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Sustainable Healthcare

On this Project:


Nicole Campion


Life Cycle Assessment of Various US Custom Packs

Disposable materials contribute to healthcare’s estimated production of 33 pounds of waste per patient bed per day or approximately 5.9 million tons of waste each year. This study analyzed the life cycle environmental impacts of disposable custom packs. A disposable custom pack is a set of sterile, disposable products prepackaged for a specific procedure with the aim of reducing time, errors, and contamination risk.

Specifically, this study analyzed 15 custom packs from 12 US hospitals, 2 Thai hospitals, and 1 non-profit medical supply organization; the custom packs are prepared and used for traditional vaginal birth. The environmental impacts from the production, use, and disposable of each custom pack was analyzed using processes LCA. The material componentweights and the greenhouse gas emissions of all 15 custom packs is shown in the Figure below. The average weight of the 12 US packs was 1.25 kg with polypropylene composing an average 58% of the total pack weight. The quantity of cotton in the custom packs was the determining factor for the highest value of GHG emissions, which was almost 17.5 kg of CO2 eq. or 88% of Pack 1. The LCA results conclude that single-use cotton products have significant impacts on the environment.

Streamlining custom packs by focusing on quantity and types of materials significantly affects a hospital’s overall environmental impact. By using design for the environment principles (i.e., source reduction or recyclability) and life cycle assessment in collaboration with clinician input, healthcare institutions can make educated streamlining efforts for their disposable custom packs

Minimal Custom Pack Design and Wide-Awake Hand Surgery
Reducing Waste and Spending in the Orthopedic Operating Room

The US health care sector has substantial financial and environmental footprints. As literature continues to study the differences in wide-awake hand surgery (WAHS) and sedation, we sought to better understand the costs and waste generation of these two approaches. We created a minimal disposable custom pack for small, hand surgery. We measured the waste from 178 small, hand surgeries performed via local-only (WAHS) or sedation with either the minimal or the standard custom packs. Patients were also asked to complete a post-operative survey on their experience. Data were analyzed using 1- and 2-way ANOVAs, 2-sample t-Tests, and Fisher’s Exact tests.

WAHS with the minimal custom pack produced 0.3kg (13%) less waste and cost $125 (55%) less in material supplies per case than sedation with a standard pack. Pack size was found to be a larger factor in waste generation than anesthetic approach, but measured waste did not include sharps. While all sedation patients required a driver to attend their surgery, only 32% of WAHS had a driver. WAHS patients reported slightly greater pain and anxiety levels during their surgery, but also reported greater satisfaction with their anesthetic choice, which could be tied to the enthusiasm of the physician performing WAHS. Surgical waste and spending can be reduced by minimizing the materials in the disposable custom pack. WAHS may also reduce waste and spending, and many patients reported greater satisfaction with their WAHS experience, suggesting that WAHS should be more broadly adopted in orthopedics.

Associated Publications

Campion, N., Thiel, C., Woods, N., Swanzy, L., Landis, A., Bilec, M. (2015). “Environmental Life-Cycle Impacts of Surgical Material Supply: A Comparative LCA of Disposable Custom Packs.” Journal of Cleaner Production. 94: 46-55

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