Greener Operations: a James Lind Alliance Priority Setting Partnership on environmentally sustainable peri-operative practice

Abstract

Objectives: To agree the top 10 research priorities for environmentally sustainable peri-operative practice. Design: surveys and literature review; final consensus workshop using a nominal group technique. Setting: UK-based. Participants: healthcare professionals, patients, carers, and the public. Outcome measures: initial survey- suggested research questions; interim survey- shortlist of indicative questions (the 20 most frequently nominated by patients, carers and the public, and healthcare professionals); final workshop- ranked research priorities. Results: initial survey- 1,926 suggestions by 296 respondents, refined into 60 indicative questions. Interim survey- 325 respondents. Final workshop- 21 participants agreed the top 10: How can more sustainable reusable equipment safely be used during and around the time of an operation?; How can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation?; How can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice; Can more efficient use of operating theatres and associated practices reduce the environmental impact of operations?; How can the amount of waste generated during and around the time of an operation be minimised?; How do we measure and compare the short- and long-term environmental impacts of surgical and non-surgical treatments for the same condition?; What is the environmental impact of different anaesthetic techniques (e.g., different types of general, regional and local anaesthesia) used for the same operation?; How should the environmental impact of an operation be weighed against its clinical outcomes and financial costs?; How can environmental sustainability be incorporated into the organisational management of operating theatres?; What are the most sustainable forms of effective infection prevention and control used around the time of an operation (e.g., PPE, drapes, clean air ventilation)? Conclusions: a broad range of end-users have identified research priorities for sustainable peri-operative care.