Greener Operations: a James Lind Alliance Priority Setting Partnership to define research priorities in environmentally sustainable perioperative practice through a structured consensus approach.

To agree on the 'top 10' research priorities for environmentally sustainable perioperative practice. Surveys and literature review; final consensus workshop using a nominal group technique. UK-based setting. Healthcare professionals, patients, carers and the public. Initial survey-suggested research questions; interim survey-shortlist of 'indicative' questions (the 20 most frequently nominated by patients, carers and the public, and healthcare professionals); final workshop-ranked research priorities. Initial survey-1926 suggestions by 296 respondents, refined into 60 indicative questions. Interim survey-325 respondents. Final workshop-21 participants agreed the 'top 10': (1) How can more sustainable reusable equipment safely be used during and around the time of an operation? (2) How can healthcare organisations more sustainably procure (obtain) medicines, equipment and items used during and around the time of an operation? (3) How can healthcare professionals who deliver care during and around the time of an operation be encouraged to adopt sustainable actions in practice? (4) Can more efficient use of operating theatres and associated practices reduce the environmental impact of operations? (5) How can the amount of waste generated during and around the time of an operation be minimised? (6) How do we measure and compare the short-term and long-term environmental impacts of surgical and non-surgical treatments for the same condition? (7) What is the environmental impact of different anaesthetic techniques (eg, different types of general, regional and local anaesthesia) used for the same operation? (8) How should the environmental impact of an operation be weighed against its clinical outcomes and financial costs? (9) How can environmental sustainability be incorporated into the organisational management of operating theatres? (10) What are the most sustainable forms of effective infection prevention and control used around the time of an operation (eg, personal protective equipment, drapes, clean air ventilation)? A broad range of 'end-users' have identified research priorities for sustainable perioperative care.

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Déclaration de conflit d'intérêts

Competing interests: CLS is a co-opted member of the Association of Anaesthetists Environment and Sustainability Committee. He has received travel expenses from the Association of Anaesthetists, the Centre for Sustainable Healthcare and Health Education England to attend professional meetings to speak on sustainable healthcare. He is a member of the SBRI Healthcare ‘Delivering a Net Zero NHS’ competition funding panel. YH is a co-founder of Green Health Wales. CL is a member of the Health Education England North East and North Cumbria Faculty of Sustainable Healthcare and the Intensive Care Society Sustainability Group. DM has accepted consulting fees from Bausch and Lomb and Nuffield Health and honoraria for education provided to Wilderness Medical Training. SMK is the chairperson of the Association of Anaesthetists Environment and Sustainability Committee. VP is vice chairperson of the Royal College of Surgeons of England Sustainability in Surgery Group. TR is an independent participant in the OneTogether programme. DJ is the budget holder for account managed within MFT Charity used to fund Greener Operations.