of a collaborative environmental mitigation strategy.