Exploring Barriers and Facilitators to Reducing the Environmental Impact of the Operating Room.

INTRODUCTION: The operating room (OR) is a major contributor to greenhouse gas emissions both nationally and globally. Successful implementation of quality improvement initiatives requires understanding of key stakeholders' perspectives of the issues at hand. Our aim was to explore surgical, anesthesia, and OR staff member perspectives on barriers and facilitators to reducing OR waste. MATERIALS AND METHODS: Identified stakeholders from a single academic medical center were interviewed to identify important barriers and facilitators to reducing surgical waste. Two team members with qualitative research experience used deductive logic guided by the Theoretical Domains Framework of behavior change to identify themes within transcripts. RESULTS: Nineteen participants including surgeons (n = 3, 15.8%), surgical residents (n = 5, 26.3%), an anesthesiologist (n = 1, 5.3%), anesthesia residents (n = 2, 10.5%), nurse anesthetists (n = 2, 10.5%), nurses (n = 5, 26.3%), and a surgical technologist (n = 1, 5.3%) were interviewed. Twelve of the 14 themes within the Theoretical Domains Framework were discovered in transcripts. Barriers within these themes included lack of resources to pursue environmental sustainability in the OR and the necessity of maintaining sterility for patient safety. Facilitators included emphasizing surgeon leadership within the OR to reduce unused supplies and spreading awareness of the environmental and economic impact of surgical waste. CONCLUSIONS: Interviewed stakeholders were able to identify areas where improvements around surgical waste reduction and management could be made at the institution by describing barriers and facilitators to sustainability-driven interventions. Future surgical waste reduction initiatives at this institution will be guided by these important perspectives.

They were uncivil, and now I am too: A dual process model exploring relations between customer incivility and instigated incivility.

Incivility from customers is a common occurrence for employees working in service-oriented organizations. Typically, such incivility engenders instigated mistreatment, both towards customers and colleagues. Not much is understood, however, about the mechanisms underlying the relations between customer incivility and instigated incivility. Answering recent calls from incivility scholars, the present research, drawing from Self-Regulatory Resource Theory and Stressor-Emotion models of workplace behaviour, explored cognitive (i.e., self-regulatory resource depletion) and affective (i.e., negative affect) pathways that would explain relations between customer incivility and instigated incivility towards others. Through two multi-wave studies with different time lags (N1  = 180, weekly lags; N2  = 192, within-week lags) and different operationalizations of the instigated incivility construct (i.e., broad [unidimensional] and narrow [multidimensional]), we find consistent support for the mediating effects of the affective pathway. While our first study finds that customer incivility is linked to broad instigated incivility through negative affect, our second study finds that customer incivility is linked to, more specifically, gossip, exclusionary behaviour, and hostility through negative affect. In both studies, however, no support was found for the mediating effects of the cognitive pathway. Implications for both research and practice are discussed, and future research directions are offered.

"Your help isn't helping me!" Unhelpful workplace social support, strain, and the role of individual differences.

While the reception of social support at work is generally considered a net positive for employees, researchers have identified that particular kinds of social support, such as unhelpful workplace social support (UWSS), tend to evoke stress and contribute to strain for recipients. Although (Gray et al. Work and Stress, 34(4), 359-385, 2020), when validating the novel UWSS measure, uncovered relations between UWSS and various outcomes, more research is needed to further understand the impacts of UWSS. Furthermore, the extant social support literature is currently lacking in its understanding of how individual differences strengthen or weaken the relations such support has with strain. Drawing from the Theory of Stress as Offense to Self (Semmer et al. Occupational Health Science, 3(3), 205-238. 10.1007/s41542-019-00041-5, 2019), we, through two studies (N 1 = 203, N 2 = 277), further explore the relations of UWSS, focusing on behavioral and psychological strain, and examine how these relations are influenced by relevant individual differences (e.g., Big Five traits). Results from our first study replicate key findings from (Gray et al. Work and Stress, 34(4), 359-385, 2020), providing additional validity evidence for the novel measure of UWSS, and demonstrate that UWSS is related to various types of behavioral strain. Our second study shows that the strength of these deleterious relations varies based on characteristics of the recipient of UWSS. Altogether, the present research contributes to the literature on social support as a stressor by elucidating further the effects of UWSS, and, perhaps more importantly, for whom UWSS is particularly deleterious.