Team Culture: How CRNAs and Anesthesiologists Are Advancing Sustainable Anesthesia Together

How NAPA’s culture empowers CRNAs to make an impact in the OR and beyond.

For Certified Registered Nurse Anesthetists, every case is a chance to make a difference — for the patient, the team, and the future of care. Across North American Partners in Anesthesia (NAPA), CRNAs are proving that clinical excellence and environmental responsibility can go hand in hand, bringing the same precision and compassion that define anesthesia care to the way we steward our resources.

Sustainable anesthesia has become part of our practice culture. Inspired by innovators like Dr. Varun Dixit, Chief Sustainability Officer and Cardiac Anesthesiologist at Henrico Doctors’ Hospital, teams of CRNAs and anesthesiologists are showing what happens when curiosity, evidence, and teamwork drive change.

From evidence to everyday practice

When low-flow anesthesia was first introduced at Henrico Doctors’, CRNAs were the first to ask questions, test the approach, and share feedback from the field. Together, the team reduced Sevoflurane use by nearly 30%, cutting costs and greenhouse gas emissions while maintaining uncompromised patient safety.

Those results spoke volumes — and today, low-flow anesthesia is part of the quality measures across NAPA. The same collaborative spirit led to eliminating piped nitrous oxide, preventing hundreds of metric tons of CO₂e emissions annually, and establishing hospital-wide recycling programs that now divert more than 180,000 pounds of waste each year.

The power of the care-team model

What made these changes stick? Trust and partnership. At NAPA, anesthesiologists and CRNAs share decision-making in the care-team model, supporting one another in the OR and beyond. When ideas like low-flow anesthesia are introduced, the team evaluates the data together, pilots the change, and refines the process side by side.

That sense of ownership — not top-down directives — is what transforms an initiative into a habit. “Change only lasts when everyone understands the ‘why’ and sees the impact firsthand,” Dr. Dixit says. “Our CRNAs were essential to that.”

Making sustainability part of patient care

For NAPA clinicians, sustainability is another form of patient advocacy. By reducing resource waste and emissions, CRNAs are helping protect the very communities their patients return to. It’s a ripple effect — small choices in the OR adding up to long-term impact for future generations.

Sustainability also strengthens the profession. It demonstrates leadership, clinical insight, and the ability to shape how anesthesia is practiced across the country. CRNAs at NAPA aren’t just delivering excellent care; they’re helping redefine what it means to “do no harm.”

A place where CRNAs can make an impact

Every advancement starts with one person asking, “What if we did this differently?”

At NAPA, those questions are welcomed. Whether it’s improving patient experience, mentoring residents, or finding smarter ways to practice anesthesia, CRNAs have a voice — and the support to turn ideas into action.

If you’re a CRNA who wants your clinical expertise to make an impact beyond the patient in front of you — join the team that’s building a more sustainable future for anesthesia and for healthcare.