Background: Existing videolaryngoscopes do not meet the needs, budgets, and cleaning protocols of low- and middle-income countries. To solve these problems, a new videolaryngoscope, the Goodscope, has been developed which is less expensive, reusable and easy to clean. The aim of this study was to evaluate the efficacy of the Goodscope compared with a commonly used videolaryngoscope, the GlideScope, when used by experienced anaesthetists and residents in anaesthesia in both a normal and difficult airway scenario. Methods: Participants randomly intubated the manikin four times using both the Goodscope and the GlideScope twice in a normal and a difficult airway scenario. The primary endpoint was time to successful intubation. Secondary endpoints were time to glottic view, time to ventilation, number of intubation attempts, successful intubation rate, and ease of intubation. Results: A total of 73 participants were included in this study. The primary endpoint, time to successful intubation, showed no statistically significant difference between the Goodscope and GlideScope in both the normal (median Goodscope 10.3 s, inter-quartile range (IQR) 8.5, 12.2 vs GlideScope 10.1 s, IQR 8.4, 13.6, P = 0.614), and difficult scenario (median Goodscope 18.5 s, IQR 14.3, 25.3 vs GlideScope 18.4 s, IQR 13.7, 24.2, P = 0.238). Similarly, no significant differences between the two videolaryngoscopes were identified for all secondary endpoints in both scenarios. Conclusion: The findings of this study suggest that the Goodscope is non-inferior to the GlideScope since no significant differences between the Goodscope and the GlideScope were identified for all primary and secondary endpoints. Therefore, this study contributes to proving the concept of an affordable reusable videolaryngoscope without compromising on quality.

Sustainability is becoming more important in numerous industries, including healthcare. Action to achieve sustainability is undertaken by various means, such as the Green Deal Healthcare. Several tools exist that can assess the environmental impact of a certain industry or company, but no tools exist that aid in actively lowering this environmental impact. Therefore, the HSMEA (Healthcare Sustainability Mode and Effect Analysis) tool was developed. This method is based on the Lean philosophy and HFMEA (Healthcare Failure Mode and Effect Analysis) tool and consists of six steps that aid in making a healthcare process more sustainable, in terms of waste production, energy use, or water use. With this tool, processes that contribute to these factors are identified in a highly structured and systematic way, and practical solutions are created and executed for these situations by a multidisciplinary team. This tool was validated in the academic hospital in Leiden, the Netherlands (Leids Universitair Medisch Centrum). Next, it was applied to two clinical case studies, assessing two processes that are currently present in the operating rooms of the LUMC. The HSMEA tool showed that with the implementation of four solutions, great improvements can be achieved in terms of waste and CO₂-equivalents production and recycling rate. These four interventions are currently being implemented in the LUMC. This novel sustainability tool has therefore proved its usefulness and clinical applicability in a healthcare setting. By implementing this tool throughout the hospital, it will support the hospital reaching its sustainability goals.