Cutting out the carbon: creating a paperless occupational health service | Nursing Times

Introduction

With the huge environmental challenges we face globally and in the UK, waste reduction is vital. The positive impact of a paperless system is undeniable. Paper, plastic and water waste is a significant issue, and the logging of forests is often unsustainable and known to destroy natural habitats and disrupt vital ecosystems. The paper manufacturing processes consume vast amounts of water and energy, and contribute to worldwide pollution (World Wildlife Fund, no date).

As an occupational health (OH) advisor with a passion for the environment, in 2020 I introduced an initiative to reduce my department’s waste to achieve a more sustainable workplace. In my previous in-house OH employments, I have always worked with paper records that need several filing cabinets to contain all the documents. I have never worked in a fully digitalised environment and am not aware of any in-house OH departments that are wholly digitalised, so this initiative felt unique.

Aims

Reducing the use of paper not only saves trees, but also conserves the energy used to convert trees into paper, then transport the paper products. Paper manufacturing is a major contributor to environmental pollution due to the production of sulphur oxides, nitrogen oxides, carbon dioxide, greenhouse gases and water pollution (Singh et al, 2022). Just over a quarter of waste dumped in landfill sites are discarded paper and paperboard (The World Counts, no date).

In addition, as paper breaks down, it creates methane – a potent greenhouse gas – and, worldwide, >350 million printer cartridges are sold each year; many are taken to landfill, where the plastic can take up to 1,000 years to decompose (Duke, 2024). I felt that, although my ink cartridge was a small drop in the ocean, reducing consumption would literally help save our oceans.

Implementation

I told my manager in the human resources team about my initiative, emphasising the beneficial outcomes I felt it would have, including improving the department’s productivity. Due to budget restraints, I had to look at the cheapest possible options for it. I worked closely with an administrator, who helped me to digitalise all previous paper-based OH records, which spanned several years. It took a few months to scan all the documents.

“This project was delivered single handedly by a passionate and skilled occupational health nurse. It demonstrated the impact the climate crisis is having on the planet, aligning with One Health principles” Judges’ comment

Outcomes

As a result of the project, we now have a fully functioning bespoke digital system, with minimal waste. I have received excellent feedback and paperless processes are now the preferred method. Not only is a paperless office an important environmental practice, but it has contributed to a more efficient OH department. Our electronic OH system can be accessed with hybrid working, further reducing our carbon footprint by lessening the need for travel to the office for patients and nurses.

In 2023 alone, going paperless saved 10,000 sheets of paper and associated printing. The initiative has resulted in sustainability benefits through reducing printing; this includes reducing electricity use, avoiding use of ink cartridges, and reducing volumes of paper waste produced, saving around 135kg carbon dioxide equivalents every year.

As well as achieving my objective of significantly reducing paper, ink and plastic use, the initiative has also enhanced patient care. It has reduced waste and pollution in other areas, such as petrol consumption, as the OH department can now be accessed off site, which helps people with hybrid working. Sharing, searching and retrieving patient information is now easier, more secure and greener than ever.

The key outcomes of the project were:

• Reduced departmental waste to give a smaller carbon footprint and better sustainability;
• Improved productivity and efficiency for the clinical team by working with a fully digitalised system that can be accessed off site;
• Improved access for patients, so they can send records – such as health surveillance questionnaires –electronically. Patients can also be assessed remotely when needed, ensuring they feel fully supported;
• Contribution to improving sustainability in our workplace;
• Influenced and strengthened Chester Zoo’s policy on sustainability and green issues.

Challenges

An initial challenge was to obtain software for electronic use only. Printing spirometry results, rather than viewing them electronically, has long been the preferred method.

The team also experienced uncertainty from other departments when moving away from previously trusted paper sources of communication. Patients often continued to hand in their health surveillance questionnaires or post them. We tried in many different ways to encourage them to send records by secure electronic means – eventually, the only thing that worked was taping shut the department’s postbox.

Another challenging aspect was time constraints. It was difficult trying to create a bespoke system and convert paper-based records to an electronic format, while fulfilling all aspects of the OH role and the day-to-day running of the department.

Conclusion and future plans

While larger-based clinical settings often have digitalised systems, many smaller clinical settings in nursing are still using paper, without realising the environmental benefits of a paperless system. This initiative is easily transferable to other clinical settings and OH environments. Although digitalisation and change can be nerve wracking for individuals who are accustomed to using paper-based filing structures, documents and methods of communication, this initiative can easily be adopted by anyone with the appropriate – but simple – training with IT.

Colleagues who work as OH advisors in other business settings, such as in a factory, have advised me that they would like to adopt my initiative after the success my department has had. So far, one such setting has started the process. Meanwhile, the system I introduced at Chester Zoo continues to develop, with long-term benefits for the patients, the workplace and the planet in mind.