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

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

Interregional coordination for a fast and deep uptake of personalised health (Regions4Permed) - multidisciplinary consortium under the H2020 project.

Personalised medicine (PM) represents a paradigm shift away from the ‘one size fits all’ approach to the treatment and care of patients with a particular condition, to one which uses emergent technologies such as diagnostic tests, functional genomic technologies, and molecular pathway profiling to better manage patients’ health and employ target therapies. The current challenge for national and regional authorities is to facilitate the shift from a reactive healthcare system based on episodic and acute care models to a personalized health (PH) system that uses preventive and predictive measures, where at-risk individuals are stratified to intervene before the onset of symptoms or risk is predicted using cutting-edge technologies before symptoms appear. While PH is paving the way toward better and more efficient patient care, it still lacks the cooperation and coordination needed to organise the fragmented field, which is a severe drawback to its development and to the placement of effective financial investments. For this reason, it is crucial to direct major efforts towards coordinating and aligning relevant stakeholders across Europe and beyond, creating a participatory approach, building trust, enabling a multi-stakeholder process, and channeling investments towards PH. Thus, Regions4PerMed aims to coordinate regional policies and innovation programmes in PM and PH to accelerate the deployment of PH for patients