Fluid Waste Management in Orthopedics

Five key questions to ask potential vendor partners.

An effective fluid waste management system is a necessity for a busy orthopedic center. After all, the specialty is famous for its messy, fluid-filled cases. While any system that collects and discharges fluid waste directly into the sewer is an upgrade from the traditional, eco-unfriendly single-use plastic suction canisters and their corresponding chemical solidifiers, a lot goes into purchasing a fluid waste management solution. Choosing the right system is a challenging proposition for busy facility leaders.

To find the right product for your ortho center’s needs, you must investigate, do your due diligence and come ready to pepper prospective vendors with the right questions.

Critical details

After doing the research, your vetting process ultimately dictates how you make out. Obviously, cost looms large in the decision-making process, but the upfront price isn’t always so cut and dried. These five questions should help you uncover a good amount of the information you need to know before purchasing.

• What is the evidence behind the product? Chances are vendors will point you to studies they commissioned about the efficacy of the product they’re selling. That makes sense. But it’s safe to assume this type of research isn’t the most scientific data out there. “In order to uncover true evidence behind a product’s efficacy or safety, cast as wide of a net as possible,” says Andy Poole, FACHE, associate director of strategy and innovation at ECRI, an independent, nonprofit organization headquartered in Plymouth Meeting, Pa., that is dedicated to improving the safety, quality and cost-effectiveness of care across all healthcare settings worldwide. “Go into the online journal repositories of the world to dig and find out as you can.” This evidence needs to be factored heavily into the purchasing decision. “When you are making an investment, saving $10,000 off of the cost of a system doesn’t matter if the product doesn’t do what it claims.”

• What are the care and cleaning requirements of the system? Find out everything you can about the cleaning and care of the equipment and ask a few pointed follow-up questions about the IFU.

It’s also an opportunity to ask about the recommended service contract. Mr. Poole says the service contract question should be an essential element of any major purchasing decision. “Some vendors tend to place the service contract in at the end of a discussion, but I’ve always liked to bring it up as early as possible in discussions, because it has a huge impact” he says. “If something is cheaper on capital but requires much more on the cleaning and service side, is it really a better investment?” 

• Where should we put the docking station? If you’re making the transition from manually throwing fluid waste into the hopper or bagging it as hazardous waste after solidifying it, you must make sure you select the best location to connect your new system into your sanitary sewer.

Facilities that are considering a stationary system should work with the vendor and the person who functions as your facilities manager to determine the appropriate place to hard-plumb into your sanitary sewer. If considering a mobile system, collaborate to find the right spot to install the docking station where you’ll connect the reservoirs of waste into the sanitary sewer. “It has to have a drain and be connected to plumbing, so work with them to identify an area that’s convenient and not on a far end of your center that’s a long walk from your ORs,” says Gregory P. DeConciliis, PA-C, CASC, administrator at Boston Out-Patient Surgical Suites in Waltham, Mass. “The whole reason you’re buying these items is to increase efficiency, so make sure that where you’re going to make a direct connection of the dock the reservoirs promote those efficiencies. It doesn’t make sense to put the connection in a place that works against that idea.”

KEY NUMBERS

Counter Cost Objections With This Primer.

If upper management can’t get past the initial price point of a new fluid waste management system, try reframing the discussion using some of these compelling facts and figures from Practice Greenhealth, a membership and networking organization for sustainable health care, delivering environmental solutions to hospitals and health systems across the U.S. While the upfront cost of fluid waste management systems is higher than the costs of single-use disposable plastic suction containers, long-term benefits include:

• Return on investment in one to three years.
• Less occupational exposure risks during collection, transport, and disposal.
• More efficient operating room cleanup and disposal procedures.
• Fewer disposable medical plastics in regulated medical waste.

Need more? According to Practice Greenhealth, “Fluid management systems save hospitals an average of $51,000 per year and reduce the risk of occupational exposure to potentially infectious and hazardous material during collection, transport, and disposal of fluid medical waste.”

For tools and resources that Practice Greenhealth offers on fluid management systems visit: osmag.net/fluid

—Outpatient Surgery Editors

• How many mobile devices do I need? Your first thought is likely that you need or want one device per room, but it might be worthwhile to consider having more than that, says Mr. DeConciliis. Having an extra one helps if the first one fills in the middle of the procedure, so you don’t need to pause the surgery to immediately drain it.

“A second device on hand that’s always empty, clean and ready to go that you can always grab to use on the fly is very helpful,” he says.

In order to uncover true evidence behind a product’s efficacy or safety, cast as wide of a net as possible.
Andy Poole, FACHE

Having two also means you don’t need to clean the first one before you use it again for the next case. The already cleaned-and-docked one is ready.

A needs-based assessment for your facility should include conversations with the vendor about the types of cases, and how many of them, you perform. If it seems like multiple devices isn’t in the budget, explore potential options with the vendor such as a lease program or having the capital item placed for free in exchange for a cost-plus program when buying the filters and other accessories that need to be purchased regularly.

The goal here is to make sure you don’t over- or undershoot what you need. “Utilization plays a pivotal role,” says Mr. Poole. “What procedures are you doing right now and what do you plan to do in the near future?”

• What additional benefits can the system provide? Many fluid waste management systems offer an array of direct and indirect benefits.

According to Practice Greenhealth, additional safety features on newer fluid waste management systems include smoke evacuation, fluid measurement, precise vacuum control, air filtration and enclosed processing, which further reduces occupational exposure risk. OSM