Sustainability indicators for gastrointestinal endoscopy: a framework proposed by the Canadian Association of Gastroenterology and the American Society for Gastrointestinal Endoscopy

Key Takeaways for GI Nurses

• A new joint framework from the Canadian Association of Gastroenterology (CAG) and the American Society for Gastrointestinal Endoscopy (ASGE) introduces standardized sustainability indicators specifically designed for GI endoscopy units, giving nursing teams measurable benchmarks to track environmental impact alongside clinical quality.
• Nurses play a frontline role in implementing sustainability measures—including single-use device selection, reprocessing protocols, energy use, and waste segregation—making their day-to-day workflow decisions directly relevant to meeting these new benchmarks.
• The framework reinforces that sustainability and patient safety are not competing priorities; well-designed indicators can support both efficient workflow optimization and rigorous infection control standards.
• Endoscopy nurses may increasingly be asked to participate in quality improvement initiatives, data collection, or unit audits tied to these sustainability metrics as institutions adopt the framework.

Clinical Relevance

The introduction of standardized sustainability indicators marks a meaningful shift in how GI endoscopy units may evaluate performance moving forward. Historically, quality metrics in endoscopy have centered almost exclusively on procedural outcomes—adenoma detection rates, cecal intubation rates, adverse event tracking—while environmental impact has remained largely unmeasured. This framework signals that professional societies now view sustainability as a core component of high-quality care delivery, not a peripheral concern. For nursing staff, this means sustainability considerations may soon be woven into existing quality assurance structures, competency assessments, and unit-level reporting rather than treated as a separate initiative.

From an operational standpoint, nurses are uniquely positioned to influence many of the variables likely captured by such indicators. Decisions around reprocessing turnaround, appropriate use of single-use versus reusable devices, procedure room energy management, and waste stream segregation (biohazard versus recyclable versus general waste) are often executed or supervised by nursing and technician staff. Having a formal framework provides nurses with a structured, evidence-informed rationale for practices that may previously have been driven by cost or convenience alone. This can strengthen advocacy for resource allocation—such as investment in reprocessing equipment or staff training—when sustainability goals are tied to recognized professional society standards rather than informal unit preferences.

Importantly, the framework's emphasis on balancing sustainability with patient safety and workflow efficiency should reassure nursing teams that these are not mutually exclusive goals. As units begin to pilot or adopt these indicators, endoscopy nurses will likely be central to data collection, staff education, and process redesign, offering an opportunity for professional development and leadership within multidisciplinary sustainability committees. Nurses who understand the framework early will be better positioned to contribute meaningfully to implementation discussions and to help their units meet emerging accreditation or reporting expectations.

Bottom Line

This CAG/ASGE framework establishes the first standardized sustainability indicators for GI endoscopy, and because nurses directly manage many of the workflow elements involved—reprocessing, waste handling, and device use—they should anticipate a growing role in tracking and implementing these metrics as units work to align environmental responsibility with continued high standards of patient safety and procedural efficiency.