NEWS & OPINION 52 EWAP SEPTEMBER 2023 Contact information McCabe: cmccabe13@hotmail.com Collaborative strategies to reduce costs and waste in the operating room Eckelman and Sherman found that the healthcare sector was responsible for 10% of the total U.S. greenhouse gas emissions, with a substantial proportion attributed to supply chain emissions, which are integral to cataract surgery. Although the healthcare sector is a major contributor to total greenhouse gas emissions in the U.S., accounting for nearly 10% of all emissions, 1 a large percentage of surveyed North American (43%) and European (32%) cataract surgeons stated they were unaware of the impact of OR waste and the healthcare system on the environment. 2,3 Despite a lack of knowledge of the precise environmental impact of OR waste, nearly all respondents felt that OR waste was excessive (93%). 2 What can we do in our own practices to reduce waste? A team approach can be the most effective and the most rewarding when tackling big issues with many involved stakeholders. A good way to start is to identify a sustainability champion in the practice and to take the EyeSustain Facility Pledge. The champion can be any member of the team (physician, nurse, or administrator). Ideally, this person will have a passion for reducing waste and will be able to recruit other members of the team from different roles within the OR, such as a surgeon, nurse, administrator, and supply chain manager. The team will identify areas for waste reduction and suggest solutions that can be tested with a pilot study prior to wider implementation. In a practice with multiple specialties and a wide variety of surgeries, this coordinated effort can identify areas where less sustainable choices could be replaced with more sustainable ones already being implemented in the practice. For example, some eye surgeries may be using full body drapes where other specialties or surgeries have transitioned to smaller drapes effectively. A sustainability team can look for ways to spread waste-reducing practices more broadly. The same is true when replacing single-use with reusable items. A pilot study followed by broad implementation can happen more effectively when a smooth process has been put in place for evaluation of waste reducing changes. The Outpatient Ophthalmic Surgery Society (OOSS) website is an important resource, along with EyeSustain. org, for information and collaboration on sustainability ideas. The OOSS Talks feature allows for real-time feedback from other ASC team members on questions, including those addressing sustainability. In addition, OOSS is investigating recycling opportunities to impact waste reduction in the OR and will have resources available on both the EyeSustain website and the OOSS website. OR waste reduction strategies are often win/win/win efforts, This article originally appeared in the July 2023 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp. by Cathleen McCabe, MD The EyeSustain website (EyeSustain.org) offers a number of suggestions and resources, including the EyeSustain Facility Pledge: • Educate surgeons and surgical staff about sustainability and the impact of OR waste. • Regularly re-evaluate surgical pack standardization to minimize waste. • Use multidose bottles of topical medication and betadine on multiple patients when possible. • Assess the necessity for patient gowns and full body draping. • Regularly reassess options for reusable versus single-use products and instrumentation. • Assess feasibility of alcohol-based surgical scrub for pre-surgical antisepsis. • Institute or update recycling strategies.
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