Greening the Operating Room

Operating rooms are the most resource-intensive area of the hospital. They drive up to 60% of a hospital’s revenue, but consume three to six times more energy per sqft, and produce more than 30% of the waste and two-thirds of its regulated medical waste. To mitigate these impacts, we have implemented a variety of programs with our OR staff and clinical champions.

In 2019, we began to monitor the greenhouse gas emissions from our anesthesia use. Anesthetic gases are potent greenhouse gases, and desflurane is the most carbon-intensive of the three that we use in our hospital. It’s ~50x more carbon-intense than sevoflurane, and it’s also the most expensive. The good news is that it can be used interchangeably with sevoflurane for most surgical cases.  In the course of two years we were able to reduce the percentage of cases where desflurane was the primary gas chosen by anesthesiologists from an average of 13% down to an average of 1%. Due to this success, we are now planning to remove our desflurane vaporizers and make it available for use only for medical necessity or teaching purposes.  This initiative saved over $190,000 since inception and removed the equivalent of 250 cars off the road.

Our physicians use a variety of devices during surgeries and many of these items are able to be collected and reprocessed by an outside vendor. By collecting these devices we are able to divert them from a landfill, and we are able to buy them back from the vendor at a cheaper rate than a new device.  We track our collection rates and repurchasing rates and continually train our physicians and nurses on which devices are able to be collected.

Operating rooms are challenging environments to collect recyclables because of the potential for contamination by biohazardous waste during a procedure. To mitigate this risk,  we utilize a pre-case recycling program where our nurses open and collect all of the recyclable packaging that is expected to be used during a case. These bags are removed from the OR before the patient is brought in for surgery, minimizing the risk of contamination of the clean recyclables.

One of the bulkiest and lightest materials that we segregate out of our waste streams is blue wrap - also known as surgical or sterilization wrap - which is made out of #5 polypropylene fabric that can be recycled or repurposed into other materials. We recycle our blue wrap and a portion of it is sent to UC Irvine where seamstresses repurpose the materials into masks for vulnerable populations in Los Angeles.

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