Delivering sustainable surgical care

Project completed as part of the 2021 Green Surgery Challenge.

Setting/Patient Group: Operating theatres

Issue to be addressed:

Aim to deliver more sustainable surgical care through two initiatives:

1. Convert inguinal hernia repairs (IHR) from general to local anaesthetic if clinically appropriate and in line with the wishes of the patient.
2. Replace single-use disposable surgical gowns with reusable ones in the Imperial Surgical Innovation Centre.

Intervention:

1. Engaged teams to understand current practice and suggest suitable alternatives relevant to aims.
2. Baseline audits of current practice and literature reviews
3. Implementation of educational campaigns
4. Measured impact of interventions

Outcome:

Clinical

• Of 85 patients on elective open IHR waiting list, 40 were deemed suitable for repair under LA.
• IHR under LA appears to be quicker, safer, and likely to improve surgical flow. It also results in reduced length of stay.
• No obvious difference in patient outcomes

Social

• 91% staff reported positively following clinical use of the reusable gowns

Environmental

• Projected total savings of 2005 KgCO2e/year from switch to LA IHR
• Projected savings of 234,661 kgCO2e/year from switch to re-usable gowns

Economic

• Estimate annual saving from IHR switch £15,984.54/year.
• If reusable gowns were introduced across our trust, we estimate a saving of £27,131.69/year.

Key learning point

This project demonstrates the value of bringing back ‘old practices’ for a sustainable future. The interventions demonstrated significant clinical, social, environmental and financial savings and align with the values highlighted in the trust’s new ‘Green Plan’.