By Selma Al-Samarrai

Sarah Nestico (left) and Ann Rodrigues are two members of the Green Team at St. Michael’s Family Health Team.
Sarah Nestico (left) and Ann Rodrigues are two members of the Green Team at St. Michael’s Family Health Team. (Photo: Yuri Markarov, Medical Media Centre)

Canada’s health care system is responsible for 4.6 per cent of the country’s pollutant emissions, both directly from healthcare facilities and vehicles, and indirectly through buying emission-intensive goods and services.

This was one of the factors that compelled a group of staff and physicians at the St. Michael’s Academic Family Health Team (FHT) to create a Green Team. Their goal was to make their practice more environmentally friendly. This started as a local initiative in the Sumac Creek Health Centre clinic just over a year ago, and is now expanding into the remaining FHT clinics.

Their first project focused on implementing a new recycling process. Within a few months, the Green Team had ordered recycling bins, placed them in high-traffic areas, and confirmed the pick-up process with Environmental Services staff.

“With the global movement around environmental sustainability, there was an increased awareness of our impact within the FHT clinics, and a lot of our team members were already really engaged on this topic,” said Sarah Nestico, Clinical Nurse Specialist, Sumac clinic.

A recent and very impactful sustainability change was the elimination of exam table paper in patient rooms in both the Sumac clinic and the Health Centre at 80 Bond clinic. This decision was made easier by the pandemic because after every patient visit, all furniture including the patient bed had to be completely wiped down, which eliminated the need for the exam paper.

Another change the Green Team successfully implemented was clarifying when to use the biohazard waste bins, which collect heavily soiled items that then need to be incinerated. They clearly distinguished what goes into the biohazard waste bins, and this helped significantly reduce what staff put in them.

The Green Team also organized education seminars on how to implement certain sustainability practices, specifically at the Sumac clinic.

“A big priority for the Green Team was just providing information,” said Julia Lee, Interim Patient and Community Engagement Specialist. “Often, unsustainable practice comes from misinformation, so education becomes a key tool in creating change.”

The education covers a wide range of sustainability practices, including behavioural changes such as encouraging staff to bring in reusable containers, utensils and cups, and general sustainability practices such as turning off computers and office lights at the end of the day and minimizing printing.

“I think part of the reason the Green Team initiatives have been so successful is because there was a very intentional interprofessional lens on it that included physicians, nurses, clinical and administrative staff,” Lee said. “There were many different processes and angles that were all taken into consideration. At the end of the day, we’re all interested in being more sustainable to protect our environment.”

The Green Team is composed of Mo AlHaj, Quality Improvement Specialist; Dr. Kathryn Dorman, Family Physician; Elsa Eman, Clerical Coordinator; Dr. Samantha Green, Family Physician; Julia Lee, Interim Patient and Community Engagement Specialist; Sarah Nestico, Clinical Nurse Specialist; Dr. Eileen Nicolle, Family Physician; and Ann Rodrigues, Registered Nurse.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit