OR Excellence Awards – Environmental Stewardship: Going Green Is a Mindset


Memorial Sloan Kettering Cancer Center’s blue wrap recycling effort boosted unity, awareness and motivation among the OR staff.

Change is difficult, especially in health care. Even if an idea sounds easy to implement, getting the effort off the ground and your team on board can be the hardest part. But this didn’t deter Memorial Sloan Kettering Cancer Center in New York City from integrating sustainability efforts within the perioperative setting. Their endeavors to reduce energy, usage and waste while increasing recycling efforts has made the cancer center this year’s winner of the OR Excellence Award for Environmental Stewardship.

The facility developed a Greening the OR Committee, which is made up of perioperative leadership, nurses, surgeons, anesthesia, environmental services, facilities management, radiology, supply chain staff and surgical support staff. The committee’s mission was to come up with ideas on how to be more energy efficient, reduce waste and procure more sustainable items. “The remarkable thing about the committee is how engaged everyone is in the mission,” says Yessenia Salgado, MS, BSN, RN, NE-BC, CNOR, director of nursing for perioperative services at the facility and co-chair of the committee. “Current efforts are aligned in supporting the facility’s Blue Wrap Recovery and Recycling Project.”

POINT OF USE Placing blue wrap recycling bins throughout the facility in easy-to-access locations makes it simple for staff to divert the material from the waste stream.

An estimated 255 million pounds of blue wrap is thrown out and sent to landfills in the U.S. each year, notes Ms. Salgado. “Blue wrap plastic can be recycled as long as what is collected has virtually zero contaminates,” she says. “It can be pelletized or rewoven and made into basins, PPE, bins, tote bags, garment bags and more.”

While the effort sounded simple enough, it took a lot of preparation and planning. “Something may spark an idea, but you need a team who is really passionate to bring it to life, as well as support from leadership. Although it may not be easy and feel like a lot of work, the Greening the OR Committee would agree, it’s totally worth it,” says Ms. Salgado.

Together the committee chose to focus its efforts on the departments that used the most blue wrap — orthopedics followed by neurosurgery. Then they researched companies that had the capability to collect and reuse the material. Four hampers designated for blue wrap and lined with clear bags were stationed in the ORs. Surgical team members were instructed to fold the blue wrap and check for contaminates before placing it in hamper. They must tie off the bag of blue wrap before dropping it in one of two 96-gallon recycling bins that were provided by a local hauling company, with which the hospital was already working. “Collaborating with an existing vendor helped streamline costs,” says Ms. Salgado. The hauling company then transports the blue wrap to two different recycling companies.

Early results yielded the collection of two 96-gallon bins in one week, which equated to 800 pounds of blue wrap being diverted. By the end of 2021, 3,000 pounds of blue wrap was collected for recycling. Ms. Salgado says the goal is to replicate this effort in other ORs and at other Memorial Sloan Kettering Cancer Center sites.

“The diversion of waste from landfills and the reduction of harm to the environment created a sense of unity, awareness and motivation among the OR staff,” says Mr. Salgado. “They feel more empowered to suggest and explore new greening options throughout their daily practice as it pertains to recycling, reusing and reprocessing.”

The perioperative team didn’t stop at blue wrap. When Ms. Salgado became director, she started noticing other areas of opportunity. “We were ordering a lot of plastic clothes hangers and disposing of them after the patient was discharged,” she says. Ms. Salgado engaged the infection control department to find out if the hangers could be reused if properly sterilized. “They were approved by infection control to be wiped down the same way we would any other contact surface,” she says. “It doesn’t take much effort, yet the endeavor not only saves the hospital money, but also keeps plastic out of landfills. That’s a win-win.” OSM

Providing Care and Supplies to Those in Need
HELPING HAND Dr. Majmundar travels to Guatemala to perform cleft lip and palate surgery on adult and pediatric patients.

Mike Majmundar, MD, originally wanted to be a cardiologist. But after shadowing a lot of different doctors, he fell in love with cleft lip and palate surgery. Since there are not a lot of cleft lip and palate patients in the U.S., Dr. Majmundar, a plastic surgeon and director of Northside Plastic Surgery in Atlanta, chose to start his own organization to help those in need.

He created Second Chance Surgeries seven years ago, a charitable foundation that partners with hospitals in Guatemala. The volunteer-based, not-for-profit provides no-cost, high-quality medical, psychological and surgical care for the health and well-being of adults and children. “We perform surgeries on patients from 3 months to 90 years old,” says Dr. Majmundar.

He travels to Guatemala one or two times a year and not only donates his time, but a plethora of surgical necessities. “The government hospitals in Guatemala do not have much of a budget,” he says. “Sterile technique is more of an idea rather than a practice, so we donate plenty of gowns, gloves, drapes and gauze.”

He also brings with him a lot of the soon-to-be-expired or just recently expired anesthesia drugs and sutures. “We get donations from other anesthesiologists, primary care doctors, pediatricians and other surgeons who have expired material that they would rather donate than waste,” he says.

Dr. Majmundar says Guatemalan hospitals often do not have access or the money to buy things that are always readily available in U.S. healthcare facilities, such as ibuprofen, acetaminophen and lidocaine. “We have been able to donate items to four different government hospitals, and they are so appreciative,” he says. “So much gets thrown away in this industry, so it’s great to see it being used by people in need.” 

Danielle Bouchat-Friedman


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