Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
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 methodolog...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Oxford University Press
2023
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| Online Access: | http://psasir.upm.edu.my/id/eprint/110278/ http://psasir.upm.edu.my/id/eprint/110278/1/110278.pdf |
| _version_ | 1848865481782460416 |
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| author | Bahrami-Hessari, Michael Adisa, Adewale 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 Nepogodiev, Dmitri Ntirenganya, Faustin Picciochi, Maria Simões, Joana Filipa Ferreira Booth, L Elliot, R Kennerton, A S Pettigrove, K L Pinney, L Richard, H Tottman, R Wheatstone, P Wolfenden, John W D Smith, A Sayed, A Emad |
| author_facet | Bahrami-Hessari, Michael Adisa, Adewale 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 Nepogodiev, Dmitri Ntirenganya, Faustin Picciochi, Maria Simões, Joana Filipa Ferreira Booth, L Elliot, R Kennerton, A S Pettigrove, K L Pinney, L Richard, H Tottman, R Wheatstone, P Wolfenden, John W D Smith, A Sayed, A Emad |
| author_sort | Bahrami-Hessari, Michael |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | 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 coprioritized 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. |
| first_indexed | 2025-11-15T14:05:24Z |
| format | Article |
| id | upm-110278 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T14:05:24Z |
| publishDate | 2023 |
| publisher | Oxford University Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-1102782025-07-02T09:37:33Z http://psasir.upm.edu.my/id/eprint/110278/ Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries Bahrami-Hessari, Michael Adisa, Adewale 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 Nepogodiev, Dmitri Ntirenganya, Faustin Picciochi, Maria Simões, Joana Filipa Ferreira Booth, L Elliot, R Kennerton, A S Pettigrove, K L Pinney, L Richard, H Tottman, R Wheatstone, P Wolfenden, John W D Smith, A Sayed, A Emad 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 coprioritized 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. Oxford University Press 2023 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/110278/1/110278.pdf Bahrami-Hessari, Michael and Adisa, Adewale and Bhangu, Aneel and George, Christina and Ghosh, Dhruv and Glasbey, James and Haque, Parvez and Ingabire, J C Allen and Kamarajah, Sivesh Kathir and Kudrna, Laura and Ledda, Virginia and Li, Elizabeth and Lillywhite, Robert and Mittal, Rohin and Nepogodiev, Dmitri and Ntirenganya, Faustin and Picciochi, Maria and Simões, Joana Filipa Ferreira and Booth, L and Elliot, R and Kennerton, A S and Pettigrove, K L and Pinney, L and Richard, H and Tottman, R and Wheatstone, P and Wolfenden, John W D and Smith, A and Sayed, A Emad (2023) Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries. British Journal of Surgery, 110 (7). pp. 804-817. ISSN 0007-1323; eISSN: 1365-2168 https://academic.oup.com/bjs/article/110/7/804/7133802 10.1093/bjs/znad092 |
| spellingShingle | Bahrami-Hessari, Michael Adisa, Adewale 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 Nepogodiev, Dmitri Ntirenganya, Faustin Picciochi, Maria Simões, Joana Filipa Ferreira Booth, L Elliot, R Kennerton, A S Pettigrove, K L Pinney, L Richard, H Tottman, R Wheatstone, P Wolfenden, John W D Smith, A Sayed, A Emad Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries |
| title | Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries |
| title_full | Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries |
| title_fullStr | Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries |
| title_full_unstemmed | Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries |
| title_short | Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries |
| title_sort | reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries |
| url | http://psasir.upm.edu.my/id/eprint/110278/ http://psasir.upm.edu.my/id/eprint/110278/ http://psasir.upm.edu.my/id/eprint/110278/ http://psasir.upm.edu.my/id/eprint/110278/1/110278.pdf |