Barriers and enablers to implementing environmentally sustainable practices in healthcare: A scoping review and proposed roadmap
Bibliographic record
Abstract
This scoping review sought to identify the barriers and enablers to implementing environmentally sustainable practices in healthcare, as well as propose a multi-phased approach to enable such implementation. The three concepts guiding the search were (1) environmental sustainability; (2) healthcare; and (3) barriers or enablers. The PRISMA checklist for scoping reviews was used to guide this search. A total of 16 articles were included and reviewed for data extraction. While most articles focused on healthcare in general, dentistry and surgery were the most recurring clinical areas of focus. Barriers and enablers were related to the individual (e.g. knowledge, skills, and attitude), institutional (e.g. budget, strategy, and readiness), geographical/infrastructural (e.g. infrastructure and public awareness), political (e.g. regulations and incentives), and other (e.g. patient awareness and knowledge). A key enabler identified was having transformational leadership with a clear vision and collaborative approach.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.053 | 0.103 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.006 | 0.007 |
| Bibliometrics | 0.028 | 0.023 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.010 | 0.011 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".