OR Excellence Award Winner

Each year, operating rooms generate hundreds of millions of pounds of blue wrap, which is often sent to landfills for a most improper burial. What to do with all that polypropylene plastic your facility produces? Instead of crumpling up your blue wrap and tossing it in the trash, why not follow the lead of Memorial Hermann Surgery Center in The Woodlands, Texas, the 2018 winner of the OR Excellence Award for Environmental Stewardship?

The staff at Memorial Hermann are so driven to reuse blue wrap that they’re even finding ways to use it outside the workplace. Mary Chiasson, RN, the director of nursing, shares a few clever examples: as a drop cloth when you’re painting, to wipe windows (it doesn’t leave behind lint) and to wrap breakables (it’s very pliable, soft and it doesn’t stain your hands like newspaper).

“I just took a garbage-bag full of it home to have on hand,” says Ms. Chiasson, who wraps it around some of the smaller plants in her yard on chilly nights. “Last year, during Hurricane Harvey, a few of our employees had to temporarily relocate so repairs could be made to their homes. They took home a lot of blue wrap and used it to pack their goods.”

Ms. Chiasson and her staff do all they can to keep blue wrap out of the OR’s trash cans, re-purposing smaller blue wraps as arm-board covers and laying larger pieces under the OR table to catch prep that runs off the patient. Blue wrap acts as a barrier during big plastics cases. It also comes in handy when you need a place to lay specimens.

Blue wrap isn’t the only OR refuse you can recycle, says Ms. Chiasson. One of her nurses discovered that Mayo stand covers make great trash bags. Another nurse takes home the plastic wrap and puts it in her own recycling bin to keep it out of the OR’s trash collection. Note: Yes, blue wrap is clean waste, but some may mistake it for red bag waste, which of course is much more costly than regular trash. Set up a recycle bin for blue wrap so staff don’t drop it in the red bag.

Reprocessed devices

Memorial Hermann is also finding success with reprocessing reusable devices. “Reprocessed” devices undergo a detailed, multistep process to clean and then disinfect or sterilize them before they’re returned to the center, which pays a fraction of the cost of a new device. Among the items the ortho-heavy ASC reprocesses are shavers and tourniquets and SpO2 probes. Just recently, the surgery center started to reprocess such ENT devices as insufflation devices and turbinate shavers. Yet that decision did not come fast. First, they had to convince the ENT surgeons, who of course wanted a new device each time they did a procedure.

“If they found out that it wasn’t new, the doctors hesitated to use it. They said it wouldn’t work as well,” says Ms. Chiasson.

The OR team conducted a blind test. It mixed reprocessed ENT devices with new ones during a few procedures.

“Only the nurses and techs knew which devices were reprocessed,” says Ms. Chiasson. “The doctors used them and reported good results, so they agreed to move forward with the use of reprocessed items.”

The OR staff also keeps on top of the staple guns. The surgeons may only use 7 of the gun’s many staples during surgery, but that doesn’t mean you should toss the gun into the biohazard bin. Staff at Memorial Hermann make sure the guns go in the reprocessing bin instead of the biohazard bin.

Some facilities may only use one reprocessing facility, but Memorial Hermann sees the benefits of using two. “We get a better rate when we use two, and some reprocessing facilities are better at reprocessing certain items than others. Some may do a better job reprocessing tourniquets than shavers, for example,” says Ms. Chiasson.

No paper, no printing

The surgery center also stopped printing patient images. It trialed a new tower that emailed images to surgeons and to patients. It also sent a digital image to the medical record.

“When we use paper, we print out 2-4 copies of each patient’s images, and those copies can be 3-4 pages long,” says Ms. Chiasson. “That’s a lot of paper.”

In the end, the center purchased 3 new towers and made plans to upgrade an older tower now in use. While they wait for their new towers, the OR staff at Memorial Hermann will continue to find even more ways to recycle, reprocess, repurpose and redirect.

“We have so many products in the OR,” says Ms. Chiasson. “That’s why we do our best to be very conscious about medical waste. Each department plays a role in the recycling process, and we are constantly looking for opportunities to save.” OSM