Do not perform routine clinical interventions in the perioperative pathway, such as antibiotic prophylaxis, histological examinations, and other procedures; instead, apply Lean Management and Sustainable Healthcare principles to ensure clinical appropriateness and rational resource use.

May 12, 2026

Do not perform routine clinical interventions in the perioperative pathway, such as antibiotic prophylaxis, histological examinations, and other procedures; instead, apply Lean Management and Sustainable Healthcare principles to ensure clinical appropriateness and rational resource use.

Type of practice

Other health practices

Age

Adult, Geriatric, Pediatric

Topic Area

Environment

In line with the principles of Lean Management and Sustainable Healthcare, reducing waste in clinical processes is a fundamental lever for sustainability of healthcare systems. The routine provision of services lacking real clinical appropriateness does not bring health benefits to the patient but potential harm, generates a significant environmental and clinical impact and consumes essential resources.
Pharmaceutical products account for approximately 20% of total healthcare emissions; in particular, antibiotic overuse fuels antimicrobial resistance (AMR) and substantially contributes to soil and marine water pollution. Similarly, laboratory investigations have a significant carbon footprint and, in low-risk elective settings, up to 70% of routine histological exams could be avoided without affecting clinical outcomes, reducing laboratory workload, the use of toxic chemical reagents and the generation of special waste.

Sources

1. Ministero della Salute. Piano Nazionale di Contrasto all’Antimicrobico-Resistenza (PNCAR) 2022-2025. Roma: Ministero della Salute; 2023. (last accessed: April 2026). https://www.salute.gov.it/imgs/C_17_pubblicazioni_3294_allegato.pdf
2. Apreja M, Sharma A, Balda S et al. Antibiotic residues in environment: antimicrobial resistance development, ecological risks, and bioremediation. Environ Sci Pollut Res Int 2022;29:3355-3371. doi: 10.1007/s11356-021-17253-2.
3. Vergara R, Théate I, Boor P et al. Surgical pathology and sustainable development: international landscape and prospects. J Clin Pathol 2025;78:233-39. doi: 10.1136/jcp-2024-209555.
4. Veronesi G et al. L’istologia selettiva nella chirurgia elettiva a basso rischio: analisi dell’appropriatezza in un centro di riferimento italiano. G Ital Chir 2023;74:112-19.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.