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Introduction: Every industry has greenhouse gas emissions, with healthcare a significant contributor. In Canada, the healthcare sector is directly and indirectly responsible for 4.6% of the country's greenhouse gas emissions. Operating rooms (ORs) are major contributors to hospital waste, making the OR low hanging fruit for analyzing environmental practices. The OR can adopt a green mindset to reduce its carbon footprint, yet barriers to going green exist. Herein we study non-hospital surgical centres in British Columbia to assess current green practices, attitudes towards environmental sustainability, and barriers to implementation. Methods: All accredited non-hospital surgical centres in BC were invited to complete a survey on current practices and plans to reduce their environmental impact. Results: Of 56 non-hospital surgical centres contacted, 18 responded, with 89% willing to adapt their practice to promote environmental sustainability, yet lacked current knowledge (56%) and formal plans (0%). The wide use of anesthetic gases with high global warming potential (64%) and disposable drapes/ gowns (78%/ 67%) were noted. Barriers to adopting green practices included: cost (44%), infrastructure (44%), regulatory guidelines (39%), knowledge (39%), and safety (28%). Conclusions: Transitioning to more environmentally sustainable practices in ORs can enhance healthcare value by reducing both costs and greenhouse gas emissions. The greatest effect can be achieved through prudent choice of anesthetic gas agent, followed by reusable linens and drapes. Education and regulatory leadership were identified as crucial for overcoming these barriers. This study underscores the need for education, guidelines, and economically viable options to transition from awareness to action.
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