I have to admit, I am obsessive about recycling. I recycle everything I possibly can at home: every scrap of paper, every shard of glass, every piece of plastic. I've carried my penchant for recycling over to Morehead Memorial Hospital in Eden, N.C., where I'm the director of surgical services. Guess what? Being environmentally conscious is a good way for surgical facilities to stretch waste-disposal budgets.

Our OR goes well beyond recycling cans and paper. We recycle the No. 2 plastic in which our disposable endoscopic instruments are packaged. We send many opened-but-unused items to a third-party company for reprocessing and we'll soon send used items for reprocessing. We save many of the items that can't be reprocessed and donate them to the local community college's nursing and surgical tech programs. And we're looking at a program that collects unused medical supplies and sends them to third-world countries. But we can do much more.

I've taken six medical missions to Ucayali Regional Hospital in Pucallpa, Peru. On my first trip, I was surprised to see the hospital OR staff going through our trash and pulling out wrap, syringes and tubing - in fact, just about everything that we threw away. Of course, all the supplies we took with us were disposable, but they were like manna to the staff there, where money for equipment and supplies is scarce. On subsequent trips, I saw our tubing drying in the utility room and our faded paper wrap on instrument trays. These folks got maximum use out of what we were throwing away. Nothing was disposable in their OR.

This forced me to look at our practices and to reevaluate how we treat our "trash." Trust me, I'm not recommending reusing all single-use devices until they fall apart. But surely we could put most of them to better use. The OR generates more trash, hazardous and non-hazardous, than any other area of the hospital. Here are some steps to reduce the amount of trash in your facility. You'll save money and protect the environment.

• Identify the recycling "champions" in your facility and let them be the core of your recycling team. Let them do the legwork for you.
• Investigate what can be reprocessed for re-use in your OR. Many companies will re-sterilize items and send them back to you for reuse.
• Look at what can be recycled in your community. Paper sometimes includes light cardboard and magazines. Regular cardboard can often be recycled, as can No. 1 and No. 2 plastic. Identify those items that your local recycling center will take. Then get your core team to be the cheerleaders for separating these items and taking them to the recycling center.
• If the company that shreds your facility's protected health information doesn't recycle, find one that does or pressure your shredder to do so.
• Find a school, a vet or a medical mission that needs supplies. Instead of throwing away that control syringe that flipped on the floor instead of the back table, give it to someone who'll use it.

One final suggestion: Don't use hazardous waste trash bags to transport recyclables to the center. When a hospital executive spotted a red plastic bag full of recyclables in a nurse's car, he called me and threatened to call the sheriff on her for taking hazardous waste out of the hospital. We now use plain trash bags.