A pragmatic quality improvement ‘good enough’ approach to measuring and comparing carbon-footprint savings associated with ‘Go Green’ switching from IV to oral therapy (IVOST) or reducing IV dose frequency

Antimicrobial stewardship (AS) quality improvement (QI) initiatives promoting IV to oral switch (IVOST)1 or reduced IV dosing frequency provide benefits for patients, staff and the environment. To determine if initiatives are effective, we need to measure if improvement has occurred. Measuring carbon-footprint savings can be challenging due to lack of available information on the environmental impact of pharmaceutical products and the time needed to complete a thorough environment impact calculation. Consequently, more pragmatic ‘good enough’ QI indicator measures need to be developed to enable improvement in the environmental impact of QI initiatives promoting reduced IV use to be more easily measured and compared. One such approach would be to remove drug and reconstitution products from the calculation and focus on the equipment commonalities used in the standard process of peripheral IV administration. This approach enables standardized indicator measures for carbon-footprint savings in terms of plastic waste reduction to be developed.