Story Highlight
– NIHR developed GAP-PACK guide for sustainable perioperative care.
– Guides on local anaesthesia, reusable equipment, and repairs.
– Collaborated with WHO and anaesthesia professional bodies.
– Aims to reduce waste without compromising patient safety.
– Involves input from 1900 professionals across 70 countries.
Full Story
A new initiative spearheaded by the Birmingham-led National Institute for Health and Care Research (NIHR) aims to enhance the environmental sustainability of perioperative care through the introduction of the Greener Anaesthesia and Perioperative Care (GAP-PACK) guide. This comprehensive framework encourages healthcare professionals worldwide to adopt practices that reduce waste in operating theatres while maintaining high standards of patient safety and care.
The GAP-PACK guide has been developed in collaboration with the World Health Organisation, along with professional organisations including the National Institute of Academic Anaesthesia, the Association of Anaesthetists GB & NI, and the World Federation of Societies of Anaesthesiologists. Its primary objective is to provide clear and actionable recommendations that enable operating theatres to diminish their environmental footprint effectively. This approach aims to facilitate clinicians in integrating sustainable practices into their routine operations.
Operating theatres are notorious for their substantial consumption of energy, use of medical supplies, and reliance on single-use plastics, which generate significant waste and financial burdens. By adopting the GAP-PACK recommendations, hospitals can implement more sustainable practices that simultaneously enhance patient recovery, comfort, and safety. Furthermore, these practices can lead to reduced risks and complications, greater efficiency for medical staff, and improved reliability of medical equipment.
The guide has received input from over 1,900 healthcare professionals across more than 70 countries, including those from low-resource settings, through an expansive global prioritisation exercise. Participants evaluated potential actions according to three key criteria: feasibility, acceptability, and affordability. Seven actions emerged as particularly effective, having garnered high scores across all three metrics, demonstrating their potential for immediate enactment by healthcare teams.
The selected seven recommendations of the GAP-PACK are as follows:
1. Utilise local or regional anaesthesia whenever suitable.
2. Prefer reusable equipment instead of relying on disposable items.
3. Observe the principle of “don’t open it unless you need it” to minimise waste.
4. Avoid unnecessary anaesthetic interventions that do not benefit patient outcomes.
5. Opt for maintenance and repair of existing equipment rather than discarding it.
6. Ensure that operating theatres are powered down when not in use to conserve energy.
7. Improve the processes of waste segregation and recycling within hospitals.
Rather than proposing substantial technological investments or costly new equipment, the GAP-PACK guide highlights how small adjustments in daily operations can significantly contribute to greener, more efficient, and safer surgical environments.
James Glasbey, who serves as an Assistant Professor and Perioperative Care Lead for the NIHR Global Group on Environmentally Sustainable Operating Theatres, noted the critical need for actionable solutions. He remarked, “The perioperative care community, both in the UK and worldwide, wants to take action against climate change but it’s not always clear where to begin. GAP-PACK has taken ‘low hanging fruit’ which can be immediately implemented in any operating theatre, and given clinical teams the tools required to make a change.”
As awareness regarding climate change and sustainability grows, healthcare consumers are increasingly expecting environmentally responsible practices in their medical care. The GAP-PACK guide represents an important step towards aligning the operations of healthcare facilities with these expectations, without sacrificing the quality of care provided to patients.
The implementation of these sustainable practices can result in significant organisational efficiencies, as well as cost savings that can be redirected to enhance services or invest in additional training for staff. Furthermore, by promoting practices such as maintaining equipment and opting for local anaesthesia, hospitals can foster a culture of sustainability that benefits both their patients and the environment.
The guide stresses that hospitals do not need to undertake extensive overhauls of their systems or invest heavily in new technology to achieve their sustainability goals. Instead, adopting simple and pragmatic changes can yield considerable improvements, demonstrating the potential for healthcare systems to balance operational logistics with environmental responsibility.
For healthcare professionals eager to engage in sustainable practices, the full GAP-PACK guide is accessible via a dedicated survey platform, providing further insights and resources to aid in effective implementation. The initiative represents a collaborative effort to promote a future where healthcare not only prioritises patient wellbeing but also actively contributes to safeguarding the planet.
Our Thoughts
The creation and implementation of the GAP-PACK guide by the NIHR highlights key safety lessons in the context of environmental sustainability in perioperative care. To avoid the unnecessary waste and environmental impact described, healthcare facilities should have adhered to the Management of Health and Safety at Work Regulations 1999, ensuring risk assessments are conducted for waste management and energy use.
Implementing the recommended practices—such as using local anaesthesia, choosing reusable equipment, and maintaining rather than discarding equipment—could significantly reduce material waste and enhance patient safety. Furthermore, the guidelines suggest actions that can mitigate risks associated with rushed or excessive interventions, aligning with the Health and Safety at Work Act 1974 stipulating employers’ responsibilities for ensuring safe working environments.
In terms of preventing similar issues, regular training on sustainability practices for healthcare professionals should be mandated, ensuring adherence to the Health and Safety (Training for Employment) Regulations 1990. Overall, the adoption of these measures would not only comply with existing legislation but promote a culture of safety and sustainability in operating theatres.
