Surgical smoke, created via energy-generating surgical devices, is a physical, chemical, and biological hazard that adversely affects the health of exposed individuals. Smoke evacuation devices (SEDs) are readily available at Doernbecher Children’s Hospital (DCH), though a 2020 gap analysis showed they are used in only 3.2% of annual smoke-generating cases. Surgical smoke evacuation legislation was introduced January 1, 2023, in Oregon, requiring hospitals and ambulatory surgery centers to prevent surgical smoke exposure in ORs. The goal of this quality improvement (QI) was to quantify the use of and track compliance of surgical smoke evacuation, while helping the facility to attain the AORN Go Clear recognition. This QI project relied on Duke University’s FADE methodology to achieve the goal. Based on supply utilization, SEDs were utilized infrequently (4.06%) during the period of Covid when surgical smoke initiatives were paused, increased to 13.88% when surgical smoke awareness and education were reinstated, and spiked to 47.65% with Go Clear audits and institution of legislation for surgical smoke evacuation. A 95% compliance rate for surgical smoke evacuation (SED and non-SED devices) allowed the site to be awarded the AORN Go Clear designation. This project supports the use of multiple interventions including surgical smoke awareness and education, equipment-related factors, and policy/regulation changes to successfully implement the use of smoke evacuation devices in ORs.