@article{Almukhtar:2024:10.1097/JS9.0000000000001951,
author = {Almukhtar, A and Batcup, C and Bowman, M and Winter, Beatty J and Leff, D and Demirel, P and Judah, G and Porat, T},
doi = {10.1097/JS9.0000000000001951},
journal = {International Journal of Surgery},
title = {Interventions to achieve environmentally sustainable operating theatres: an umbrella systematic review using the behaviour change wheel},
url = {http://dx.doi.org/10.1097/JS9.0000000000001951},
year = {2024}
}

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TY  - JOUR
AB  - Introduction: The healthcare sector is a major contributor to the climate crisis, and operating theatres (OTs) are one of the highest sources of emissions. To inform emissions reduction, this study aimed to (i) compare the outcomes of interventions targeting sustainable behaviours in OTs using the Triple Bottom Line framework, (ii) categorise the intervention strategies using the 5Rs (reduce, recycle, reuse, refuse, and renew) of circular economy, and (iii) examine Intervention Functions (IFs) using the Behaviour Change Wheel (BCW).Methods: Medline, Embase, PsychInfo, Scopus, and Web of Science databases were searched until June 2023 using the concepts: sustainability and surgery. The review was conducted in line with the Cochrane and Joanna Briggs Institution’s recommendations and was registered on PROSPERO. The results were reported in line with PRISMA, Supplemental Digital Content 1, https://links.lww.com/JS9/D210 (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.Results: Sixteen reviews encompassing 43 life-cycle analyses, 30 interventions, 5 IFs, and 9 BCW policy categories were included. 28/30 (93%) interventions successfully led to sustainability improvements; however, the environmental outcomes were not suitable for meaningful comparisons due to their using different metrics and dependence on local factors. The ‘reduce’ strategy was the most prolific and commonly achieved through ‘education’ and/or ‘environmental restructuring’. However, single-session educational interventions were ineffective. Improving recycling relied on ‘environmental restructuring’. More intensive strategies such as ‘reuse’ require multiple intervention functions to achieve, either through a sustainability committee or through an intervention package.Conclusion: Policymakers must examine interventions within the local context. Comparing the outcomes of different interventions is difficult an
AU  - Almukhtar,A
AU  - Batcup,C
AU  - Bowman,M
AU  - Winter,Beatty J
AU  - Leff,D
AU  - Demirel,P
AU  - Judah,G
AU  - Porat,T
DO  - 10.1097/JS9.0000000000001951
PY  - 2024///
SN  - 1743-9159
TI  - Interventions to achieve environmentally sustainable operating theatres: an umbrella systematic review using the behaviour change wheel
T2  - International Journal of Surgery
UR  - http://dx.doi.org/10.1097/JS9.0000000000001951
UR  - http://hdl.handle.net/10044/1/113066
ER  - 

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