GoGREEN: REDUCING THE ENVIRONMENTAL IMPACT OF OPERATING THEATRES - A BEHAVIOURAL SCIENCE APPROACH

NHS对英国的碳足迹贡献很大，占英国总碳足迹的4%。手术室的能耗是医院其他部分的三到六倍，是造成浪费的主要原因。本研究的目的是确定英国医院行为改变的可能性，以减少手术室实践对环境的影响。最近的研究和亲环境倡议提出了实用指南，以尽量减少手术室对环境的影响，例如减少麻醉气体（例如，使用局部麻醉而不是全身麻醉），合理化手术器械（例如，简化手术器械托盘）以及选择可重复使用的产品和设备（例如，可重复使用的长袍和工具而不是一次性的）。然而，许多提出的解决办法忽视了在执行过程中至关重要的行为因素。这是实践中的证据，英国医院的可持续发展倡导者报告说，这些和类似的绿色手术指南采用缓慢。虽然外科医生和其他医院工作人员意识到并关注环境浪费和气候危机，但许多人报告说，在实践中实施亲环境行为面临重大挑战，并且在环境意图和个人的亲环境行为之间存在着众所周知的差距。因此，了解如何授权手术室工作人员采用绿色手术程序对于医疗保健系统的净零转型至关重要。在这个项目中，我们将与外科医生、其他手术室工作人员和帝国NHS信托医院的更广泛的利益相关者密切合作，确定在手术室采用绿色手术原则和实践的最重要的促进因素和障碍。有了这些见解，我们将共同设计具有最高环境效益的手术途径行为改变干预措施，这可以帮助缩小手术室中环境意图和亲环境行为之间的差距。我们将运用环境心理学、行为科学和以人为本的设计原则的见解，提出一套干预措施，用于促进手术中环境指导方针的实施。

NHS contributes substantially to the UK's carbon footprint, accounting for 4% of England's total carbon footprint. Operating theatres are shown to be three to six times more energy-intensive than the rest of the hospital and a major contributor of waste. The aim of this research is to identify possibilities for behaviour change in UK hospitals to reduce the environmental impact of operating theatres practices.Recent research and pro-environmental initiatives have proposed practical guidelines to minimise environmental impact in operating theatres such as reduction of anaesthetic gas (e.g., using local anaesthetic instead of general anaesthetic), rationalising surgical instruments (e.g., streamlining surgical instrument trays) and opting for reusable products and equipment (e.g., reusable gowns and tools instead of disposable ones). However, many of the proposed solutions overlook the behavioural factors that are crucial in the implementation process. This is evidence in practice, where sustainability champions in UK hospitals report on slow adoption of these and similar green surgery guidelines.While surgeons and other theatre staff are aware and concerned about environmental waste and climate crisis, many report significant challenges in implementing pro-environmental behaviours in their practice, and there is a well-known gap between environmental intentions and pro-environmental behaviours of individuals. Therefore, understanding how theatre staff can be empowered to adopt green surgery procedures is critical for the net-zero transition of healthcare systems.In this project, we will work closely with surgeons, other theatre staff and the broader stakeholders at Imperial NHS Trust hospitals to identify the most important facilitators of and barriers to the adoption of green surgery principles and practices in operating theatres. With these insights, we will co-design interventions for behaviour change for the surgery pathway with the highest plausible environmental benefits, and that can help to close the gap between environmental intentions and pro-environmental behaviour in operating theatres. We will employ insights of environmental psychology, behavioural science and human-centred design principles to propose a package of interventions that will be used to facilitate the implementation of environmental guidelines in surgery.