Table 6.

Critical appraisal of toolkits^a that support greening clinical care and clinic management for family doctors.

	Clear purpose	Evidence-based elements	Detailed implementation process	Adaptation to family practice	Evaluation component to study effectiveness and success	Updated regularly
Climate Change Toolkit34	Yes	Yes	No	Short list of greening “tips” within document, refers reader to My Green Doctor for detailed implementation.	No	Nob
Climate Change Toolkit for Health Professionals35	Yes	Yes	No	Module 8 contains information on engaging patients, refers reader to Green Office Toolkit. Majority of focus on education of reader.	No	No
GHG + H2O Green Facility Toolkit36	Yes	Yes	Yes	Hospital focus, section for small- and medium-sized facilities refers to PAHO Smart Hospitals Toolkit above.	See Smart Hospitals Toolkit	No
Green Impact for Health Toolkit9	Yes	Yes	Yes	Easy to use, comprehensive toolkit that covers multiple topics, gives clear direction, of note >1,000 practices participatingc. Activity logs and archives for individual practices on main site. Multilevelled approach to interventions so participation can be tailored.	Comprehensive, tracking, evaluation, and reporting methods, and awards for implementation.	Yes
Green Office Toolkit37	Yes	Yes	Yes	Specific to individual medical practices, comprehensive, 30 pages, no assets (infographics, posters, etc.).	Suggestions for tracking energy, water, waste	No
Greener Practice Asthma Toolkit41	Yes	Yes	Yes	Part of Greener Practice, UK-based primary care sustainability network, provides useful assets, QI project support, links to Center for Sustainable Healthcaree for education.	Comprehensive quality improvement project support	Yes
Greening General Practice: A Toolkit for Sustainable Practice38	Yes	Yes	Yes	Specific to individual medical practices, comprehensive, 40 pages, no assets.		Yes
My Green Doctor12	Yes	Yes	Yes	Specific to individual medical practices, extensive resources, easy to implement by beginning with minimal time commitment during medical staff meetings, multilevelled approach to interventions so participation can be tailored.	Suggestions for tracking energy, water, waste, cost-savings	Yes
Practice Greenhealth49	Yes	Yes	d	Comprehensive resource directed at hospitals; special membership required for community health centres.	Resources for tracking and auditing	Yes
Smart Hospitals Toolkit43	Yes	Yes	Yes	Hospital focus, small- and medium-sized facilities operations, Pan-American Health Organisation (PAHO)/World Health Organisation’s disaster risk reduction programme.	Resources for tools and tracking, cost/benefit analysis	No
The Greener Respiratory Pathway39	Yes	Yes	No	Comprehensive resource directed at primary care, with links to many assets, created by Primary Care Respiratory Society.	Through links	No

^aCriteria derived from article by Yamada et al.²²

^bUpdated according to 17 October 2017 Facebook post.

^cFrom https://www.youtube.com/watch?v=nNP5MUBrV7k October 2021, Accessed 22 August 2022.

^dCentre for Sustainable Healthcare, https://sustainablehealthcare.org.uk/courses/sustainable-primary-care, Accessed 22 August 2022.