Pediatric Surgeon Perceptions on Operating Room Environmental Stewardship and Current Institutional Climate-Smart Actions

Gwyneth A Sullivan; Audra J Reiter; Charesa Smith; Richard D Glick; David E Skarda; Hau D Le; Kenneth W Gow; Barrie S Rich; Mehul V Raval; American Academy of Pediatrics Section on Surgery Delivery of Surgical Care Committee

doi:10.1016/j.jpedsurg.2023.06.013

Pediatric Surgeon Perceptions on Operating Room Environmental Stewardship and Current Institutional Climate-Smart Actions

J Pediatr Surg. 2023 Dec;58(12):2278-2285. doi: 10.1016/j.jpedsurg.2023.06.013. Epub 2023 Jun 27.

Authors

Gwyneth A Sullivan¹, Audra J Reiter¹, Charesa Smith¹, Richard D Glick², David E Skarda³, Hau D Le⁴, Kenneth W Gow⁵, Barrie S Rich², Mehul V Raval⁶; American Academy of Pediatrics Section on Surgery Delivery of Surgical Care Committee

Affiliations

¹ Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
² Division of Pediatric Surgery, Department of Surgery, Cohen Children's Medical Center, New Hyde Park, NY, USA.
³ University of Utah, Department of Surgery, Division of Pediatric Surgery, Salt Lake City, UT, USA; Primary Children's Hospital, Intermountain Health Care, Salt Lake City, UT, USA.
⁴ Division of Pediatric Surgery, Department of Surgery, American Family Children's Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
⁵ Seattle Children's Hospital and the University of Washington, Seattle, WA, USA.
⁶ Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. Electronic address: mraval@luriechildrens.org.

PMID: 37468347
DOI: 10.1016/j.jpedsurg.2023.06.013

Abstract

Background: Operating rooms generate significant greenhouse gas emissions. Our objective was to assess current institutional climate-smart actions and pediatric surgeon perceptions regarding environmental stewardship efforts in the operating room.

Methods: A survey was distributed to members of the American Pediatric Surgical Association in June 2022. The survey was piloted among ten general surgery residents and two professional society cohorts of pediatric surgeons. Comparisons were made by demographic and practice characteristics.

Results: Survey response rate was 15.9% (n = 160/1009) and included surgeons predominantly from urban (n = 93/122, 76.2%) and academic (n = 84/122, 68.9%) institutions. Only 9.8% (n = 12/122) of pediatric surgeons were currently involved in operating room environmental initiatives. The most common climate-smart actions were reusable materials and equipment (n = 120/159, 75.5%) and reprocessing of medical devices (n = 111/160, 69.4%). Most surgeons either strongly agreed (n = 48/121, 39.7%) or agreed (n = 62/121, 51.2%) that incorporation of environmental stewardship practices at work was important. Surgeons identified reusable materials/equipment (extremely important: n = 61/129, 47.3%, important: n = 38/129, 29.5%) and recycling (extremely important: n = 68/129, 52.7%, important: n = 29/129, 22.5%) as the most important climate-smart actions. Commonly perceived barriers were financial (extremely likely: n = 47/123, 38.2%, likely: n = 50/123, 40.7%) and staff resistance to change (extremely likely: n = 29/123, 23.6%, likely: n = 60/123, 48.8%). Regional differences included low adoption of energy efficiency strategies among respondents from southern states (n = 0/26, p = 0.01) despite high perceived importance relative to other regions (median: 5, IQR: 4-5 vs median: 4, IQR 4-5, p = 0.04).

Conclusions: While most pediatric surgeons agreed that environmental stewardship was important, less than 10% are currently involved in initiatives at their institutions. Opportunities exist for surgical leadership surrounding implementation of climate-smart actions.

Level of evidence: Level III.

Keywords: Conservation; Cross-sectional survey; Environment; Operating room; Pediatric; Surgeons.

MeSH terms

Child
Humans
Operating Rooms*
Surgeons*
Surveys and Questionnaires
United States