Waste in the Operating Room

This article was written by James Cagliostro.
The rising cost of healthcare has not only affected patients, it has affected the way in which hospitals operate. While this presents a real challenge to hospitals, it has also led to a serious re-examination of how the healthcare industry is spending its money.
“In 2012 the National Academy of Medicine estimated the U.S. health care system squandered $765 billion a year, more than the entire budget of the Defense Department…The annual waste, the report estimated, could have paid for the insurance coverage of 150 million American workers — both the employer and employee contributions.” (https://www.propublica.org/article/what-hospitals-waste)
The Operating Room truly is a double-edged sword when considering profitability for a hospital. Click To Tweet

1. It is often the biggest generator of revenue for a hospital.
2. It also tends to be the largest consumer of supply costs and the biggest generator of waste.

“Of all the waste a hospital generates, as much as 20 to 30 percent comes directly from the operating room.” (https://www.sustainablecitynetwork.com/topic_channels/community/article_4f75089a-2023-11e5-845d-77ea3aaa4065.html)
According to Kate Huncke, M.D., vice chair of the department of anesthesia at NYU Langone Medical Center, New York City, “The waste generated from the OR is way out of proportion to the footprint it occupies within the hospital. There’s significant opportunity for improvement.” (https://www.hhnmag.com/articles/3647-sustainability-in-the-operating-room) It’s an opportunity that many hospitals have yet to take advantage of.

1. One frequently overlooked factor to consider is the actual cost of OR waste disposal. It is not as simple as taking the trash bags out to be sent to the landfill. State and federal laws require certain operating room waste to be disposed of in very specific ways, which can cost 10 to 15 times as much as ordinary waste disposal. This is a cost that simply cannot be overlooked.
2. Another opportunity for minimizing waste is to recycle, rather than dispose of items that would normally be thrown out. “Disposing of bio-hazardous waste costs an average of 28 cents a pound, while recycling costs an average of just a penny a pound.” (https://www.sustainablecitynetwork.com/topic_channels/community/article_4f75089a-2023-11e5-845d-77ea3aaa4065.html) Simply recycling the plastic and cardboard that OR equipment is packaged in can lead to cost savings, not to mention minimizing the environmental footprint that your facility is leaving.
3. An additional factor to consider is the use of disposable equipment. The increase in single-use disposable items in the OR came directly from efforts to decrease the risk of infection and spread of disease in the hospital. However, the advancements in sterilization techniques and cleaning solutions that have been made cannot be ignored. The measures taken to prevent the spread of infection must remain a priority, but we also must use an approach that is cost-effective. If autoclaving or a specific cleaning product has been shown to achieve effective sterilization, the recurring purchase of single-use items for the OR may not be necessary.
4. The purchase and intentional use of energy-efficient equipment is another way in which operating rooms can save the hospital money. By finding ways to reduce energy waste, ORs can decrease the cost of its operating expenses and at the same time decrease the impact on the environment. Any realized savings can be redirected to improving the patient experience and improving efficiency in other areas of the hospital.
5. Lastly, a thorough look at the supply chain and how surgical supplies are being packaged can lead to decreased waste and substantial savings. Many hospitals order prepackaged kits for their operating rooms. While this is easier, it definitely leads to increased waste if surgeons consistently use only a portion of what is contained in the prepackaged kit. By assembling your own surgery kits, using trays and surgery kits that can be sterilized and reused, a hospital can ensure that the kits being sent to OR contain only what the surgeon will actually use.

Closing:
As we consider hospital waste, the key concept to understand is SUSTAINABILITY, which is the ability of a system to continue doing what it is doing over time. If a hospital or health system hopes to succeed, grow, and increase revenue long-term all while providing high-quality patient care, it must focus on sustainability. An essential part of the sustainability equation is recognizing where waste is occurring and finding ways to minimize that waste.
As hospitals and health systems consider their own sustainability, their attention has concentrated on improving efficiency, reducing cost, and improving patient experience. Waste reduction can have an immediate and lasting impact in all three of these areas.