ThTP3.9 Perceptions and priorities of perioperative staff and the public for sustainable surgery: a validated questionnaire study

Abstract

Abstract Aims To determine the attitudes and beliefs of perioperative staff and the public to sustainability initiatives in surgery, and whether differences exist between the two groups. Despite a drive to improve surgical sustainability, few interventions have been adopted. Stakeholder engagement is considered a key barrier to implementation. Methods Validated healthcare questionnaires were developed using a stepwise process. A systematic review was undertaken to identify key domains pertaining to sustainability, and ensure content validity. Initial questionnaires were refined using an iterative process of feedback from focus groups. Psychometric validation was conducted to remove question ambiguity. The final validated questionnaire was distributed to perioperative staff and the public using a multi-modal approach. Results Only 37.1% of perioperative staff reported implementation of sustainability initiatives in their departments. Yet, staff (45.7%) and the public (48.2%) somewhat agreed that sustainability should influence a surgeon’s procedural decision-making. Insufficient staff education regarding sustainability was a potential cause for lack of adoption, with 71.4% reporting they had no formal training. Staff and the public agreed outcomes (38.6% v. 42.7% p=0.767) and surgeon experience with a technique (28.6% v. 40.0%, p=0.082) were more important than sustainability. However, 40.9% of the public did not consider operative time an important factor compared to sustainability, whilst 45.7% staff would only tolerate procedures 25% longer. Conclusions Engaging stakeholders is central to implementing long-term environmentally sustainable initiatives in surgery, without compromising patient outcomes. More work is needed to understand the relative trade-offs considered by perioperative staff and the public, as well as providing both groups with more education on ecological outcomes.