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

ObjectivesTo agree the top 10 research priorities for environmentally sustainable peri-operative practice. Designsurveys and literature review; final consensus workshop using a nominal group technique. Setting: UK-based. Participantshealthcare professionals, patients, carers, and the public. Outcome measuresinitial 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. Resultsinitial survey- 1,926 suggestions by 296 respondents, refined into 60 indicative questions. Interim survey- 325 respondents. Final workshop- 21 participants agreed the top 10: O_LIHow can more sustainable reusable equipment safely be used during and around the time of an operation? C_LIO_LIHow can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation? C_LIO_LIHow can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice? C_LIO_LICan more efficient use of operating theatres and associated practices reduce the environmental impact of operations? C_LIO_LIHow can the amount of waste generated during and around the time of an operation be minimised? C_LIO_LIHow do we measure and compare the short- and long-term environmental impacts of surgical and non-surgical treatments for the same condition? C_LIO_LIWhat is the environmental impact of different anaesthetic techniques (e.g., different types of general, regional and local anaesthesia) used for the same operation? C_LIO_LIHow should the environmental impact of an operation be weighed against its clinical outcomes and financial costs? C_LIO_LIHow can environmental sustainability be incorporated into the organisational management of operating theatres? C_LIO_LIWhat 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)? C_LI Conclusionsa broad range of end-users have identified research priorities for sustainable peri-operative care. Strengths and Limitations of this StudyO_LIWe have defined the top 10 research priorities according to healthcare professionals, patients, carers, and members of the public, in an important and expanding area of health research. C_LIO_LITo our knowledge, this is the first research priority setting partnership in any field of sustainable healthcare. C_LIO_LIPatients, carers, and members of the public comprised 21% of survey respondents overall, a smaller proportion than in many priority setting partnerships. This may have been because of the online methods used (due in part to the COVID-19 pandemic) or the novel subject matter. C_LIO_LIThe James Lind Alliance process is consensus-based, transparent, and includes measures to ensure that patient, carer and public opinions are represented. C_LIO_LIThe scope of our work was limited to care provided from or in the secondary care setting to patients who may benefit from surgical management so does not include the full patient journey; more sustainability-focussed priority setting partnerships would be beneficial in the future. C_LI Original Protocol of the StudySee https://www.jla.nihr.ac.uk/documents/greener-operations-sustainable-peri-operative-practice-psp-protocol/27106