E2A: Green Team

Should we create a Green Team at our office? The pros and cons.

Here is a vodcast that walks you through starting to ‘green’ your clinic. Based on our 2023 scoping review¹ and the efforts of the Central Family Medicine and South Health Campus Teaching Clinics we developed the following playbook.

How to Initiate the ‘Greening’ of Your Community Medical Clinic – A Playbook

The Playbook

This “Greening Playbook” is based on efforts and changes made at the Central Family Medicine Teaching Clinic (CFMTC) located in downtown Calgary. It is designed to centre Planetary Health in clinical and teaching practice. The Playbook is informed by a scoping literature review that maps out toolkits and practical aids available to support family physicians and primary care clinics in making their operations and clinical care more environmentally sustainable (Wicklum et al., 2023).

The Greening Playbook provides a clear, step-by-step approach to integrating sustainable practices within your clinic. The Playbook offers strategies to initiate conversations about sustainability within your clinic, build momentum and increase engagement so you can establish a high-functioning Green Team. Whether you are just beginning to explore sustainability within your practice or looking to enhance existing efforts being made within your clinic, this Playbook offers practical guidance to support meaningful long-lasting change.

Follow along, through the table of contents for the steps needed to help ‘green’ your clinical practice. Resources are available in the Appendix and are also linked throughout this document.

If you need guidance of any kind, please email ug**@******ry.ca

You can also download the Playbook in its entirety below.

Appendices will also be available as separate documents throughout this page.

Step 1: Educate your staff about Planetary Health

Objective: Educate all clinic staff about the principles of Planetary Health (PH), the importance of sustainable practices in healthcare and motivate them to make a difference!

Invite staff to a PH educational opportunity

Choose one of:

Hold a group meeting to watch the videos and vodcasts on the Planetary Health website, then discuss them together
Send an email asking staff to watch the videos independently and complete the task by a specified date
Alternatively, request a live or virtual presentation from a Planetary Health presenter; contact our department for a list of available presenters

An example of an email invitation is available in Appendix A: Email invite to all staff education

Step 2: Survey staff to assess interest

Objective: Gather insights and feedback from staff on their awareness, attitudes, and suggestions about sustainability in the clinic

Steps:

Decide whether you will use the example survey in Appendix B ‘as-is’ or adapt it for your clinic
Decide how you will distribute the survey (paper format or online format, or both)
Set a completion deadline
Distribute the survey and include an explanation of how the results from the survey will help guide your future Green Team’s work
Review the survey results and share these key themes at the next Green Team meeting!

Find a sample of a survey in Appendix B: Staff Interest Survey

Step 3: Establish a “Green Team”

Objective: Establish a dedicated team responsible for driving and overseeing greening initiatives in the clinic

Steps:

Green Team Formation:
1. Invite interested staff from all departments to join the Green Team
2. It is essential to ensure diverse representation in your Green Team, to capture different perspectives across clinic operations
3. Encourage collaboration but allow individuals to volunteer for projects that match their own interests, strengths and what they are most passionate about
Initial Meeting:
- Discuss the Green Team’s goals and objectives
- Assign specific roles and responsibilities to team members
- Develop a preliminary action plan for implementing sustainable practices
- Start with small but measurable projects! Think SMART Goals! (Specific, Measurable, Achievable, Relevant, Timely)
- Determine how often the team will meet, even if that is reserving 5–10-minute allocated timeslot in each staff meeting
- Follow-through, achieve this by tracking actions and revisiting them at future meetings

Step 4: Develop a Planetary Pledge

Objective: Collaboratively create a clear, concise and actionable clinic-wide commitment to sustainability, that all staff members can support and adhere to

Steps:

Draft the Pledge:
1. Work collaboratively within the Green Team, to draft a pledge that outlines the clinic’s commitment to Planetary Health and specific sustainable practices
2. Ensure the pledge is clear, concise, and actionable
  1. A sample pledge is available in Appendix C: Example of Planetary Pledge
Review and Finalize:
1. Share the draft pledge with all staff for feedback and suggestions
2. Incorporate any necessary changes and finalize the pledge
Adoption and Promotion:
1. Have the pledge ready for signing at your quality improvement session (see below)
2. Officially adopt the pledge
3. Encourage all staff to sign the pledge as a visible sign of their commitment
4. Display prominently in the clinic

Step 5: Schedule a Sustainability in Quality Improvement (SUSQI) Session

Objective: Ensure that all staff feel included in the clinic’s greening efforts, even if they aren’t part of the Green Team, and identify Planetary Health projects that are both feasible and impactful for your specific clinic

Steps:

Planning:
1. Schedule a half-day session focused on sustainability QI projects
2. We suggest that you consider hosting a SUSQI lunch or breakfast to maximize attendance!
3. Send out a pre-SUSQI Day survey to staff to gather ideas and priorities
  i. A template is available in Appendix D: Pre-training email invite and survey
4. Provide clear guidelines and resources to help staff identify, design and implement sustainability projects
Execution:
1. Divide staff into small groups to work on specific projects
2. Encourage collaboration and innovation in developing sustainable solutions
3. Send out post-SUSQI project survey to collect feedback on participants’ experiences during the session and to guide follow-up meetings
  i. A template is available in Appendix E: Post-training email and survey

Step 6: Put Planetary Health on the Ongoing Agenda

Objective: Ensure Planetary Health remains integrated into routine clinic operations

Steps:

Agenda Inclusion:
1. Allocate a dedicated 5–10-minute Planetary Health item to every staff meeting agenda to discuss Planetary Health updates and initiatives
2. Rotate the responsibility of agenda item among Green Team members
3. Use this time to bring attention to ongoing Planetary Health campaigns or to present a sustainable practice to be implemented in clinic or at home
Use this time to discuss:
1. Share progress on current sustainability projects
2. Introduce new ideas and initiatives
3. Highlight one practical action staff can take in clinic or at home
4. Address any challenges or questions from staff

Maintaining a Green Clinic

The steps outlined in this Playbook provide all you need to make Planetary Health a consistent focus for your clinic.

Regular check-ins, along with long and short-term projects will help staff meet patient and environmental needs.

Below is a list of projects that have been helpful at the CFMTC.

Projects

Here are a few Greening projects that have been implemented successfully at our own clinic. While these Greening projects have worked well for us, we encourage brainstorming during the previously mentioned designated meetings for unique projects that are best suited to your own clinic! This playbook is a part of the Department of Family Medicine’s Earth to Action (E2A) project. If you would like to sign up for it, please email ug**@******ry.ca. We will notify your clinic when we have new ideas and resources available.

E2A is designed in a ‘campaign’ format. Each campaign will have educational materials for healthcare providers and for patients on a certain subject. Our first three subjects are Planetary Health Foundations, Extreme Heat and Wildfire Smoke, and Climate-Wise Management of Asthma is coming soon.

Inhalers

Switching patients from metered-dose inhalers (MDIs) to dry powder inhalers (DPIs) can significantly reduce a patient’s carbon footprint while maintaining good asthma control. At CFMTC, this initiative began with a resident-led proposal and is now supported through an ongoing clinic campaign. The clinic monitors inhaler prescribing monthly to track progress and guide further improvement.

Paper

We have reduced the use of unnecessary paper during patient visits.
Examination beds are still sanitized between visits, but paper covers are now used only when needed rather than automatically for every patient, which has led to meaningful reductions in paper consumption.

Lighting

Clinic managers noticed that lights were left on unnecessarily overnight. In response, the clinic adjusted settings so that non-essential lights automatically turn off at 6 p.m., reducing energy use with a simple operational change.

Below you will find a curated table of project ideas developed as a result of CFMTC’s initial greening meetings and campaign development process. These initiatives were categorized into four strategic areas of focus: Planetary Health Foundations, Clinical Care, Preparedness, and Clinical Operations.

Using a structured framework like this allowed us to organize our thoughts and greening efforts comprehensively and effectively. This type of structuring will help your team systemically prioritize and implement sustainability projects. This approach is useful when identifying and organizing greening projects within your own clinic.

Planetary Health Foundations	Clinical Care	Preparedness	Clinic Operations
SUSQI: Sustainable Healthcare & Sustainability in Quality Improvement	Metered-dose Inhaler Reduction	Preparedness for Extreme Temperatures	Establishing a Green Team
SUSQI: Primer for Carbon Footprinting in Healthcare	Plant-Forward Diets	Preparedness for Wildfire Smoke (considerations for populations at increased risk, including people experiencing homelessness, outdoor workers, older adults, immunocompromised individuals, and others with higher exposure or vulnerability)	Waste Reduction
Communications Training	Patient Education	Wildfire Smoke Considerations in Pregnancy	Energy Use / Sourcing Improvements
Public Education/Advocacy	Choosing Wisely (reducing unnecessary tests and medications)	Community Wellness Initiatives with a Planetary Health Focus (e.g., walking groups, nature-based programs, community gardens, green spaces)	Sustainable Transportation Strategies
Mobilizing Change (through education)	Virtual Care Optimization	Testing/Monitoring New Outbreaks	Single-Use Product Reduction
	Preventative Health Strategies
	Social Prescribing

Appendices

Each of these appendices can also be downloaded so you can tailor them to your needs.

Appendix A: Email invite to all staff education

Dear [Recipient’s Name],

We are excited to invite you to an upcoming educational event at [Clinic Name] dedicated to promoting sustainable practices and environmental responsibility within our clinic. As healthcare professionals, we have a unique opportunity to lead by example in reducing our environmental impact and fostering a healthier planet.

Event Details:
Date: [Insert Date]
Time: [Insert Time]
Location: [Insert Location]
RSVP by: [Insert RSVP Deadline]

What to Expect:

Informative Session: Learn about the latest strategies and practices for reducing waste, conserving energy, and minimizing our carbon footprint in healthcare settings.

Hear from experts in environmental sustainability and healthcare about successful greening initiatives.

Interactive Workshops: Participate in hands-on activities designed to spark ideas and solutions for our clinic.

Networking Opportunities: Connect with colleagues who are passionate about sustainability and share ideas.

Join Our Green Team: We are also thrilled to announce the formation of a Green Team at [Clinic Name]. This team will spearhead our ongoing efforts to implement sustainable practices and ensure our clinic remains at the forefront of environmental stewardship. Whether you have experience in sustainability or are simply eager to make a difference, we welcome your enthusiasm and input.

Why Participate?

Make a Positive lasting Impact: Contribute to meaningful changes that benefit both our community and the environment.

Professional Development: Gain valuable knowledge and skills that can enhance your career.

We hope you will join us for this important event and consider becoming a part of our Green Team. Together, we can make a significant impact on our clinic and the environment. Please RSVP by [RSVP Deadline] to [Contact Email/Phone Number]. Feel free to contact us if you have any questions or need further information. Thank you for your commitment to a greener future!

Warm regards, [Your Name]
[Your Position]
[Clinic Name]
[Contact Information]

Feel free to customize this template with specific details about the event and your clinic.

Appendix B: Staff Interest Survey

Sustainability Survey

Our clinic is greening! We’re making our workplace more environmentally sustainable through SUSQI (Sustainability in Quality Improvement) studies, recycling initiatives, and personal efforts in reduction. Let’s keep the momentum going – complete this short, 7-question survey to indicate your interest in further projects. All data will be submitted anonymously, with the option to provide your name at the end if you’d like to be part of the Green Team.

Please complete the survey below.

Thank you!

1. Are you responding to this survey as a(n):
o MOA
o LPN
o Receptionist
o Administrator
o CDS
o RN
o Physician
o Resident
o Other: [Specify]

2. On a scale from 1 (not important at all) to 10 (extremely important), how important is it to you that your workplace has a goal of becoming environmentally friendly?
1 2 3 4 5 6 7 8 9 10 (circle one)
(Place a mark on the scale above)

3. On a scale from 1 (not passionate at all) to 10 (extremely passionate), how passionate are you about making your workplace environmentally sustainable?
1 2 3 4 5 6 7 8 9 10 (circle one)
(Place a mark on the scale above)

4. We can green our clinic in two ways: clinic operations and clinical care.

Here are some examples of each:

Clinic Operations	Clinical care
Decreasing single use supplies	Counselling patients on active transport, e.g. taking a bike or walking.
Recycling	Counselling patients on dietary changes such as reducing red meat consumption and eating a plant-forward diet – it improves your health AND it is good for the environment.
Decreased electrical use	Counselling patients on decreasing the use of propellant-containing multi-dose inhalers

Would you be interested in advocating for change in these areas?
o Yes
o No

5. If yes, are there specific areas of interest for you or additional areas of interest?
o [Open ended answer]

6. Would you like to be part of a fun and effective Green Team to improve the sustainability of our clinic?
o Yes
o No

7. Please provide your name:
o [Open ended answer]

Thank you for your response!

Appendix C: Example of Planetary Pledge

The Central Family Medicine Teaching Clinic Planetary Health Pledge

I, as a healthcare worker, solemnly pledge to…

Practice my career with conscience and dignity and in accordance with good practice, taking into account Planetary Health values and principles
Advocate for equity and justice, inclusive of Indigenous Ways of Knowing, by actively addressing environmental, social, and structural determinants of health while protecting the natural systems that underpin a viable planet for future generations
Attend to our own health, wellbeing, and abilities in order to provide care and serve the community to the highest standards
Be a role model for my patients and society by embodying Planetary Health principles in my own life, acknowledging that this requires maintaining the vitality of our common home

Appendix D: Pre-training email invite and survey

Email Template

Dear [Clinic Name/Healthcare Professional],
Thank you for expressing interest in learning more about sustainability in healthcare. We’re thrilled to have you on board as we work towards creating a more environmentally responsible healthcare system, through the creation of our very own Green Team.

Upcoming Informative SUSQI (Sustainability in Quality Improvement) Meeting.

We’d like to remind you about our upcoming informative meeting:
Date: [Insert date]
Time: [Insert time]
Location: [Insert location or virtual meeting link]
This meeting will provide an overview of sustainable healthcare practices, discuss potential implementation strategies, and offer a platform for questions and collaborative discussions.

Pre-Meeting Survey

To help us tailor the meeting and future workshops to your specific needs and interests, we kindly request that you complete a brief survey:
Survey Link: [Insert survey link]
The survey should take approximately 10-15 minutes to complete. Your responses will help us:

Gauge your current understanding of healthcare sustainability
Identify areas of particular interest or concern
Customize our workshops to address your clinic’s unique challenges

Please complete the survey by [Insert deadline], as this will allow us time to analyze the results before the meeting.

We look forward to your participation in the survey, meeting, and subsequent workshops. Together, we can make significant strides towards more sustainable healthcare practices.
If you have any questions or concerns, please don’t hesitate to reach out.

Best regards,
[Name, Title, Clinic]
Survey
1. Name:
2. Professional role
o Administrator
o Receptionist
o MOA
o LPN/RN
o Pharmacist
o Resident
o Physician
o Other: _____________

3. Years in professional role
o <5 years
o 5–15 years
o >15 years

4. On a scale from 1 (not comfortable at all) to 10 (very comfortable), how comfortable are you with understanding the principles of Planetary Health (PH)?

1 2 3 4 5 6 7 8 9 10 (circle one)

5. On a scale from 1 (very little impact) to 10 (very strong impact), to what extent do you feel climate change affects the following:

Your outlook?
1 2 3 4 5 6 7 8 9 10 (circle one)

Your decision making?

1 2 3 4 5 6 7 8 9 10 (circle one)

Your health?
1 2 3 4 5 6 7 8 9 10 (circle one)

6. How comfortable are you initiating a SUSQI (Sustainability in Quality Improvement) project?
o Very comfortable
o Comfortable
o Neutral
o Uncomfortable
o Very Uncomfortable

Thank you for your response!

Appendix E: Post-training email and survey

Email Template

Dear [Clinic Staff/Workshop Participants],

We hope this email finds you well. On behalf of the entire organizing team, I want to express our sincere gratitude for your attendance and active participation in our recent Sustainability in Quality Improvement (SUSQI) Day.

Thank you for your participation!

Your engagement, insights, and enthusiasm throughout the workshop were truly inspiring.

Key Takeaways

During the workshop, we:

Explored strategies at our clinic for reducing our environmental impact
Identified potential challenges and brainstormed solutions
Developed action plans for immediate and long-term sustainability improvements

Final Survey — We Value Your Feedback

To help us evaluate the effectiveness of the workshop and plan future initiatives, we kindly request that you complete a brief final survey:

Survey Link: [Insert survey link here]

The survey should take approximately 5-10 minutes to complete.

Please complete the survey by [Insert deadline]. Your responses will be kept confidential and used solely for the purpose of improving our sustainability programs. If you are interested in joining the Green Team please indicate so!

Next Steps

We will compile and share a summary of the workshop outcomes and action plans in the coming weeks.

Stay tuned for announcements about future sustainability initiatives and events!

If you have any questions or would like to discuss any aspects of the workshop further, please don’t hesitate to reach out.

Best regards,
[Name, Title, Clinic]

Survey
1. Your name:

2. On a scale from 1 (not comfortable at all) to 10 (very comfortable), how comfortable are you with understanding the principles of Planetary Health (PH)?

1 2 3 4 5 6 7 8 9 10 (circle one)

3. On a scale from 1 (very little impact) to 10 (very strong impact), to what extent do you feel climate change affects the following:

Your outlook?
1 2 3 4 5 6 7 8 9 10 (circle one)

Your decision making?

1 2 3 4 5 6 7 8 9 10 (circle one)

Your health?
1 2 3 4 5 6 7 8 9 10 (circle one)

4. What two PH (Planetary Health)/environmental commitments are you willing to make over the next 6 months (personal or professional)?
o [Open ended response]

5. Please list the SUSQI (Sustainability in Quality Improvement) projects that our clinic could do in the next year in order of preference, i.e. list what you believe is the most important first and the least important last.
o [Open ended response]

6. How comfortable are you initiating a SUSQI project?
o Very comfortable
o Comfortable
o Neutral
o Uncomfortable
o Very Uncomfortable

7. Are you interested in becoming a member of the Green Team?
o Yes
o No

Thank you for your response!

References:

¹ Wicklum S, et al. Clinical tools for greening care: a scoping review. CASCADES; 2023. Accessed February 16, 2026. https://cascadescanada.ca↩