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 endoscopy units, signaling that environmental stewardship is becoming a formal quality metric alongside traditional clinical benchmarks.
• Nurse managers and charge nurses should anticipate requests to track and report data related to resource use, waste generation, and procedural efficiency as these indicators are incorporated into unit quality dashboards.
• Frontline endoscopy nurses may see changes to supply opening practices, reprocessing workflows, and single-use device policies as units work to align with the new benchmarks.
• Early engagement with unit leadership on sustainability data collection can help nursing staff shape practical, workflow-friendly implementation rather than having top-down mandates imposed without frontline input.

Clinical Relevance

The introduction of formal sustainability indicators marks a meaningful shift in how endoscopy units will be evaluated moving forward. Historically, quality metrics in GI endoscopy have centered on clinical outcomes such as adenoma detection rates, cecal intubation rates, and adverse event tracking. This new framework adds an operational and environmental dimension to that quality conversation, meaning nursing staff will increasingly be asked to document and monitor factors like procedural supply consumption, energy use associated with equipment, and waste stream management. For nurses who already juggle extensive documentation requirements, this represents both a new responsibility and an opportunity to influence how data collection is integrated into existing workflows.

From a unit operations standpoint, these indicators will likely prompt reassessment of routine practices that nurses oversee daily—room turnover protocols, instrument reprocessing cycles, disposable versus reusable device selection, and inventory management. Nurse managers tasked with compliance will need to balance sustainability goals with infection control standards and patient safety, ensuring that any changes to supply or reprocessing practices do not compromise procedural safety or efficiency. This may require updated competency training and revised standard operating procedures, giving nursing staff a central role in operationalizing the framework at the bedside and procedure room level.

For professional development, this update signals that sustainability literacy is becoming a relevant skill set for GI nurses, particularly those in leadership, quality improvement, or educator roles. Understanding how to interpret sustainability metrics, communicate their rationale to staff, and troubleshoot implementation challenges will position nurses as valuable partners in unit-level quality initiatives. As accrediting bodies and professional societies increasingly incorporate environmental metrics into practice standards, nurses who proactively build familiarity with these concepts will be better equipped to support their units through the transition and advocate for feasible, patient-centered implementation strategies.

Bottom Line

GI nurses should recognize that sustainability is emerging as a formal quality indicator in endoscopy practice, and should expect unit-level conversations about resource use, waste reduction, and supply practices to intensify—making early involvement in planning and protocol review essential to ensure these changes are both practical and safe to implement at the bedside.