Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Management Control Systems: Tecniche e Processi per implementare le strategie.

Il ibro si concentra sulle tecniche del processo di controllo manageriale - come la determinazione dei prezzi di trasferimento, la preparazione del budget, i sistemi di valutazione delle prestazioni nonchè la definizione dei sistemi di incentivazione - e le considerazioni di ordine comportamentale connesse all'utilizzo di tali tecniche quali la motivazione, la coerenza degli obiettivi e i problemi che nascono nelle relazioni tra superiori gerarchici e subordinati

Product costing in UK manufacturing organizations

This paper reports and comments on the findings from a questionnaire survey on the product costing practices used by 260 UK manufacturing companies. The aims of the paper are (1) to provide evidence to ascertain the extent to which recent criticisms of product costing can be judged and (2) to compare and comment upon the theory and practice of product costing. The survey findings indicate that product costs computed to meet inventory valuation requirements are widely used for decision-making and internal profit measurement. The majority of firms, however, used both full costs and variable costs for decision-making and the findings suggest that product cost information is used in a more flexible manner than that depicted by previous studies. The paper reports on the methods used by companies to compute full product costs. Most organizations used questionable overhead allocations that are likely to result in the reporting of distorted product costs. The concluding sections of the paper discuss the possible reasons why observed practices differ from conventional wisdom and suggest areas where further research is required.