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Waste reduction

The sustainable hospital: Waste reduction best practice tip

As healthcare institutions seek ways to make their operations more sustainable and contribute to the fight against climate change, one very simple metric to focus on is total plastic waste generated by a facility.

Any change in healthcare operations that brings down this total waste figure means reduced use of raw materials in the production process, reduced costs for waste disposal or recycling, and ultimately reduced CO2 emissions from waste incineration. 

 

When an option arises to eliminate a whole stream of single-use waste, it’s an opportunity that healthcare practitioners and managers naturally take seriously.

Processing sterile goods for the OR

The ongoing performance of operations in the hospital depends on an uninterrupted supply of newly sterilized reusable equipment, typically provided by a facility’s central sterile services department (CSSD).

There are two widely used methods of handling instruments and equipment during this autoclave sterilization process in the CSSD.

 

One method works with single-use wrap (often called “blue wrap”) that is used to pack the instruments while they are sterilized and then stored.

The other method uses reusable containers (typically called rigid sterile containers or “RSCs”) for this same packing and storage function.

 

Blue wrap delivers sufficient sterilization performance, but there is a dramatic difference in the quantity of downstream waste generated by these two procedures.

Reusable sterile container

Waste quantity comparison

Sterilization with blue wrap vs. AESCULAP® sterile containers

  • Annual surgeries

    0

    of a typical mid-sized hospital in Germany

  • Single-use wrap

    0kg

    of polypropylene waste is generated each year

  • Sterile containers

    0kg

    total annual waste quantity

AESCULAP® rigid sterile containers result in 95% less waste than blue wrap.

Looking at the numbers

Take the example of a typical mid-sized hospital in Germany where 10,610 annual surgeries are performed with an average of 3 sterilization sets per surgery:

 

  • When single-use wrap is used for instrument sterilization 3,310 kg of polypropylene waste is generated each year.
  • By contrast, when reusable rigid sterile containers are used, the total annual waste quantity is just 149 kg – less than 5 percent of the waste quantity coming from single-use wrap. And two thirds of this 149 kg figure consists of paper filters, with a mere 46 kg of plastic waste being generated from the container locks over a whole year of sterilization activity.

Reduced waste, plus reduced costs

A strong argument can be made for such a switchover simply on the basis of its positive effects in connection with waste generation. But strikingly, the benefits of the rigid sterile container sterilization method also extend to costs.
 

Following the initial investment in new equipment for the rigid sterile container process, hospitals actually save money in their ongoing processing of sterile equipment for the OR.
 

  • In a US-based calculation, it has been estimated that a conversion to rigid sterile containers can save a medium size hospital up to $20K annually in disposable operating expenses and more than 150 hours in processing time. [1]
  • Similarly, a Germany-based study found that use of a sterilization container without an inner wrap was the most cost-effective option for processing of sterile equipment – with a per-use cost of €2.05 set sterilization as compared to €3.87 per set sterilization for two layers of single-use sterilization wrap. [2]

 

With a cost-benefit profile like this, it’s no surprise that more and more hospitals are taking the waste-reduction step of moving from single-use sterilization wrap to reusable rigid sterile containers.

More interesting facts about sterile packaging systems

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[1] Figure from Aesculap website. Referenced: “Data on file at Aesculap”

[2] Krohn, M.; Fengler, J.; Mickley, T.; Flessa, S. Analysis of processes and costs of alternative packaging options of sterile goods in hospitals – A case study in two German hospitals. Health Econ. Rev. 2019, 9, 1. https://doi.org/10.1186/s13561-018-0218-2