Getting Into Going Green


Small initial steps lead to significant progress toward more sustainable surgery.

Do no harm guides the culture of safe patient care. At The Valley Hospital in Ridgewood, N.J., the mantra also extends to protecting the environment. As part of a commitment to explore environmentally friendly options in the hospital, surgical team members are constantly looking for ways to develop more sustainable options in the OR. Over the last several years, their initiatives have included diverting supplies from the waste stream as well as collaborating with outside companies to reprocess, repurpose and recycle single-use items. They segregate infectious waste from recyclable materials at the point of use and even make concerted efforts to cut down on using hard copies of the daily surgical schedule.

The staff has learned that going green does not have to be an overwhelming, costly process; instead, it can involve minor changes that lead to a larger initiative that promotes positive change.

Segregating waste. Finding new ways to reuse, repurpose and recycle items is the most crucial component of effective sustainability programs. The important step is the first one taken, no matter how small it seems. The Valley Hospital began with simple waste management strategies and discovered it was easier for staff members to be conscious about the environment when they are truly engaged in daily efforts to go green.

The hospital’s staff must decide among eight to 10 collection bins, green bags, clear bags and red bags when sorting through used supplies and instruments at the point of use. To make sure the right receptacle is used, the leadership team holds in-services during which the staff is educated and tested on where individual items should be placed.

Members of the surgical team enter a room lined with every type of bin and bag used in the hospital. They’re shown pictures of supply items and instruments and asked where they should be placed. It’s a fun and engaging way to reinforce the importance of recycling material in the OR and ensure the team does it correctly.

“Knowing where each item goes is essential to our environmental initiatives, so we test our team’s knowledge during the in-service,” says Tirso Ballesteros, MSN, RN, CNOR, The Valley Hospital’s director of perioperative services. “It has become a fun day of education.”

Mr. Ballesteros says these interactive in-services are easy to organize and run. They create a sense of community among members of the surgical team, who can ask questions and collaborate on suggestions for improvements to the hospital’s greening efforts. 

Relying on reusables. Erin Stolfe, manager of the OR and OR business at The Valley Hospital, says adding up minor changes in greening efforts results in significant savings in sustainable operations and points to the hospital’s ability to repurpose or recycle about 3,500 items. “That might not seem like much, but it’s a significant change in terms of us limiting red bag waste,” she explains. “It’s resulted in the hospital saving thousands of dollars.”

Part of these savings have been realized through the hospital’s recent initiative to transition from using disposable supplies to opting for reusable items whenever possible. The need to move away from disposables emerged out of necessity during the pandemic, when needed supplies were suddenly in short supply. Staff members were using reusable isolation gowns, which were sought-after commodities along the frontlines of care at the time and highlighted the benefits of investing in reusable supplies. “The less we spend on disposables, the less of a drain it is on the healthcare system as a whole,” says Ms. Stolfe. “We try very hard to be fiscally responsible.”

Maintaining momentum. Keeping staff engaged in ongoing going green efforts is essential. Mr. Ballesteros puts together quarterly reports to highlight what the team has accomplished, as well as how they can continue to help move innovative ideas forward. The reports encourage team members to come up with new ideas of their own or ways to improve current initiatives. For example, the reports sparked conversations about developing a better disposal system for robotic arms, a development that showed how keeping sustainable solutions top of mind can lead to ongoing positive impacts on the environment.

The less we spend on disposable supplies, the less of a drain it is on health care as a whole.
— Erin Stolfe

The hospital staff’s continuous curiosity keeps them searching for new ways to improve upon current practices. They monitored the use of the printer in the surgical department and discovered it was one of the busiest in the hospital. To cut back on the amount of paper used, department leaders reduced the number of hardcopies of the surgical schedule they print out on a daily basis. This small opportunity for improvement was discovered by talking to the OR staff about constantly looking for ways to green their workspace. They realized there’s always a possibility to learn and do more.

Gradual change

One small positive step toward a greener OR environment helps to mitigate waste and encourages staff to continue to ask questions about what they can do to protect the planet. Ultimately, these small steps — which any facility can take — culminate in big reductions on health care’s overall carbon footprint.

Going green might not happen all at once. It begins by asking questions about how surgical care can be improved from a sustainability standpoint and what specific steps are needed to make improvements happen. These questions can result in cost-effective, impactful change that furthers environmentally friendly efforts in health care. OSM

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