By Michael Velez
While operating rooms generate the highest revenue for hospital administrators, it turns out they also generate the most waste and supply costs in any given hospital. I began looking into this issue after my Anesthesia and Surgery rotations at Thomas Jefferson University Hospital Einstein Hospital respectively, in Philadelphia. During my time in the operating room (OR), I noticed that the amount of trash accumulated and seemingly recyclable plastic materials thrown away each day is outrageous. Every day, the environmentalist in me would cringe at the sight of each operating room’s waste bins as the abundance of plastic and cardboard wrappers for the various sterile supplies required for each procedure overflowed.
As an innovator at heart, I was compelled to investigate further to better understand the harmful potential of the issue. My suspicions were confirmed when I learned that 20 to 30 percent of hospital waste comes directly from the OR.3
As it currently stands in many hospitals, these products are instead discarded in the OR together with materials that do come into contact with bodily fluids. While I understand that there needs to be proper disposal for single-use devices (SUDs) and equipment that get contaminated with patient fluids that can serve as infectious sources, I feel strongly that recycling the packaging materials and supplies that don’t touch bodily fluids is easily possible, while those that do come into contact with patients should undergo some sort of cleansing or sterilization process that allows them to be recycled rather than adding to waste landfills.
If packaging and uncontaminated products were properly discarded separately from their contaminated counterparts, they could be recycled by NGOs into other products like aprons, tote bags, or other byproducts or even into new wrapping for future single-use devices.
Though the trash buildup associated with the packaging of these products is one thing, the waste generated from the SUDs themselves are a whole other problem altogether. This problem is so rampant that it is finally leading hospital administrators to take notice. Consequently, over the last decade, hospitals and private companies alike are starting to realize the potential financial and environmental benefits that come from reprocessing SUDs. I found that only a few companies exist that reprocess SUDs with Stryker Solutions, a subsidiary of Stryker, dominating the market. Nevertheless, only a small fraction of existing hospitals use services like these. Even as the market leader, Stryker Solutions only serves 3,000 hospitals (Jefferson NOT included) meaning there is plenty of opportunity to make an even bigger impact across the nation. In 2016 alone, Stryker helped health systems save over $300 million and eliminate 12.9 million pounds of medical waste from landfills.2 If we could compound this effect by increasing hospital participation, the impact could be enormous.
Though the numbers speak for themselves, sustainability in practice is not limited to just demonstrating the benefits of waste reduction, recycling materials, and eliminating infection for patient safety. It requires active implementation and training for all staff in the operating room. This includes physicians, anesthesiologists, nurses, medical technicians and maintenance staff who need to be informed of the financial and environmental aspects of sustainable practices and programs and then trained in their respective roles to uphold them.3 With the COVID-19 global pandemic currently active, I can only imagine that the PPE and SUD usage, and consequently the generation of plastic waste, has exponentially increased further worsening the issue. Now more than ever, all large organizations need to be doing their part and hospitals are no exception.
Sources:
http://sustainability.stryker.com/
https://www.beckersspine.com/orthopedic-a-spine-device-a-implant-news/item/35547-stryker-s-sustainability-solutions-bill-scott-talks-reprocessed-medical-devices.html
http://tinehealth.com/2017/09/04/how-to-reduce-operating-room-waste/
https://practicegreenhealth.org/topics/greening-operating-room/greening-or