The Green Planet: development and early evaluation of a novel method for climate actions in clinical practice

BACKGROUND: Climate change is becoming an increasingly serious threat to human health. At the same time, healthcare delivery is contributing substantially to greenhouse gas emissions, thus aggravating climate disruption. To integrate climate actions into clinical practice is therefore important but remains challenging. Health professionals often express environmental awareness but face barriers to engaging in pro-climate behaviours at work. There is limited evidence on how workplace interventions can be designed and implemented to support such behaviours. This study describes the development and early evaluation of Green Planet, a co-created method designed to integrate climate awareness and actions into healthcare. METHODS: The Green Planet was developed through a service design process in collaboration with managers and clinical staff at a Swedish hospital, adapting an established quality improvement method, the Green Cross, to focus on climate actions. The method was tested over a six-weeks period in a medicine ward. A qualitative evaluation was conducted using eight semi-structured interviews, one focus group discussion with eleven participants, and three non-participatory observations. Data was analysed using an inductive thematic analysis to examine how the method was used in practice, and a deductive thematic analysis guided by the Capability, Opportunity, Motivation-Behaviour (COM-B) model to explore how the intervention influenced conditions for pro-climate behaviours. RESULTS: The Green Planet was largely implemented as intended, with local adaptations to fit clinical routines. Staff reported that the method increased awareness and knowledge about climate actions, promoted reflection on everyday practices, and fostered a sense of collective responsibility. The intervention enhanced capability, opportunity, and motivation for pro-climate behaviour, particularly by making climate actions visible, concrete, and part of daily team discussions. Challenges included variable staff engagement, time constraints, and reliance on a designated test leader. CONCLUSIONS: This early evaluation suggests that a co-created, theory-informed method integrated into existing work routines can strengthen conditions for pro-climate behaviours in healthcare settings. The Green Planet shows promise as an adaptable approach to normalising climate action in everyday clinical practice. Further research is needed to assess long-term effects, scalability, and measurable environmental impact.