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health care circular systems approach

How Reprocessing Medical Devices Can Save Millions While Diverting Waste

health care circular systems approachMedical waste — more than 5.4 tons per year for an average operating room — costs each operating room about $5,243, according to the 2015 Practice Greenhealth Sustainability Benchmark Report.

A partnership between Johnson & Johnson subsidiary Ethicon, which manufacturers surgical devices and and Intermountain Healthcare is tackling this issue, reducing waste and operating room expenses, through a circular systems approach. In 2015 this approach saved the health care company about $250,000 on medical devices, or 22 percent on total spending of $1.1 million. It also diverted 59,964 pounds of waste from landfills, avoiding 35,978.4 pounds of CO2 emissions.

Single-use medical devices, such as ultrasound catheters, surgical drills and laparoscopy scissors, are designed to be used only once and then tossed. This creates a huge amount of medical waste — and can be expensive for hospitals to replace new single-use items.

Intermountain, a Salt Lake City-based health care system with 22 hospitals and 185 clinics, already recycled materials and had been doing this for several years. But simply recycling wasn’t helping the health care company meet its environmental or business goals, says Steve Bergstrom, Intermountain director of sustainability. “We needed to reduce consumption and the only way to accomplish that was through a circular approach,” he said in an interview with Environmental Leader.

After discussing this concept at CleanMed, a health care industry environmental conference, Intermountain and Ethicon teamed up to improve medical device collection and reprocess devices. The partnership works like this: Intermountain collects used medical devices. It returns them to Ethicon, which sends them to Sterilmed, also a Johnson & Johnson company, for reprocessing. Sterilmed turns the old devices into new ones and then Intermountain buys back a mix of reprocessed and OEM devices from Ethicon.

“It required an interdepartmental effort on both sides to make this work,” Tim Lessek, senior marketing manager of Ethicon, told Environmental Leader.

Both Lessek and Bergstrom are discussing the success of their reprocessing partnership at a CleanMed 2016 session today.

Reprocessing not only diverts waste from landfills, it also costs less to purchase reprocessed devices compared to new ones. Sterilmed says the average reprocessed single-use device costs 50 percent less than a new device. And the reprocessed medical devices are just as good. As an FDA-registered medical device manufacturer, Sterilmed products are held to the same standards for cleanliness, sterilization and functionality as the original equipment manufacturer.

Lessek says bringing all parties to the table — from original equipment manufacturers and reprocessed device makers to sustainability officers, surgeons and purchasers — was key to making the partnership work and achieving cost and environmental benefits. “The circular approach requires an attack from all different angles. If the partnership is limited to a small set of stakeholders, you are selling yourself short.”

This concept extends beyond the circular systems approach and is vital to improving the overall environmental performance of the health care industry — which stands to save up to $15 billion over 10 years by adopting more sustainable practices, according to the University of Chicago-Illinois.

“You have to make sure this message and vision of sustainability is understood by all departments and stakeholders across the enterprise,” Lessek said. “We have engineers making decisions every day about material selection and packaging that may seem insignificant if they don’t see the larger picture about the impact they can have on improving the healthcare system from an environmental perspective. Reducing packaging size, reducing the amount of components in our packaging, the amount of plastic in a device — this may seem insignificant but if you can fit more boxes on a pallet and if those boxes are smaller, you save on fuel and shipping costs.”

While reprocessing devices can improve the health care industry’s environmental performance, there are still key barriers that prevent widespread success and support, such as physician resistance.

Bergstrom says Intermountain overcame this challenge by showing physicians the science behind reprocessing and letting them test the devices in blind studies so they could see how the products performed without any prejudice.

“Since we have introduced this program more than 90 percent of our surgeons are confident in and happy to use sterile reprocessed devices,” said Intermountain’s Dr. Mark J. Ott, surgeon and chief medical director, central region, in a white paper about the partnership. “These devices are indistinguishable from the original product in their function and our surgeons are happy to reduce the cost of care and the impact on the environment.”

Another important lesson learned is partnering with companies that share similar values, Bergstrom says. “With the circular methodology, everyone has to be looking to reduce the environmental impact. Typically the model has been: a manufacturer will sell to us, we use the product and then the health care industry has to figure out what to do with the product. That has been a key interrupter. Recycling, quite honestly, isn’t the answer any longer. We need to reduce and reuse.”

Don’t miss our Environmental Leader 2016 Conference in June.

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