At a time when the Army is looking for areas to cut operating costs, Army Medicine's "Greening the Operating Room" program is generating considerable savings by reducing waste streams. Within a military treatment facility, the operating room (OR) is one of the largest users of supplies and one of the largest producers of waste.
MEDCOM's Greening the OR program centers around reducing the amount of regulated medical waste (RMW) through proper segregation of waste, recycling OR plastics, wider use of reusable materials such as surgical gowns, and diverting single-use medical devices (SUDs) to collection for reprocessing by a U.S. Food & Drug Administration registered vendor.
Green OR savings at just one Army medical center reduced regulated medical waste sent for disposal by 151,546 pounds over three years and saved almost $80,000. During this same period, 7,521 pounds of operating room plastics and 6,460 pounds of clean, used blue wrap were recycled. In only six months, reusable surgical packs yielded additional savings of $7,900. Using these packs reduced the medical waste stream by 25,550 pounds and reduced the solid waste disposed by 6,330 pounds. Diverting SUDs from the RMW waste stream and purchasing reprocessed devices instead of new ones at one Army medical center yielded savings of $463,903 in FY12.
The majority of OR waste is generated before the patient enters the room. Most nonhazardous OR waste can be recycled, including cardboard; clean, used blue wrap; and medical plastics, including overwraps, rigid trays, saline bottles, tissue sealing devices, staplers, and plasma wands. Replacing disposable surgical gowns, surgical towels, basins, and patient warming devices with reusable items reduces waste sent for disposal.
Pre-packaged surgical packs often contain items that are not used; eliminating unnecessary, unused items reduces the cost of the pack and the cost of disposing of these items. In reusable surgical packs, many disposable items are replaced with items that are approved for reprocessing through an FDA-registered vendor. Reusable surgical packs save money by reducing the amount of RMW and solid waste.
Collecting single-use medical devices (SUDs) for remanufacturing dramatically reduces the amount of RMW sent for disposal, while purchasing FDA-registered SUDs can provide additional cost savings -- all without capital investment. The MEDCOM SUD policy signed on 6 August 2012 stipulates the following:
• MTFs may allow collection of SUDs for reprocessing by an FDA-approved vendor, but MTFs may not reprocess SUDs internally.
• A decision to use reprocessed SUDs must be made by the MTF Commander advised by a multidisciplinary group comprised of medical, nursing, patient safety, logistics, risk management, preventive medicine, central materiel services, and infection control.
The potential financial benefits of Greening the OR are significant. Significant savings are possible if Greening the OR strategies are adopted across the Military Health System. By supporting mission readiness through sustainability, MEDCOM is demonstrating that green medicine is not only practical and sustainable on a large scale but that it is also fiscally and socially beneficial to implement such practices.
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