Sustainability Checklists

Anesthesiology Sustainability Checklist

1. Reduce Inhaled Anesthetic Atmospheric Waste

• ❑   Utilize low fresh gas flows.
• ❑   Avoid high impact inhaled anesthetics like desflurane and nitrous oxide.
• ❑   Consider intravenous and regional techniques when clinically appropriate.
• ❑   Abandon centralized nitrous oxide piping and switch to portable tank management systems.
• ❑   Waste anesthetic gas trapping (for volatiles only) and destruction (for nitrous oxide) technologies appear promising; however, research is required on their efficacy, efficiency, and life cycle emissions before they can be recommended.

2. Reduce IV Pharmaceutical Waste

• ❑   Advocate for and use prefilled syringes
• ❑   Advocate for and use appropriately sized vials for an individual patient.
• ❑   Dispose of unused medications and vials according to regulations (but not exceeding).

3. Reduce Anesthesia Equipment Waste

• ❑   Only open equipment intended for immediate use.
• ❑   Consider purchase of reusable or reprocessed equipment over disposable.
• ❑   Reprocess or recycle suitable disposable equipment.
• ❑   Adjust stock levels to minimize discarding expired items.
• ❑   Reformulate prefabricated kits to eliminate unnecessary items.
• ❑   Reformulate anesthesia supply carts to eliminate unnecessary items.
• ❑   Donate expired or unused open equipment to appropriate groups, (e.g., medical missions, simulation centers.)

4. Solid Waste Segregation

• ❑   Segregate waste according to type (pharmaceutical, solid, biohazard, etc.).
• ❑   Avoid default of placing all waste into biohazard or sharps bins.
• ❑   Repurpose and recycle batteries.
• ❑   Consider intraoperative recycling program for clean plastics, paper, and cardboard.

5. Linens

• ❑   Consider reusable linens.
• ❑   Avoid unnecessary use of reusable and disposable towels and blankets.

6. Electronics

• ❑   Avoid excess electronics and upgrades without proven benefit to patient care.
• ❑   When negotiating equipment upgrades/contracts, request vendors take back old equipment for refurbishment and donation, or request vendor use a certified sustainable electronics recycling vendor.
• ❑   Use a certified sustainable electronics recycling vendor to dispose of old equipment.

7. Leadership

• ❑   Educate staff regarding the health, safety, and cost benefits of pollution mitigation projects.
• ❑   Develop/join/lead a sustainability committee at a department, hospital, or society level and advocate for dedicated sustainability officer roles.
• ❑   Collaborate with hospital leadership to embed pollution prevention as part of the core business mission to improve the health of our patients, employees, and the surrounding community.
• ❑   Become involved in development of environmental preferable purchasing and contracting standards.
• ❑   Evaluate new equipment, facility, and workflow options for improved sustainability.
• ❑   Perform strategic sustainability quality improvement and research projects that will lead to financial and environmental savings for the department and hospital.

Sustainable Meetings Checklist

Event planner leadership

• ❑   Designate an individual on the convention planning team to oversee sustainability initiatives.

Carbon neutrality

• ❑   Set a low carbon emissions event goal.
• ❑   Develop a mitigation plan and track progress.
• ❑   Offer a portal for optional purchase of verified carbon credits through the registration platform.

Virtual participation

• ❑   Maximize virtual event planning.
• ❑   Provide hybrid (virtual and in-person) participation options for speakers and attendees.

Transportation

• ❑   Prioritize venues that are accessible by active (walking and city bikes) and public transport.
• ❑   Provide attendees with low-emitting public transportation options, such as electric shuttles.

Venue and accommodations

• ❑   Prioritize sustainability-certified venues, including buildings and operations (e.g., through Leadership in Energy and Environmental Design).
• ❑   Prioritize sustainability-certified hotels, including buildings and operations (e.g., through Eco-Management and Audit Scheme or Hotel Carbon Measurement Initiative), and provide information to attendees through the registration platform.

Catering and for-purchase food and beverage best practices

• ❑   Contract for reusable plates and cutlery, and certified biodegradable disposables for to-go options.
• ❑   Increase ratio of vegetarian and vegan to meat and dairy options for meals and snacks.
• ❑   For catered meals, reduce plate size to diminish food waste.
• ❑   Donate all surplus food to local food redistribution organizations, where local codes permit.

Materials

• ❑   Minimize print materials and maximize electronic materials.
• ❑   Offer reusable bags and beverage containers for sale, but do not give away.
• ❑   Reuse materials from previous conferences.

Waste management

• ❑   Strongly encourage venues to provide waste sorting bins (including recycling and compost) with clear sorting instructions, and staff/volunteers to assist in sorting at highly attended sessions.
• ❑   Strongly encourage venue staff to record the amount of solid waste generated.

Raising awareness

• ❑   Communicate eco-friendly event planning and operations measures, e.g., through registration portal and on-site printed materials, and annual board reports.
• ❑   Encourage attendees to bring their own reusable travel cups and utensils, e.g., through the registration portal.

^* Adapted from “COVID, Climate Change, and Carbon Neutral Medical Conferences”, ASA Monitor, Vol. 85, pp22-23, January 2021.¹³¹