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{
    "pk": 50597,
    "title": "Creating and Maintaining a “Climate-Smart” Emergency Department: A Scoping Review of Current Progress and Future Potential",
    "subtitle": null,
    "abstract": "<p><strong>Introduction:</strong> Climate change represents one of the most significant global health threats, with emergency departments (ED) serving as frontline responders to climate-related health emergencies. While EDs are major contributors to healthcare’s environmental footprint and critical responders for climate disasters, no comprehensive review has examined sustainability and climate-resilience initiatives specifically implemented in ED settings.</p>\n<p><strong>Methods: </strong>We conducted a scoping review examining literature on sustainable and climate-resilient measures in EDs. Comprehensive searches of PubMed, Scopus, and Embase were performed from inception through November 2024, using terms related to EDs combined with sustainability and climate-resilience concepts. Two reviewers independently screened papers, with inclusion criteria requiring ED-specific focus and concrete sustainability or resilience interventions.</p>\n<p><strong>Results:</strong> Seven studies met inclusion criteria, representing diverse geographic contexts. Three addressed sustainability interventions including waste reduction, sustainable procurement, device reprocessing, and renewable energy adoption. Case examples demonstrated co-benefits, such as 31% reduction in ambulance carbon dioxide emissions and $3 million savings from device reprocessing programs. All studies described resilience interventions encompassing disaster preparedness, surge capacity, infrastructure continuity, and clinical protocols. However, significant gaps were identified: Only 13-20% of hospitals in surveyed countries had disaster plans, and no studies documented fully operational climate-smart EDs. Global frameworks were referenced but not operationalized in ED settings.</p>\n<p><strong>Conclusion: </strong>There is a limited body of peer-reviewed studies that describe measures to close the implementation gap between current climate science and operational practices in EDs. Despite extensive policy recommendations and demonstrated benefits, no studies have described any existing programs. Emergency medicine requires translation of conceptual frameworks into measurable interventions, standardized outcome measures, and systematic implementation of climate-smart healthcare practices.</p>",
    "language": null,
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [],
    "section": "Climate Change",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/2s697442",
    "frozenauthors": [
        {
            "first_name": "Lea",
            "middle_name": "",
            "last_name": "Moujaes",
            "name_suffix": "",
            "institution": "Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland",
            "department": ""
        },
        {
            "first_name": "Kayla",
            "middle_name": "",
            "last_name": "Iuliucci",
            "name_suffix": "",
            "institution": "Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland",
            "department": ""
        }
    ],
    "date_submitted": "2025-09-25T18:58:49.338000+03:00",
    "date_accepted": "2026-01-03T00:26:26.576000+03:00",
    "date_published": "2026-05-04T05:58:00+03:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/50597/galley/50332/download/"
        }
    ]
}