FLOW CHART Direct-to-drain fluid waste management systems limit the amount of costly regulated medical waste.

Going green is the right thing to do for the environment, but taking steps to reduce your facility's carbon footprint can also result in significant returns on eco-friendly investments. Here are 10 ways you can save big by reprocessing, reorganizing, reducing and recycling.

1. Reprocess SUDs
When you outsource the sterile processing of single-use devices (SUD) to government-regulated third-party vendors, you buy back the devices at typically half the original cost. In 2014, hospitals with single-use-device reprocessing programs saved an average of $130,286, with additional savings in lower waste disposal fees, according to Practice Greenhealth's 2015 Sustainability Benchmark Report (osmag.net/CmGy6Z). The University of Washington Hospitals in Seattle diverted 5.8 tons of waste and saved $496,123 in 2008 by reprocessing more than 100 different SUDs.

2. Prune your supply kits
Reviewing the contents of OR procedure kits and packs and eliminating items that largely go unused saves an average of $1,028 per kit, according to Practice Greenhealth's Healthier Hospitals 2015 Milestone Report (osmag.net/DK4Qej). At the University of Maryland Medical Center (UMMC) in Baltimore, staff monitored the contents of their packs and identified an unused or return rate of more than 10%. Since 2010, they have reduced the return rate to 1.2%, which resulted in savings in 2014 of more than $140,000.

3. Move (back) to reusables
More than 80% of Practice Greenhealth's award-winning hospitals use reusable devices in the OR. According to Practice Greenhealth, UMMC moved to reusable textiles more than 15 years ago, and in 2010, diverted 138,748 pounds of waste and saved $38,850 in avoided waste disposal costs. The medical center also saved $39,000 in returned instruments alone. Kaiser Permanente reduced its regulated medical waste (RMW) by 3.8% and diverted 30 tons of medical waste by using reusable surgical gowns and basin sets.

4. Segregate regulated medical waste
With minimal upfront or capital costs, you can save big on RMW. All it takes is education, benchmarking, staff training, appropriate receptacle size, color and placement, as well as regular auditing and data tracking. Magee-Womens Hospital of the University of Pittsburgh Medical Center achieved a 47% reduction in RMW, diverting 28,795 pounds of waste and saving $89,000. By diverting and recycling surgical waste, Inova Fairfax Hospital in Falls Church, Va., decreased RMW in its ORs by 18.6% over a 6-month period, resulting in $15,000 in savings.

5. Recycle medical plastic
An important component of an OR waste reduction program includes collaborating with your waste management vendor to recycle clean medical plastics. Recycling bins in ORs are a much more common sight today, and education and signage make it convenient for staff to divert recyclable materials into the appropriate waste stream. The nursing staff in the ORs of Fletcher Allen Medical Center in Burlington, Vt., initiated a recycling program in 2010 that achieved a 38% recycling rate, which results in approximately 50 tons of recyclable material being collected annually at a savings of roughly $6,000. Spectrum Health in Grand Rapids, Mich., initiated a medical plastics recycling program in its 45 ORs in 2007. The program saved the health system more than $200,000 and diverted 2,943 tons of waste. In 2010, the OR recycled 42,500 pounds of blue wrap, saving $1,300 in avoided waste costs.

6. Use rigid sterilization containers
Disposable sterilization wrap is polypropylene (plastic #5) and it comprises 19% of OR waste (osmag.net/Eu6ZfF). To reduce and divert the material, hospitals are using rigid sterilization containers for high-volume instrument sets and packs. In 2014, Dartmouth Hitchcock Medical Center in Lebanon, N.H., implemented rigid sterilization containers for 50% of its instrument sets to avoid generating 20 tons of waste and spending more than $122,000 on sterile wrap and subsequent disposal fees. Mills-Peninsula Medical Center in Burlingame, Calif., purchased rigid sterilization containers in 2006 at a cost of $34,987 and saved $25,173 in avoided blue wrap purchases and $26,000 in rewrapping costs (for torn sterilization wrap), achieving a return on investment after 8 months. Boulder Community Hospital in Colorado spent $150,000 on rigid sterilization containers in 2003 and by 2005 had reduced its annual blue wrap purchase expenses from $250,000 to $60,000 — less than a 2-year payback. Additionally, the hospital substituted peel pouches for blue wrap in preparing sterile towel packs, which were the most frequently sterilized items. To date, the hospital has saved over $1 million in avoided supply costs.

7. Go direct-to-drain for fluid waste
Fluid waste management systems dramatically reduce RMW and the risk of exposure to bloodborne pathogens. Automatically discharging fluid waste directly into the sewer system in compliance with local and state regulations can replace the need for disposable plastic suction canisters and chemical solidifiers. In 2010, the technology let Bronson Methodist Hospital in Kalamazoo, Mich., avoid generating 8 tons of RMW and reduce the volume of plastic suction canisters purchased for a savings of $7,200. St. Mary's Hospital Medical Center in Green Bay, Wis., implemented a fluid management system in 2007 that reduces its regulated medical waste by 5,400 pounds each year for an annual savings of more than $10,000.

HARD EVIDENCE Sterilization containers eliminate the need to purchase and dispose of blue wrap.

8. Use reusable sharps containers
Reusable sharps containers can replace disposable plastic sharps containers, and further reduce RMW and supply expense in the OR. Third-party companies collect full reusable sharps containers, then empty and disinfect them before they're returned for reuse. Borgess Medical Center in Kalamazoo, Mich., made the switch to reusable sharps containers in 2007. The transition has enabled the facility to reduce its RMW by 10.5 tons each year for an annual savings of $11,000. The reusable sharps container program at Illinois Masonic Hospital in Chicago reduced its RMW by 10 tons and saved the organization $13,000 in 2010.

9. Focus on energy efficiency
Reducing air exchange rates and adjusting temperature parameters in unoccupied ORs, as well as replacing halogen bulbs with LED lighting, can save your facility $2,000 to $3,200 per OR per year (osmag.net/PH5Uon). Memorial Sloan Kettering Cancer Center in Basking Ridge, N.J., implemented an air acuity and HVAC setback system throughout all of its 28 ORs, reducing air exchanges from 25 to 12 per hour when the rooms are unoccupied. The project alone reduces the facility's energy use by 652,150 kWh and 39,741 therms each year, leading to $91,933 in annual savings. Further energy reduction can be achieved with the use of motion sensors. By installing HVAC occupancy sensors in 2 of its new digitally-controlled ORs, Providence St. Peter Hospital in Olympia, Wash., reduced its energy use by 25,000 kWh and 2,460 therms and is saving $4,000 dollars per year.

10. Donate unneeded, unused supplies
Putting obsolete, basement-dwelling durable medical equipment and unused, expired supplies into the hands of healthcare providers via third-party organizations for beneficial reuse engages facilities in global health. Rather than disposing of unneeded items through the waste stream, many facilities explore options for reuse through surplus resale or charitable donations to organizations in the community or developing countries in need. See osmag.net/aRvR3S for more about donating equipment and supplies.