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

Beyond Brainstorming: Exploring Convergence in Teams

Collaborative brainstorming is often followed by a convergence activitywhere teams extract the most promising ideas on a useful level of detail from the brainstorming results. Contrary to the wealth of research on electronic brainstorming, there is a dearth of research on convergence. We used experimental methods for an in-depth exploration of two facilitation-based interventions in a convergence activity: attention guidance (focusing participants on procedures to execute a convergence task) and discussion encouragement (engaging participants in conversations to combine knowledge on ideas). Our findings show that both attention guidance and discussion encouragement are correlated with higher convergence quality. We argue that attention guidance’s contribution is in its support of coordination, information processing, and goal specification. Similar, we argue that discussion encouragement’s contribution is in its stimulation of idea clarification and idea combination. Contrary to past research, our findings further show that satisfaction was higher after convergence than after brainstorming