(also known as ‘Health Care Environmentalism’ or ‘Green Health Care’)
The two parts to this piece.
- We waste a ton of material in health care. Can we reduce this safely?
- We waste a ton of material to prevent and reduce infection; other industries must clean up their act because to some degree, we can’t.
I don’t hear much about the topic, and while there’s a few organizations who are aware of it, we don’t discuss it much. It’s hard to imagine that hospitals create over 2 million tons of waste each year, but when you think how many nitrile gloves a person goes through in a typical day, it certainly adds up. Then add all the sharps (needles, syringes, guide wires, glass ampules, scalpels, instruments) and it adds up even more. Did you realize these kits just get thrown away? Metal tweezers and scissors, tossed away. Then add the gowns and kit packaging, and it gets even worse.
So first of all, can we do better? Can we reduce packaging, or identify recyclable materials? I would imagine some manufacturers are already looking into this as a way to reduce their costs, but certainly none of it is done around here, in the progressive stronghold of the Bay Area. (We certainly could save on paper by moving to electronic medical records as well.)
The reason there’s so much waste in the first place is to encourage sterility. When you typically open a package to do a procedure (a lumbar puncture, a central line, etc) you open up a water-resistant plastic kit with waxed-paper lid and find a paper-wrapped package inside, sterile on the inside. Often there’s also a gown inside to wear, as well as a standard size of sterile gloves to put on. You gown up, put on the sterile gloves, and now you can go through the insides of the package, which include: multiple needles, multiple syringes, guidewires, glass bottles with lidocaine in them, a disposalble scalpel, some suture with needle, and some skin-cleaning pads as well. All of this is packaged under sterile conditions, so that very limited bacteria will be present when you’re doing the procedure, to prevent the patient from getting an infection due to the procedure.
A lot of this we can’t easily eliminate without creating large hurdles to performing the procedure–and even if we packaged items separately, they would require separate sterile packaging, which may just add the trash mess as well, and taking more time to gather supplies. And the costs (financial as well as to the patient, obviously) to an infection in the blood are great–they can kill people. So a lot of this we can’t improve.
That’s why other industries need to do a better job of reducing their waste–because we in health care have some degree of “fixed” waste that we will always have (until we develop wireless IV tubing, of course). Other industries must work even harder to clean up their environmental acts to compensate for the continued mess that health care makes.