Project Leads: Dr Shashi Prasad (Consultant), Elizabeth Fitzhugh (Sustainability Lead, Department of Anaesthesia and Perioperative Medicine) and Theatre 5/6 staff at University Hospitals Coventry and Warwickshire NHS Trust.

The Intercollegiate Green Theatre Checklist is a cross-speciality supportive tool designed to empower surgical teams to create sustainable practice changes within their own departments. Each recommendation on the checklist is grounded in the principles of sustainable quality improvement, including the “triple bottom line” of environmental, social, and economic improvement. This pilot was undertaken to establish the practicality of adoption in a busy tertiary head and neck service.

To implement the checklist, the theatre team integrated it into their morning briefs, which gave members an opportunity to highlight any challenges to implementation that they anticipated. To make changes to practise, team members incorporated the 5RS of surgical sustainability: Rethink, Reduce, Repurpose, Recycle, and Research. The implementation process was closely monitored, and relevant personnel were consulted to mitigate any obstacles.

The pilot found that 14 of the 16 measures on the Intercollegiate Green Theatre Checklit could be implemented in their practice. Three specific steps (adopting reusable gowns, reducing water and energy consumption, and using lowest carbon-appropriate waste systems) led to a 160kg reduction in CO₂e and a 1296L reduction in water consumption. Extrapolated data suggests that widespread adoption of these measures could lead to an annual decline of 28 tonnes of CO₂e and savings of £81,000. Measures that could not be implanted included reprocessing intraoperative equipment, removing surplus from single-use surgical packs, and reusable patient drapes and trolley covers.

The pilot demonstrated that local, ground-up initiatives can be implemented with a paradigm shift in thinking to enable solutions to ensure a sustainable future for surgical practitioners and patients. In future, the checklist will be used as a scorecard to monitor progress, and the data from the pilot will serve as a roadmap to influence wider adoption of sustainable practice across the surgical division.

Design for Life