Operating Room To Ozone: Advancing Sustainability In Inhalational Anesthesia – A QI Project

Abstract

Purpose: This quality improvement (QI) initiative aimed to increase anesthesia providers' awareness of the environmental effects of inhaled anesthetics. The goal is to lower greenhouse gas emissions from anesthesia services and promote eco-friendly practices among providers. Background: Climate change is identified as the primary health concern of the century due to increasing anthropogenic greenhouse gas (GHG) emissions leading to ongoing global warming. Operating rooms, known for their high energy consumption, play a significant role in GHG emissions in healthcare. Anesthetics for inhalation, previously vital for anesthesia, are a major contributor to the environmental impact in healthcare. Sustainable anesthesia practices are becoming increasingly important globally in the fight against the climate crisis. Methods: Anesthesia providers employed by Summit Anesthesia were recruited via email to participate in project education. Over two weeks, a pre-recorded educational presentation on current practices in sustainable anesthesia was made available to the group’s anesthesia staff. Following the educational intervention, participants were asked to complete a digital retrospective post-pre-survey to assess their knowledge of the content and intent to change practice. Results: Following the educational intervention, anesthesia providers demonstrated a significant increase in cognitive knowledge and intent to implement sustainable anesthetic practices. Mean knowledge scores improved across all three assessed domains: overall knowledge of sustainable anesthetic practices increased from 3.00 to 5.71 (90.48% increase), knowledge of volatile agent selection enhanced from 2.43 to 5.86 (141.18% increase), and understanding of low fresh gas flow (LFGF) techniques rose from 2.57 to 5.71 (122.22% increase). Additionally, post-education scores increased across all CPD-Reaction Questionnaire constructs, with the most substantial improvements in intention (44.3%), beliefs about capabilities (42.2%), and social influence (33.4%). These findings indicate that targeted education can enhance anesthesia providers’ knowledge and motivation to adopt environmentally sustainable practices. Conclusions: This quality improvement (QI) initiative improved anesthesia providers’ knowledge and intent to implement sustainable practices. Findings highlight the effectiveness of targeted education in promoting eco-friendly anesthesia practices. Continued efforts are essential to reinforce sustainable behaviors and mitigate the environmental impact of inhaled anesthetics in healthcare.