Other Initiatives
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Identifying and supporting interventions in primary care that contribute to climate mitigation and climate resilience. Click here to learn more.
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Identifying opportunities to increase the visibility and impact of sustainability efforts. Click here to learn more.
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Determining how to assess and harness the environmental benefits of virtual care, learning, and work. Click here to learn more.
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Ensuring commitment to advancing equitable outcomes both in the areas of climate mitigation and resilience. Click here to learn more.
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Developing city-healthcare partnerships to explore opportunities for the healthcare sector to support city-led climate action. Click here to learn more.
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Identifying opportunities to leverage healthcare purchasing for sustainability. Click here to learn more
Working Group
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Working Group Lead
Robin McLeod, Vice Chair, Quality and Best Practices, Department of Surgery, UofT
Working Group Members
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)
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Working Group Lead
Dr. Anita Rao, Anesthesiologist, Trillium Health Partners; Lecturer, Department of Anesthesiology and Pain Medicine
Working Group Members
Dr. Elaine Ng, Staff Anesthesiologist, Co-chair, Perioperative Care Unit Green Committee, Director of Education, Department of Anesthesia and Pain Medicine, Hospital for Sick Children (SickKids); Associate Professor, Department of Anesthesiology and Pain Medicine, University of Toronto
Cameron Irani, RN, MN, The Hospital for Sick Children (SickKids)
Jhanvi Solanki, RN, MN, Vice President, Clinical Programs, Humber River Hospital
Dr. Tenille Ragoonanan, Anesthesiologist, Perioperative Team Champion for Sustainability, Michael Garron Hospital
Dr. Melissa Ho, Anesthesiologist; Co-lead Perioperative Sustainability, North York General Hospital; Lecturer, Department of Anesthesiology and Pain Medicine, University of Toronto
Dr. Kim-Chi Tran, Urologist, Scarborough Health Network; Co-founder & Co-chair, Ontario Medical Association Green is Health Medical Interest Group; Board Member, Canadian Coalition for Green Health Care
Dr. Danyela Lee, Anesthesiologist, Sinai Health; Lecturer, Department of Anesthesiology and Pain Medicine, University of Toronto
Dr. Soniya Sharma, Anesthesiologist, Sinai Health; Assistant Professor, Department of Anesthesiology and Pain Medicine, University of Toronto
Barbara McArthur, Patient Care Manager; Co-Chair, Green OR Task Force, Sunnybrook Health Sciences Centre
Dr. Martin Van der Vyver, Anesthesiologist; Co-Chair, Green OR Task Force, Sunnybrook Health Sciences Centre; Assistant Professor, Department of Anesthesiology and Pain Medicine, University of Toronto
Dr. Munir Jamal, Head, Division of Urology, Trillium Health Partners; Lecturer, Department of Surgery, University of Toronto
Jack Li, Operating Room – Clinical Nursing Educator, Unity Health Toronto
Dr. Sarah Ward, Orthopaedic Surgeon, St. Michael’s Hospital; Assistant Professor, Department of Surgery, University of Toronto
Dr. Ali Abbass, Anesthesiologist; Chief of Environmental Stewardship and Sustainability, St. Joseph’s Hospital, University Health Network
Dr. Laura Donahoe, Thoracic & Lung Transplant Surgeon; Operating Room Green Team Lead, Toronto General Hospital, University Health Network; Assistant Professor, Department of Surgery, University of Toronto
Dr. Karen Devon, Endocrine and Thyroid Surgeon, Women’s College Hospital; Associate Professor, Department of Surgery, University of Toronto
Emily Pearsall, Manager, Best Practice in Surgery, Department of Surgery, University of Toronto
Secretariat
Fiona Miller, Director, Centre for Sustainable Health Systems, University of Toronto & CASCADES
Brittany Maguire, Managing Director, Centre for Sustainable Health Systems, University of Toronto
About the Community of Practice Sustainable Operating Rooms Initiative
Operating rooms 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. The operating room contributes to environmental degradation in several ways, such as via the use of disposable products and single-use surgical devices; unnecessary energy used for heating, ventilation, and air conditioning; and the use and disposal of anesthetic gases and pharmaceuticals. Other sources of it negative environmental impact include biohazardous medical waste. Overall, Operating rooms 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 sought to synthesize available evidence and guidance to support practice change across Toronto Academic Health Science Network operating rooms.
Guidance document
Led by the Department of Surgery’s “Best Practice in Surgery” Team, the Working Group developed an evidence-based guidance document to help hospitals improve the environmental sustainability of their operating rooms. The Greening ORs: A guidance document for improving the environmental sustainability of operating rooms is available on the Best Practice in Surgery website.
Score Card
The Term One Working Group drew on the guidance document to define key areas for sustainability action in the operating room. Drawing on this framework and through discussions with expert stakeholders across the Toronto Academic Health Science Network, the Working Group then developed a scorecard addressing 4 areas of environmental impact: anesthetic gases, reusables, waste management, and energy management.
The Sustainable Operating Room Scorecard was updated in 2023 by the Term Two Working Group, with full representation from across the Toronto Academic Health Science Network.
Click here to view the current and previous versions of the Sustainable Operating Room Scorecard.
CASCADES hosts a variety of other resources that are relevant to achieving a sustainable OR here.
If you’d like to share any ideas, questions, or resources, please email cshs@utoronto.ca.