Fairview surgeon greens his operating room
In a given year, America’s hospitals produce over 2 million tons of waste, which is 1% of the entire waste generated in the United States. Even a small surgical procedure can result in the disposal of multiple pounds of medical gowns, gloves, sterile wrap, and equipment. This problem has not gone unnoticed, and one surgeon at the University of Minnesota Medical Center-Fairview (UMMC) is doing his best to reduce the amount of waste used in his operating room.
Reducing Surgical Waste
Dr. Rafael Andrade has made it his mission to reduce hospital waste resulting from surgeries. One surgery can require many pieces of disposable equipment, and with over 20,000 annual surgeries performed at UMMC, there is a significant amount of waste discarded. Dr. Andrade took the initiative to begin cutting waste for one of his routine operating room procedures, a vascular access port placement. This procedure is completed over 200 times per year at UMMC; it allows doctors to have easy access to a patient’s vein for blood draws, medication, and CT scan contrast injections.
Dr. Andrade noticed that the protocol for the vascular access port placement contained some redundant and unnecessary equipment. By working with his staff and operating room nurses, he was able to reduce waste without compromising the safety and success of the operation.
For each surgical procedure, the doctor uses a set of instruments and tools called a pick. The pick for a vascular access port placement originally required 44 items, but Dr. Andrade condensed it down to 27. The newly designed pick means that there are fewer syringes, sutures, drapes, and dressings being discarded. Additionally, Dr. Andrade considered other waste reduction measures for his pick. For example, the original pick contained a 1 liter container of sterile saline; however, the port placement procedure uses less than 500 ml. By substituting 500 ml sterile saline for the 1 liter bottles, 20 lbs of waste could be reduced. Dr. Andrade also evaluated the opportunity to use reusable gowns and linens that can be sterilized and rewashed up to 50 times before being discarded. The cost of washing the reusable gowns is $1.08 per gown, while the cost of disposable gowns is $2.39 each.
These measures, along with the reduced number of items in the pick, have the potential to save UMMC $2,000 in material costs, eliminate 80 lbs of waste, and reduce greenhouse gas emissions by 64 lbs, assuming Dr. Andrade completes 40 vascular access port placement procedures annually.
Additional Efforts at Fairview
On a much larger scale, the entire Fairview system is striving to improve its environmental performance. Fairview Health Services operates seven hospitals in Minnesota and has set goals to reduce energy use, water use, and materials.
For example, Fairview Southdale Hospital has installed motion sensor lighting in non-essential rooms and storage spaces. These sensors will automatically turn the lights off when rooms are not in use. Additionally, the hospital is replacing 19,000 light bulbs with lower wattage ones. The hospital expects the motion sensors alone to save around $30,000 in the first year. Fairview Southdale is also looking at other ways to reduce waste. In an effort to reduce water use, the hospital is installing low-flow fixtures. Also, biodegradable containers are being implemented into the cafeteria.
UMMC is also hosting a MnTAP intern this summer. She is working within the facility to conduct a life cycle and infection prevention analysis of disposable versus reusable gowns. At the end of her internship, she will make recommendations based upon her analysis that will help UMMC move forward in a more sustainable manner.
For More Information
Dr. Andrade and his efforts were featured on WCCO TV in the Twin Cities. To view the story, visit <www.wcco.com/health/hospital.going.green.2.986876.html>.
Additionally, MnTAP has a case study available online that provides more information on Dr. Andrade’s project <www.mntap.umn.edu/health/142.html>.
