Abstract
Background
Waste is endemic in the U.S. health care system. Operating rooms are a source of significant
solid waste. Surgeons are integral to many decisions in the operating room.
Method
Online survey of surgeons at 2 major academic centers in the United States assessing
perspectives on intraoperative waste and willingness to work to actively reduce intraoperative
waste.
Results
We received responses from 219 surgeons: 90% agreed or strongly agreed that waste
of sterile surgical items is an issue, and 95% agreed or strongly agreed to a willingness
to change the operating room workflow to reduce waste. Surgeons estimated 26% of single-use,
sterile supplies opened for surgery were unused at the end of the case. The barriers
to waste reduction cited most frequently were: (1) lack of awareness of waste, (2)
lack of concern for waste, and (3) lack of time to address the waste.
Conclusion
Surgeons understand there is significant waste in the operating room and are willing
to change their workflow to reduce waste. Changes in operating room practices that
reduce waste will be beneficial to health systems’ finances and their efforts to improve
population health through a reduction in consumption and pollution. Efforts should
be directed toward reducing operating room waste with an initial focus on the elimination
of unnecessary waste of sterile surgical supplies. Further work is needed to determine
the precise sources of perioperative waste and what initiatives can be implemented
to reduce this burden while maintaining high-value patient care.
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References
- Waste in the US health care system: estimated costs and potential for savings.JAMA. 2019; 322: 1501-1509
- The Lancet Commission on pollution and health.Lancet. 2018; 391: 462-512
- Health care pollution and public health damage in the United States: an update.Health Aff (Millwood). 2020; 39: 2071-2079
- sustainability benchmark data.https://practicegreenhealth.org/sites/default/files/2020-06/2019_sustainability_benchmark_data.pdfDate: 2019Date accessed: January 21, 2022Date accessed: January 21, 2022
- Medical waste incinerator waste management plan: Malcolm Grow Medical Center, Andrews Air Force Base.IERA-RS-BR-SR-2001-0004, Maryland2001
- Greening the OR.https://practicegreenhealth.org/topics/greening-operating-room/greening-orDate accessed: January 21, 2022
- Cost-effective use of operating room supplies based on the REMEDY database of recovered unused materials.J Clin Anesth. 1994; 6: 400-404
- Doctors pledge to do no harm: the entire health care sector should do the same by battling climate change.STAT News, 2021
- Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inform. 2009; 42: 377-381
- A national survey on attitudes and barriers on recycling and environmental sustainability efforts among Canadian anesthesiologists: an opportunity for knowledge translation.Can J Anaesth. 2019; 66: 272-286
- A survey of anesthesiologists’ views of operating room recycling.Anesth Analg. 2012; 114: 1049-1054
- Ophthalmic Instrument Cleaning and Sterilization Task Force. Survey of cataract surgeons’ and nurses’ attitudes toward operating room waste.J Cataract Refract Surg. 2020; 46: 933-940
- Greening the health system.https://sustainability.ucsf.edu/greening_the_health_systemDate accessed: January 21, 2022
- Help UCSF reach carbon neutrality by 2025.https://sustainability.ucsf.edu/stay_informed/carbon_neutrality_campaign_2019Date accessed: January 21, 2022
- Operating room waste: disposable supply utilization in neurosurgical procedures.J Neurosurg. 2017; 126: 620-625
- Operating room supply cost awareness: a cross-sectional analysis.Urol Pract. 2019; 6: 73-78
- Association between surgeon scorecard use and operating room costs.JAMA Surg. 2017; 152: 284-291
- Waste generated during glaucoma surgery: a comparison of two global facilities.Am J Ophthalmol Case Rep. 2018; 12: 87-90
- The 2020 report of the Lancet Countdown on health and climate change: responding to converging crises.Lancet. 2021; 397: 129-170
- Call for emergency action to limit global temperature increases, restore biodiversity, and protect health.N Engl J Med. 2021; 385: 1134-1137
- Sustainable procurement: improving health.https://supplier.kp.org/impactspending/what-we-do/sustainable-procurement/Date accessed: January 21, 2022
- Transforming the medical device industry: road map to a circular economy.Health Aff (Millwood). 2020; 39: 2088-2097
- Evaluation of operative waste in a military medical center: analysis of operating room cost and waste during surgical cases.Am Surg. 2019; 85: 717-720
- OR waste reduction. Perioper Care Oper Room Manag. 2019; 15: 100073
- Reducing operating room costs through real-time cost information feedback: a pilot study.J Endourol. 2015; 29: 963-968
- Effects of a surgical receipt program on the supply costs of five general surgery procedures.J Surg Res. 2019; 236: 110-118
- Efficacy of education followed by computerized provider order entry with clinician decision support to reduce red blood cell utilization.Transfusion. 2015; 55: 1628-1636
- Reduction in operating room plasma waste after evidence-based quality improvement initiative.Anesth Analg. 2018; 126: 1662-1665
- Provider education and vaporizer labeling lead to reduced anesthetic agent purchasing with cost savings and reduced greenhouse gas emissions.Anesth Analg. 2019; 128: e97-e99
- Understanding costs of care in the operating room.JAMA Surg. 2018; 153e176233
- Sustainability Benchmark Report.Date: 2021
Article info
Publication history
Published online: January 26, 2022
Accepted:
December 27,
2021
Footnotes
Matthew J. Meyer and Tyler Chafitz shared first authorship.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- A call to arms to implore surgeons to be involved in managing operating room wasteSurgeryVol. 171Issue 5
- PreviewWhen asked to provide a cogent review of an article submitted to Surgery on operating room waste, I had hesitancy based on not being a content expert. I read the abstract and then thought to myself: How many times at the end of a case have I taken all the drapes, gloves, and so on, including many items which were not used, and piled them up in the waste basket? I also reflected back on a time when I performed a number of time at the University of Virginia Health Care system, where I performed a number of carotid endartectomies, mostly without shunts, primarily to see the shunts thrown out at the end of case unused.
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