Massachusetts Health & Hospital Association

Improving Safety: Eliminating Surgical Smoke by 2024

Quotation marks with an EKG symbol

The MHA Board of Trustees is calling on all Massachusetts hospitals to eliminate surgical smoke from their facilities by 2024 through the implementation of a nationally recognized smoke evacuation program. Surgical smoke is produced by the destruction of tissue by use of lasers or electrosurgical devices. Research studies confirm that surgical smoke can contain toxic gases and vapors such as benzene, hydrogen cyanide, formaldehyde, and bioaerosols, as well dead and live material, including blood tissue particles, bacteria, and viruses.

MHA’s Clinical Issues Advisory Council (CIAC) – the group consisting of clinical leaders from across the state that advises the board – created the MHA Workgroup on Surgical Smoke Evacuation, which then developed and fielded surveys on the issue. A 2021 MHA survey found that of the 55 unique responders, 40% always use surgical smoke evacuators and 61% have a smoke evaluation policy in place.

“Massachusetts hospitals continue to improve their efforts to eliminate surgical smoke, but CIAC and now the MHA Board want to jumpstart those efforts,” said Michael Gustafson, M.D., president of UMass Memorial Medical Center, chair of CIAC, and a member of the MHA Board. “The necessary goal is to protect all members of the OR team – surgeons, nurses, allied healthcare staff, and, of course, patients – from hazard. It’s part of the culture of safety that all hospitals strive for.”

MHA sent a commitment letter to each hospital asking them to educate senior leadership on the long-term hazards of exposure to surgical smoke, implement a policy and invest in the devices to eliminate surgical smoke, and report back to MHA on their progress. Currently seven facilities in Massachusetts have received the Association of periOperative Registered Nurses (AORN) “Go Clear Award,” one of the nationally recognized programs hospitals can participate in to meet the MHA Board’s 2024 target.

Surgeons, whose hands hold the lasers and whose vision is affected by both smoke and the evacuation devices, are key to the success of the initiative. Dr. John J. Mazzucco, a general surgeon at Holyoke Medical Center, has been a leading advocate for the elimination of surgical smoke throughout the MHA process. “There is definitely a requirement to adapt to the new technology introduced into the OR,” he says. “But the benefits to the care team in terms of protecting them from the proven bioaerosols, as well dead and live material, including blood tissue particles, bacteria, and viruses far outweighs the need for the learning curve surgeons must undertake.”

Baystate Medical Center and Baystate Franklin Medical Center are among the Massachusetts hospitals that already have received AORN’s Go Clear Gold Award. “Because of how surgeries are conducted, patients are exposed to surgical smoke usually for short periods of time.” said Patricia Samra, R.N., VP of HR and Total Rewards at Baystate Health. “But studies have shown that perioperative nurses report twice as many respiratory issues as compared to the general population, and the hazard to those in the OR day in and out is of great concern. Eliminating surgical smoke not only makes sense from a clinical viewpoint, but it shows our staff – who work in extraordinarily stressful situations – that we place great importance on their health and wellbeing.”

MHA will be conducting education programs and sharing best practices in the coming months to assist hospitals reach the goal of eliminating surgical smoke by 2024.