Perceptions and priorities of perioperative staff and the public for sustainable surgery: a validated questionnaire study
File(s)
Published version
Author(s)
Gadi, Nishita
Lam, Kyle
Winter Beatty, Jasmine
Acharya, Amish
Purkayastha, Sanjay
Type
Journal Article
Abstract
Background:
Surgery is a substantial contributor to healthcare-related emissions. Despite a drive to improve sustainability, few interventions have been adopted. Stakeholder engagement is considered a key barrier to implementation. This study aimed to determine the attitudes and beliefs of perioperative staff and the public to sustainability initiatives in surgery, and whether differences exist between the two groups.
Materials and Methods:
Separate validated healthcare professional and public questionnaires were developed using a stepwise process. A systematic review was undertaken using Medline, Embase and Cochrane, to identify key domains pertaining to sustainability, and ensure content validity. Initial questionnaires were developed and refined using an iterative process of feedback from focus groups. Psychometric validation was conducted to remove question ambiguity. The final validated questionnaire was distributed to perioperative staff and the public using a multi-modal approach involving online tools, and in person.
Results:
Only 37.1% of perioperative staff reported implementation of sustainability initiatives in their departments. Yet, staff (45.7%) and the public (48.2%) somewhat agreed that sustainability should influence a surgeon’s procedural decision-making. Insufficient staff education regarding sustainability was a potential cause for lack of adoption, with 71.4% reporting they had no formal training. Moreover, discrepancies in the perceived importance of sustainability may have contributed. Staff and the public agreed that outcomes (38.6% v. 42.7% P=0.767) and surgeon experience with a technique (28.6% v. 40.0%, P=0.082) were more important than sustainability. However, 40.9% of the public did not consider operative time an important factor compared to sustainability, whilst 45.7% staff would only tolerate procedures 25% longer.
Conclusions:
Engaging stakeholders is central to implementing long-term environmentally sustainable initiatives in surgery, without compromising patient outcomes. More work is needed to understand the relative trade-offs considered by perioperative staff and the public, as well as providing both groups with more pertinent education on ecological outcomes.
Surgery is a substantial contributor to healthcare-related emissions. Despite a drive to improve sustainability, few interventions have been adopted. Stakeholder engagement is considered a key barrier to implementation. This study aimed to determine the attitudes and beliefs of perioperative staff and the public to sustainability initiatives in surgery, and whether differences exist between the two groups.
Materials and Methods:
Separate validated healthcare professional and public questionnaires were developed using a stepwise process. A systematic review was undertaken using Medline, Embase and Cochrane, to identify key domains pertaining to sustainability, and ensure content validity. Initial questionnaires were developed and refined using an iterative process of feedback from focus groups. Psychometric validation was conducted to remove question ambiguity. The final validated questionnaire was distributed to perioperative staff and the public using a multi-modal approach involving online tools, and in person.
Results:
Only 37.1% of perioperative staff reported implementation of sustainability initiatives in their departments. Yet, staff (45.7%) and the public (48.2%) somewhat agreed that sustainability should influence a surgeon’s procedural decision-making. Insufficient staff education regarding sustainability was a potential cause for lack of adoption, with 71.4% reporting they had no formal training. Moreover, discrepancies in the perceived importance of sustainability may have contributed. Staff and the public agreed that outcomes (38.6% v. 42.7% P=0.767) and surgeon experience with a technique (28.6% v. 40.0%, P=0.082) were more important than sustainability. However, 40.9% of the public did not consider operative time an important factor compared to sustainability, whilst 45.7% staff would only tolerate procedures 25% longer.
Conclusions:
Engaging stakeholders is central to implementing long-term environmentally sustainable initiatives in surgery, without compromising patient outcomes. More work is needed to understand the relative trade-offs considered by perioperative staff and the public, as well as providing both groups with more pertinent education on ecological outcomes.
Date Issued
2023-06-01
Date Acceptance
2023-02-15
Citation
Annals of Medicine and Surgery, 2023, 85 (6), pp.2400-2408
ISSN
2049-0801
Publisher
Wolters Kluwer
Start Page
2400
End Page
2408
Journal / Book Title
Annals of Medicine and Surgery
Volume
85
Issue
6
Copyright Statement
Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed
under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://journals.lww.com/annals-of-medicine-and-surgery/Abstract/9900/Perceptions_and_priorities_of_perioperative_staff.542.aspx
Publication Status
Published
Date Publish Online
2023-05-03