JAMA video highlights OR sustainability

Editor's Note

If global healthcare were a country, it would rank as the fifth-largest emitter of greenhouse gases.

So says Dr. Sofya Asfaw, a trauma and critical care surgeon at Cleveland Clinic, in a JAMA Network video on “greening” the OR. Published July 17, the short film features experts like Asfaw who are working to make ORs more sustainable and inspire others to make similar changes. Highlights include:

• ORs account for 20-60% of hospital waste and are among the most energy-intensive areas. Initiatives to reduce this impact include adjusting HVAC systems, changing anesthetic gas types, reducing water usage, and implementing recycling programs.
• The Cleveland Clinic's innovative "purple bin" program has diverted over 1 million tons of plastic from landfills since 2011.
• The impact of anesthetic gas is significant and varies widely. Desflurane, for instance, has a 20-fold higher impact than sevoflurane. Some institutions have greatly reduced or eliminated desflurane use, resulting in substantial carbon footprint reductions.
• Nitrous oxide, another potent greenhouse gas, poses additional challenges due to pipeline leaks. Several hospitals are decommissioning central nitrous oxide systems in favor of portable cylinders.

The film emphasizes the notion that minimizing waste and making smarter choices need not compromise patient care. OR professionals seeking to foster a culture of sustainability should focus on education and data-driven decision-making.