Green Surgery Report: Surgical Care Pathways
Read Section 3 of the Green Surgery Report
The environmental impact of surgical patient care can be reduced by interventions throughout the surgical care pathway.
Streamlining patient pathways includes reducing low-value steps and unnecessary consultations (including creating ‘one-stop’ clinics), and rationalising and eliminating unnecessary pre-operative investigations.
Use of telehealth, digital patient management systems and centralised lean electronic medical records can reduce carbon impacts.
Pre-operative optimisation can reduce complication rates, including smoking cessation, alcohol moderation, exercise, nutrition, and weight optimisation.
Operations should be performed in a timely manner, and in ambulatory day-case or outpatient settings where clinically appropriate.
In-hospital stay can be minimised, for example through enhanced recovery protocols and early discharge planning and virtual wards.
Post-operative tests and imaging should not be performed where unnecessary.
(1) Streamline surgical patient pathways e.g. reducing low-value steps and unnecessary consultations; rationalising unnecessary investigations (pre-, intra-, or post-operative); creating ‘one-stop’ clinics
(2) Optimise patients pre-operatively (e.g. smoking cessation, alcohol moderation, exercise, nutrition, optimise weight)
(3) Minimise length of hospital stay
Carpal tunnel decompression in procedure room
Digital care pathway for total knee replacement
Early mobilisation in CICU
Eliminating unnecessary pre-operative blood test
Omitting routine Group and Save test
Reducing pathology sample transport
Reducing same day surgery cancellations
Shortened admission booklet
Virtual fracture clinic
*** Note: Outcomes data from case studies have not been verified and some financial and greenhouse gas emission figures are based on projections.