Organizations see monetary gains — and some environmental good — from recycling and reusing materials.
Hospital trash includes gloves, gowns, packaging, tubing and other single-use items such as sequential compression devices, blades, forceps, scissors and clamps. | 123RF Stock Photo
Editor's note: This article originally appeared in the Physician Leadership Library in March 2017.
Food is what America throws away most. In 2010, stores, restaurants and homes discarded what federal researchers estimated to be 133 billion pounds — or 31 percent of the food supply.
“And second to [food] is things that come out of hospitals,” says Martin Makary, MD, MPH, surgical director of the multidisciplinary Johns Hopkins Pancreatitis Center, who has written about waste reduction in health care. “So if we look at an operation that I might perform, there’s a tremendous amount of gowns, gloves, packaging, tubing” and other items thrown away.
“And a hospital,” he continues, “may perform up to 100 operations in a day.”
The total landfill estimate for U.S. health care facilities: 4 billion pounds annually, according to a 2008 study in the journal Materials Management in Health Care. And the throwaway culture only continues to grow, thanks to products being made and sold more cheaply.
“The amount of waste generated by medical care … isn’t something that we [have] traditionally thought about when it comes to reducing carbon footprint, saving money and lowering the amount of waste produced,” Makary says.
But as they realize such benefits are possible, more hospitals are finding ways to cut back on the trash. They’re often doing so in a two-pronged approach: recycling, just as people do with paper, cans and bottles at home, and reprocessing, in which items normally destined for the landfill after one use (commonly called “single-use devices,” or SUDs) re-enter service after cleaning and inspection.
“Staff here are very earth-friendly — and not just ’cause we’re only 30 miles from Colorado,” jokes Dave Turnbull, materials manager at New Mexico’s San Juan Regional Medical Center, who helped form the hospital’s Green Team in 2007 and launch its robust recycling, reprocessing and food-waste programs. “I think most folks in the U.S. feel that way, I hope. The less carbon footprint that we can do, it saves Mother Earth … for future generations.”
A 2002 survey by the U.S. Food and Drug Administration found that about a quarter of hospitals administered care with at least one type of SUD. The most common SUD then was the sequential compression device, which is put over bedridden patients’ legs to improve blood flow. Others included blades, forceps, scissors and clamps.
The number of hospitals with contracts with third-party companies that restore SUDs is sometimes said to have mushroomed to 70 percent by 2008, but the root source of that figure, HospitalManagement.net, doesn’t note its own source.
Regardless, Makary says he feels confident the figure has grown past a quarter and continues trending upward as more hospitals realize the benefits.
San Juan, for example, says it has saved $2 million from reprocessing since 2007. And Johns Hopkins, which also has a Green Team spearheading its efforts, says reprocessing cut costs by $2.8 million from 2010 to 2014.
Together, San Juan’s reprocessing, recycling and food-waste programs divert about 200 tons annually from the landfill. But unlike reprocessing, the latter two don’t come with profits.
Recycling — of cardboard, shredded paper, batteries, computer parts and other materials — is like what someone would do with at-home goods but on a bigger scale, and the food waste (kitchen scraps) is taken to New Mexico State University’s agricultural center for compost.
The hospital targeted diverting at least 30 percent of its waste a year, and Turnbull says that goal has been met for the past four.
On paper, the reprocessing procedure is simple. Staff members put their used SUDs — as well as those opened but unused — together in a single receptacle. They’re then delivered to the original manufacturers (such as Johnson & Johnson or Medtronic) or third-party companies (such as Arizona-based Stryker, which San Juan uses) for sterilization, inspection, recalibration, testing and repackaging.
“They all have to go through the same level of FDA approval, the same regulations. They’re all held to the same standards,” SuzAnne Gil, San Juan’s clinical resource manager, says of readying equipment for reuse.
Yet Makary does note a difficult component of reprocessing: training hospital staff to put the correct items in the receptacle and getting them to do so consistently.
“Just by putting things in the proper type of waste basket in the operating room, a hospital can save $1 million,” he says.
As for the business arrangement, one common route is the manufacturer or third-party company paying to receive the equipment and then selling the same item back at a discount, Makary says. This is where the net savings are from.
The companies help interested hospitals set up such programs and also generate reports that calculate the diverted tonnage and money saved.
“In today’s world of savings [and] cutting costs,” Turnbull says, “it’s a win-win.”
Meeting quarterly to discuss updates and possible improvements, San Juan’s 13-member Green Team comprises an array of staff members, from nurses to housekeepers. These varied perspectives have allowed for waste to be tackled holistically, Turnbull says.
Since the Farmington Daily Times in New Mexico published a story about San Juan’s efforts in December, other hospitals have reached out wondering how they could replicate such a program, Gil says.
“We’re talking to a lot more people, and we’re hoping we can get some more ideas and do a little bit more sharing,” she says. “It does make you feel good to know you’re having a positive impact [and] you’re working with a bunch of people that want to do the same.”
Michael Stone is a freelance health care writer based in Tennessee.