Sustainable Operating Rooms

Sustainability in Operating Rooms

Operating rooms (ORs) are key sites for patient care. They are also energy and waste intensive spaces that have been shown to have a negative impact on the environment and – consequently – human health. This includes the use of disposable products and single-use surgical devices; unnecessary energy used for heating, ventilation, and air conditioning; the use, leaks, and disposal of anesthetic gases and pharmaceuticals; and biohazardous medical waste. Overall, ORs generate up to a third of total hospital waste.  

Implementing strategies to support environmental sustainability in the operating room presents an opportunity to reduce waste and expenditure, while ensuring sterility and patient safety. 

The Sustainable Operating Rooms Working Group has sought to synthesize available evidence and guidance to support practice change across Toronto Academic Health Science Network (TAHSN) operating rooms.  

Sustainable Operating Room Scorecard 

Since 2022, TAHSN has mobilized a Sustainable OR Scorecard, identifying and refining indicators in accordance with areas of opportunity and need. 

  • The scorecard identifies 10 high-impact and achievable sustainability strategies that can be implemented within ORs, agreed upon by the Sustainable OR Working Group, with representation from each of the 11 TAHSN hospitals with ORs. 
  • The working group also meets regularly to discuss how to make progress on items in the scorecard and have identified reusable surgical gowns as their collective priority. 
  • Since the launch of the Sustainable OR Scorecard, TAHSN OR teams have achieved significant improvements on all 10 items. 

Each year, ORs score themselves and results are shared with the OR teams, the Leadership Table, and the TAHSN CEO Committee. To learn more, see below for: 

  • Annual TAHSN scorecard results, which compares all the TAHSN Operating Rooms to each other 
  • Fillable scorecard revised each year, which can be used to track and measure progress 

Scorecards

TAHSN Results

Fillable Scorecard

TAHSN Results

Fillable Scorecard

TAHSN Results

Fillable Scorecard

Previous Work

Led by the Department of Surgery’s Best Practice in Surgery, the Working Group developed an evidence-based guidance document to help hospitals improve the environmental sustainability of their operating rooms.

Working Group

TAHSN Representatives:

  • Jhanvi Solanki, RN, MN, Vice President, Clinical Programs, Humber River Hospital
  • Dr. Tenille Ragoonanan, Anesthesiologist; Perioperative Team Champion for Sustainability, Michael Garron Hospital
  • Wissam Halimeh, Quality Manager, Michael Garron Hospital
  • Dr. Melissa Ho, Anesthesiologist; Co-lead Perioperative Sustainability, North York General Hospital
  • Dr. Kim-Chi Tran, Urologist, Scarborough Health Network
  • Dr. Elaine Ng, Staff Anesthesiologist; Co-chair, Perioperative Care Unit Green Committee; Director of Education, Department of Anesthesia and Pain Medicine, SickKids
  • Cameron Irani, RN, MN, SickKids
  • Dr. Soniya Sharma, Anesthesiologist, Sinai Health
  • Dr. Martin Van der Vyver, Anesthesiologist; Co-Chair, Green OR Task Force, Sunnybrook Health Sciences Centre
  • Barbara McArthur, Patient Care Manager; Co-Chair, Green OR Task Force, Sunnybrook Health Sciences Centre
  • Dr. Anita Rao, Anesthesiologist (Working Group Chair); Physician Lead of Environmental Sustainability, Trillium Health Partners
  • Dr. Munir Jamal, Head, Division of Urology, Trillium Health Partners
  • Laurie Thomas, Senior Clinical Director of Surgery, Unity Health Toronto
  • Dr. Sarah Ward, Orthopaedic Surgeon, St. Michael’s Hospital, Unity Health Toronto
  • Dr. Ali Abbass, Anesthesiologist; Chief of Environmental Stewardship and Sustainability, St. Joseph’s Hospital, Unity Health Toronto
  • Dr. Laura Donahoe, Thoracic & Lung Transplant Surgeon; Operating Room Green Team Lead, Toronto General Hospital, University Health Network
  • Emily Pearsall, Manager, Best Practice in Surgery, Department of Surgery, University of Toronto
  • Dr. Karen Devon, Endocrine and Thyroid Surgeon, Women’s College Hospital

Secretariat

  • Fiona Miller, Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health; Director, Collaborative Centre for Climate, Health & Sustainable Care, University of Toronto
  • Brittany Maguire, Managing Director, Collaborative Centre for Climate, Health & Sustainable Care, University of Toronto

TAHSN Representatives

  • Jhanvi Solanki, RN, MN, Vice President, Clinical Programs, Humber River Hospital
  • Dr. Tenille Ragoonanan, Anesthesiologist; Perioperative Team Champion for Sustainability, Michael Garron Hospital
  • Wissam Halimeh, Quality Manager, Michael Garron Hospital
  • Dr. Melissa Ho, Anesthesiologist; Co-lead Perioperative Sustainability, North York General Hospital
  • Dr. Kim-Chi Tran, Urologist, Scarborough Health Network
  • Dr. Elaine Ng, Staff Anesthesiologist; Co-chair, Perioperative Care Unit Green Committee; Director of Education, Department of Anesthesia and Pain Medicine, SickKids
  • Cameron Irani, RN, MN, SickKids
  • Dr. Soniya Sharma, Anesthesiologist, Sinai Health
  • Dr. Martin Van der Vyver, Anesthesiologist; Co-Chair, Green OR Task Force, Sunnybrook Health Sciences Centre
  • Barbara McArthur, Patient Care Manager; Co-Chair, Green OR Task Force, Sunnybrook Health Sciences Centre
  • Dr. Anita Rao, Anesthesiologist (Working Group Chair), Trillium Health Partners
  • Dr. Munir Jamal, Head, Division of Urology, Trillium Health Partners
  • Laurie Thomas, Senior Clinical Director of Surgery, Unity Health Toronto
  • Jack Li, Operating Room – Clinical Nursing Educator, Unity Health Toronto
  • Dr. Sarah Ward, Orthopaedic Surgeon, St. Michael’s Hospital, Unity Health Toronto
  • Dr. Ali Abbass, Anesthesiologist; Chief of Environmental Stewardship and Sustainability, St. Joseph’s Hospital, Unity Health Toronto
  • Dr. Laura Donahoe, Thoracic & Lung Transplant Surgeon; Operating Room Green Team Lead, Toronto General Hospital, University Health Network
  • Emily Pearsall, Manager, Best Practice in Surgery, Department of Surgery, University of Toronto
  • Dr. Karen Devon, Endocrine and Thyroid Surgeon, Women’s College Hospital

Secretariat

  • Fiona Miller, Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto; Director, Centre for Sustainable Health Systems
  • Brittany Maguire, Managing Director, Centre for Sustainable Health Systems, University of Toronto

TASHN Representatives

  • Robin McLeod, Vice Chair, Quality and Best Practices, Department of Surgery, UofT
  • Ali Abbass, Anaesthesiologist, St. Joseph’s Health Centre (SJHC), Unity Health Toronto
  • Laura Donahoe, Thoracic Surgeon, Toronto General Hospital; Assistant Professor, Department of Surgery, UofT
  • Emily Pearsall, Manager, Best Practice in Surgery, Department of Surgery, UofT
  • Ed Rubenstein, Director of Environmental Compliance, Risk and Sustainability, UHN

Secretariat

  • Fiona Miller, Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health; Director, CSHS
  • Nicole Simms, Managing Director, Centre for Sustainable Health Systems (through summer 2021; now with CASCADES)