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Greener Operations: a James Lind Alliance Priority Setting Partnership to define research priorities in
Max Clayton-Smith1, Hrishi Narayanan2, Clifford Shelton3,4
1Manchester Royal Infirmary, Manchester, UK.
Objectives:
To agree on the 'top 10' research priorities for environmentally sustainable perioperative practice.
Design:
Surveys and literature review; final consensus workshop using a nominal group technique.
Setting:
UK-based setting.
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-1926 suggestions by 296 respondents, refined into 60 indicative questions. Interim survey-325 respondents. Final workshop-21 participants agreed the 'top 10': (1) How can more sustainable reusable equipment safely be used during and around the time of an operation? (2) How can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation? (3) How can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice? (4) Can more efficient use of operating theatres and associated practices reduce the environmental impact of operations? (5) How can the amount of waste generated during and around the time of an operation be minimised? (6) How do we measure and compare the short-term and long-term environmental impacts of surgical and non-surgical treatments for the same condition? (7) What is the environmental impact of different anaesthetic techniques (eg, different types of general, regional and local anaesthesia) used for the same operation? (8) How should the environmental impact of an operation be weighed against its clinical outcomes and financial costs? (9) How can environmental sustainability be incorporated into the organisational management of operating theatres? (10) What are the most sustainable forms of effective infection prevention and control used around the time of an operation (eg, personal protective equipment, drapes, clean air ventilation)?
Conclusions:
A broad range of 'end-users' have identified research priorities for sustainable perioperative care.
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