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Reducing the environmental impact of surgery on a global scale: Systematic review and co-prioritization with healthcare workers in 132 countries
Adisa, Adewale Bahrami-Hessari, Michael Bhangu, Aneel George, Christina Ghosh, Dhruv Glasbey, James Haque, Parvez Ingabire, J. C. Allen Kamarajah, Sivesh Kathir Kudrna, Laura
Adisa, Adewale
Bahrami-Hessari, Michael
Bhangu, Aneel
George, Christina
Ghosh, Dhruv
Glasbey, James
Haque, Parvez
Ingabire, J. C. Allen
Kamarajah, Sivesh Kathir
Kudrna, Laura
Author
Adisa, Adewale
Bahrami-Hessari, Michael
Bhangu, Aneel
George, Christina
Ghosh, Dhruv
Glasbey, James
Haque, Parvez
Ingabire, J. C. Allen
Kamarajah, Sivesh Kathir
Kudrna, Laura
Ledda, Virginia
Li, Elizabeth
Lillywhite, Robert
Mittal, Rohin
Pettigrove, K. L.
et. al.
National Institute for Health Research (NIHR)
Bahrami-Hessari, Michael
Bhangu, Aneel
George, Christina
Ghosh, Dhruv
Glasbey, James
Haque, Parvez
Ingabire, J. C. Allen
Kamarajah, Sivesh Kathir
Kudrna, Laura
Ledda, Virginia
Li, Elizabeth
Lillywhite, Robert
Mittal, Rohin
Pettigrove, K. L.
et. al.
National Institute for Health Research (NIHR)
Abstract
Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.
Keywords
consultation, general anesthesia, carbon, health personnel, income, operating room, perioperative care, safety, operative surgical procedures, specialty surgery, anesthetic gases
Date
2023
Type
Article
Journal
British Journal of Surgery
Book
Volume
110
Issue
7
Page Range
804-817
Article Number
ACU Department
School of Allied Health
Collections
Relation URI
Source URL
Event URL
Open Access Status
Gold open access
License
CC BY-NC 4.0 (Creative Commons Attribution-NonCommercial 4.0 International)
File Access
Notes
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/ licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.