Patient care pathway (standard care versus intervention)

I had a discussion with the Health Foundation (https://www.health.org.uk/) a couple of years back specifically on the asthma pathway and differences between 'good' and 'poor' outcomes for patients - a paper has been published by Alex Wilkinson since (https://thorax.bmj.com/content/79/5/412). There was some similar work on diabetes outcomes, but Ive not seen it published anywhere.

I think it would be pretty impressive if the all the NICE guidelines were carbon footprinted... Then hotspots within the whole pathway could be identified and creative solutions found

Hi Mel,

The Sustainable Healthcare Coalition have produced thorough guidelines on how to perform this - ranging from high-level appraisal to granular analysis. We have a new webpage showcasing all of this (DOI - I work for them and have been involved in the process!). We also have a new pathway carbon calculator in the works (due for release next 6-8 weeks), though this will be for high-level appraisals only.

https://shcoalition.org/patient-care-pathways/

We are actually looking for collaborators to work on pathway case studies with us - this was something I was going to advertise through the networks next week.

Please drop me an email - rose@shcoalition.org

I think that these studies would be very important, particularly for conditions where disease prevention outside of the medical system (eg primary cardiovascular disease prevention) is an effective option. But, there are a lot of analyses, based on a lot of assumptions, that may need to be done.

Another approach may be more feasible if studied empirically at a community level
eg
i) communities in cohort A treat predisposition to poor outcomes of disease X by best practice guidelines (which focus on one individual patient and are blind to outcomes in diseases W, Y and Z), vs
ii) communities in cohort B treat predisposition to disease X by community wide interventions (effectively outside of a traditional healthcare system enhancing access to good, planet friendly, food, activity, socialization) which also, incidentally or otherwise, reduces predisposition to diseases W, Y and Z.

Which communities more effectively reduce disability adjusted life years for a given level contribution to global energy and resource, compared to baseline, after 5 years, after 10 years?

I'm a licensed, certified (ANFT), (Forestry England) Forest Therapy Guide. My work in the Forest of Dean is seen as a structured nature intervention based on Forest Bathing - a slow, inclusive sensory walking practice which has come from Japan where it's called Shinrin Yoku . There's lots of research around the benefits of this practice.

That is interesting Carina. I searched Shinrin Yoku in PubMed and found a lot of articles as you suggest. Can you highlight the top ones in terms of your perspective and/or an epidemiologic approach? ie forest proximity as a determinant of health?