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Creating and Maintaining a "Climate-Smart" Emergency Department: A Scoping Review of Current Progress and Future Potential.

Introduction: 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 clima...

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Published in:Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health Vol. 27; no. 3; pp. 505 - 512
Main Authors: Moujaes, Lea, Iuliucci, Kayla
Format: research systematic review Journal Article
Published: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health May2026
Online Access:View this record in EBSCOhost
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      dt: May2026
      vid: 27
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      pid: 29816
      pub: Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
      place: Orange, California
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        194736164
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        10.5811/westjem.50597
        194736164
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        atl: Creating and Maintaining a "Climate-Smart" Emergency Department: A Scoping Review of Current Progress and Future Potential.
      aug:
        au:
          Moujaes, Lea
          Iuliucci, Kayla
        affil: Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland.
      sug:
        subj:
          Emergency Service
          Climate Change
          Disaster Planning
          Human
          Scoping Review
          PubMed
          Embase
          Medical Waste Disposal
          Energy-Generating Resources
          Protocols
      ab: Introduction: 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. Methods: 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. Results: 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. Conclusion: 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.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        Journal Article
      ougenre: Article
    language: English
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