TRUNC. HD - Trying to Reduce UN-necessary Carbon

A knowledge hub for KQIP sustainability projects

Welcome to the Trunc. HD knowledge hub, an interactive knowledge and resource platform to support health care professionals with sustainability QI projects. This is a platform for you to share your challenges, to learn best practices, and to contribute to quality improvement with a network of renal professionals.

It is a place to connect with, learn from, and support each other.

TRUNC. HD

Healthcare contributes 4-5% of global carbon dioxide equivalent (CO2e) emissions.

Haemodialysis (HD) contributes disproportionately to this due to its resource intensive nature. The Yorkshire and Humber Kidney Network (YHKN), in partnership with Kidney Quality Improvement Partnership (KQIP) launched Trying to Reduce UnNecessary Carbon in Haemodialysis (TRUNC-HD); a regional quality improvement (QI) initiative to reduce the environmental impact of HD, building on established renal sustainability programmes within the region.

A sustainability fellow, Dr Stephanie Coo and Y&H KQIP QI manager, Leeanne Lockley engaged and collaborated with stakeholders across participating dialysis services. Local teams attended four face-to-face workshops using modified sustainability-focused (susQI) tools to design and implement interventions. Regional meetings, held thrice annually, facilitated progress sharing and collaboration. Baseline and progress data were gathered to assess environmental and financial impacts. The greenhouse gas (GHG) savings was quantified in carbon dioxide equivalent (CO2e) and calculated using hybrid carbon foot printing methodology. Data sources to calculate the GHG savings including direct measurements where available, the Department for Energy Security & Net Zero and Department for Environment Food & Rural Affairs 2024 greenhouse gas conversion factors, published carbon footprint estimates of medical equipment and expert opinion.
See summary of estimated annual greenhouse gas and financial savings of completed TRUNC_HD projects.

TRUNC-HD initiative demonstrates the impact of a regional, collaborative approach to addressing climate change, delivering environmental and financial savings, professional development, and service improvements. Scaling up current interventions regionally could achieve annual savings of approximately 120 tonnes of CO2e and nearly £200,000 per year.

To find out more about how to implement the intervention, please click the buttons below:

Empowering patients to be involved in sustainability

Encouraging dialysis patients to bring their own blankets and cups to reduce waste, electricity and water use.

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Moving from 1:33 to 1:44 central acid concentrate

Using a more concentrated acid mix to reduce plastic waste and transport emissions.

Recycling acid cannisters

Diverting plastic acid cannisters from waste for incineration through systematic recycling efforts.
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Reducing consumable waste

Identifying and minimising unnecessary medication ordering through a waste and ordering audits
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Reducing dialysate flow rate form 800mls/hr to 500mls/hr

Reducing dialysate flow rate from 800ml/min to 500ml/min to conserve water and acid concentrate without compromising treatment efficacy
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Reducing food waste

Preventing excess food disposal by improving ordering practices
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Reducing number of dialysis machine heat discinfections

Reducing energy, water and citric acid use by optimising the frequency of machine heat disinfection cycles
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Using the ICHD carbon calculator

Using the Newcastle ICHD carbon calculator to identify emission reduction opportunities in the care pathway.
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Resources

TruncHD

Find additional resources from Yorkshire & Humber TRUNC.HD projects and events here!
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Share your feedback

We would greatly appreciate your feedback on the DAYLife hub. 

Your insights will help us to develop a high quality, useful and intuitive hub to support home dialysis quality improvement projects throughout the UK.

Workstreams

The DAYLife programme is centred on four workstreams, each of which has a dedicated hub with relevant resources and a community space. 

Shared Haemodialysis Care

This working group provides resources to support the 'shared care' approach in haemodialysis, where patients gradually develop skills alongside health professionals, allowing for for self-paced decision-making.

Psychosocial Support

Distress is a natural response to kidney failure and related treatment choices. This workstream provides resources for embedding proactive holistic support systems that address the emotional and social dimensions of home dialysis.

Shared Decision Making

Access this workstream for guidance on fostering a participatory environment where patients' values and preferences are central to selecting appropriate CKD treatments.

Peer Support

Peer support from other patients and carers is crucial in informing, choosing, and maintaining home dialysis.  Access this workstream for resources to develop peer-to-peer networks that enhance patient confidence and treatment engagement in home dialysis.

What's new?

Check out the most recent resources that we've added to the knowledge hub.

DAYLife Programme Resources
Reports, webinars, slides, links to patient resources, FAQs and more.

Four Workstreams
Targeted resources related to shared haemodialysis care, psychosocial support, shared decision making, and peer support.

Community
A place to share experiences, ask questions, and network with healthcare professionals  interested in driving quality improvement in home dialysis.

Under development...

More resources are in the works!

Home dialysis QI reporting
Are you involved in a QI project on home dialysis? We've created a reporting system for home dialysis QI projects. Please share your project details to inform others and strengthen the knowledge network.

QI report repository
We are currently compiling and sharing a database of home therapies QI projects in the UK. Use the repository to connect with others working on similar projects and gain insights that will help with your own projects.

Latest community posts

The TRUNC. HD Team

KQIP
KQIP is a dynamic network of kidney health professionals, patients and carers who are committed to developing, supporting and sharing improvement in kidney services, to enhance outcomes and quality of life for people with kidney disease.

The UKKA KQIP Team:

  • Leeanne Lockley
Yorkshire & Humber Network
Blurb

The Yorkshire & Humber Kidney Network Team:

  • Mark Wright
  • All the Y&H Unit Staff


This section is restricted to healthcare professionals to ensure PMCPA compliance. If you are not a healthcare professional, but are leading on a home therapies quality improvement project and would like to submit a report, please email us at kqip@ukkidney.org. 

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