{
  "abstract": "Background Pursuing climate-conscious care has become a key focus of quality improvement (QI) efforts. Hospitals across Alberta, Canada, implemented a multicomponent intervention to reduce unnecessary blood urea nitrogen (BUN) testing. This study evaluated the broader environmental impact of the intervention across multiple hospital medicine settings.Methods Using a pre–post study design, monthly BUN test counts were compared before and after implementing the initiative across six hospital medicine wards to calculate percentage reductions. A secondary analysis assessed the initiative’s environmental impact using the Lab Wisely Carbon Calculator, which converted reduced BUN testing into equivalent travel distances. Avoided carbon dioxide (CO₂) emissions were estimated at 32.1 g/test and tree equivalents were calculated using an annual absorption rate of 21.77 kg CO₂/tree.Results Hospitals showed monthly reductions in unnecessary BUN testing between 51% and 95%, saving an estimated 5101.92 km of travel and avoiding 169.39 kg of CO₂ emissions monthly, equivalent to planting about 93 trees annually. The climate impact varied by hospital, reflecting differences in the intervention strategies used.Conclusions Integrating environmental metrics into QI initiatives offers a strategic path to climate-conscious care, promoting sustainability alongside fiscal responsibility and resource efficiency.",
  "authors": [
    {
      "affiliations": [
        "Alberta Health Services, Edmonton, Alberta, Canada",
        "Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada"
      ],
      "name": "Pamela Mathura"
    },
    {
      "affiliations": [
        "McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada"
      ],
      "name": "Xinyu Amy Shi"
    },
    {
      "affiliations": [
        "Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada"
      ],
      "name": "Sandra Marini"
    },
    {
      "affiliations": [
        "Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada"
      ],
      "name": "Narmin Kassam"
    }
  ],
  "title": "From patient to planet: integrating climate impact into a hospital medicine initiative reducing blood urea nitrogen testing",
  "uid": "b43ce590-00f4-5b4c-ab95-534062ab0809"
}