Hospitals are coming together to improve surgical recovery with a focus on environmental sustainability and green lens. Cut the Carbon: Reducing Surgical Waste will enhance patient care, support pandemic recovery, and have a focus on sustainable healthcare solutions.
Recognizing that efficient care often means less waste and less of an environmental impact, this campaign uses the principles of Enhanced Recovery After Surgery (ERAS): the implementation of patient-centered, evidence-based, and interdisciplinary pathways with a green lens. The goal is to improve the patient’s journey through the preoperative, intraoperative, and postoperative phases of surgical care while reducing surgical waste.
Many teams have already implemented ERAS pathways and have begun to think sustainably. This campaign is an opportunity to focus on aspects that your team feels could be improved and to spread successes to other surgical specialties and procedures.
This campaign aligns with current pandemic recovery endeavors across Ontario and will enable faster recovery and improve surgical outcomes for patients in Ontario.
Operating rooms (ORs) generate up to a third of total hospital waste1. This waste has a negative environmental impact. Major sources of OR emissions include disposable materials, single-use devices, anesthetic gas use, biohazardous medical waste, and energy used for heating, ventilation, and cooling1. Implementing strategies to encourage environmental sustainability will reduce waste and financial expenditure, while ensuring patient safety and positive environmental impact.
Reference:
1 Simms N, Devitt K, Irani C, Khan N, Meng F. Sustainable Perioperative Care [Internet]. CASCADES (Creating a Sustainable Canadian Health System in a Climate Crisis). [2023]. Available from https://cascadescanada.ca/resources/sustainable-perioperative-care-playbook/
Between April 1, 2025, and March 31, 2026, Surgical Network hospitals, supported by Ontario Health, will make a commitment to continue improving outcomes for patients by implementing or building on Enhanced Recovery After Surgery (ERAS) best practices and at the same time reducing waste.
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Teams will choose at least one surgery type with the aim of improving at least one surgical outcome by 20% using ERAS principles.
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Additionally, teams will choose at least one carbon reducing change idea to implement.
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Track your progress: Collect data using the process and balancing measures below to help you determine the success of your approach and its impact on patients and hospital length of stay.
Process Measures
- The full list of process measures is available on the Quorum page
Balancing Measures*
*Balancing measures help ensure changes implemented to improve one element of patient care are not causing new problems in other areas of care.
Ontario Surgical Quality Improvement Network members: Demonstrate your participation in this campaign in your Surgical Quality Improvement Plans.
Not a member? No problem – send an email to ONSQIN@ontariohealth.ca to find out how your hospital can join the campaign.
CASCADES
CASCADES is a national multi-year capacity-building initiative to address healthcare’s contribution to the climate crisis. CASCADES aims to leverage, support, and enhance existing capacity around sustainable healthcare. The offer professional development training programs, resources, and events that celebrate and expand existing knowledge, skills and networks. While also providing support to efforts to test and spread sustainable innovations in service delivery and system design.
Learn more on how your team can get involved.
Click here for the Perioperative Playbook and more resources, including the new Fillable Sustainable Perioperative Care Scorecard.
The Canadian Coalition for Green Health Care
The Canadian Coalition for Green Health Care has been supporting organizations deliver health care sustainably for over 20 years. Their vision is to see a net zero Canadian Health System. To accomplish this, they have partnered with changemakers to build capacity in individuals and organizations to develop green health policies and practices. Click here to learn more about how hospitals can get connected to their work.
MyPractice Report: General Surgery
General surgeons who perform appendectomies, cholecystectomies, and select hernia repairs can sign up to receive a confidential practice report that offers personalized data on your opioid prescribing patterns in relation to your peers. Suggestions and tools to support quality improvement efforts are also included.
MyPractice Report: Orthopaedic Surgery
Orthopaedic surgeons who perform hip and knee replacements can sign up to receive a confidential practice report that includes personalized data on your opioid prescribing patterns, along with suggestions to help improve care for your patients.
Quality Standard: Opioid Prescribing for Acute Pain
Learn more about opioid prescribing for acute pain using this quality standard produced by Ontario Health in consultation with clinical experts and patients. It outlines what high-quality care looks like for clinicians when they’re prescribing opioids and is based on the best evidence.
Share its accompanying patient guide with your patients to help them ask informed questions about opioid prescribing and additional techniques they can use to help manage their pain post-surgery.
Quality Standard: Surgical Site Infection
Learn more about preventing and managing Surgical Site Infections (SSIs) using this quality standard produced by Ontario Health in consultation with clinical experts and patients. It outlines what high-quality care looks like for clinicians when they are caring for surgical patients.
Local Initiatives
Many organizations and hospitals are already taking steps to implement Enhanced Recovery After Surgery best practices and sustainable healthcare solutions.
If you’re a member of the Ontario Surgical Quality Improvement Network, you’ve been receiving updates about these local initiatives through the Surgical Network’s Community of Practice.
If you’re not a member, but are interested in learning more about local initiatives, email ONSQIN@ontariohealth.ca.
People who are about to have surgery might be apprehensive about the procedure and their recovery, especially during the pandemic. They may experience anxiety or fear about post-surgical pain affecting their daily lives. Plan and prepare for surgery, together — talk with your patients and their caregivers about what to expect at every stage of the surgical process.
Start the conversation:
Enhanced Recovery After Surgery (ERAS) Resources for Clinicians:
Communications Materials
Celebrate and share that your hospital is taking on the Cut the Carbon: Reducing Surgical Waste challenge. Here are some suggested communications tools you may find helpful:
Quorum
Members of the Ontario Surgical Quality Improvement Network can engage with others and exchange success stories and challenges on
Quorum, an online quality improvement forum. Share tools, resources, and best practices your team is using for Enhancing Surgical Recovery at your hospital.
For more information on the Cut the Carbon: Reducing Surgical Waste campaign or to join the Ontario Surgical Quality Improvement Network, please contact ONSQIN@ontariohealth.ca.