J. Bailey1, P. Johnston1, M. Maloney1, A. Panigrahi1, A. V. Gore1, Z. Sifri1 1New Jersey Medical School,Newark, NJ, USA
Introduction: Many opened operating room (OR) supplies are not used during surgery due to bulk packaging, unanticipated findings leading to a change in strategy, or case cancellation. These unused supplies are disposed of despite remaining free from biohazards and often sterile, resulting in environmental burden and disposal cost. It is estimated that approximately two million pounds of recoverable supplies worth over $15 million are disposed of annually at the average academic medical center. These same supplies are in need in many low- and middle-income countries (LMICs) where humanitarian teams use donated funds to purchase similar items. We hypothesized that implementation of a material salvage program could reduce the environmental burden of the OR while financially benefitting the academic medical center, humanitarian organizations, and LMICs.
Methods: Volunteers planned the salvage of clean, non-sterile items that were previously discarded as medical waste. Goals were widespread implementation and ease of collection as to not place additional burden on the OR staff. Signage was posted at central locations in the OR to educate on the purpose of and to encourage participation in the program. Bins were located centrally, labeled for supply collection and emptied twice weekly. Supplies were then weighed, inventoried, and packaged for utilization in resource poor areas. The cost of shipment was covered by fundraising efforts of global heath medical-student interest groups.
Results: Materials were salvaged from 14 operating rooms at an urban academic medical center for 107 consecutive days in 2016. In total, 909 pounds of supplies were collected, of which 854 pounds (94%) were salvageable materials, with 54 pounds (6%) deemed unusable. Annualizing these data, this program would lead to salvage of approximately 1.5 tons of usable materials per year for a savings of more than $500 in waste disposal. Of the materials salvaged, 70% were OR supplies, 17% were wound care supplies, and 13% were personal protective equipment. To date, these supplies have been shipped to Ecuador for disaster relief following the recent earthquakes, to Ebola endemic areas for personnel protection, and for capacity building and support for short-term surgical missions in LMICs. Total investment is 7 hours per month, and less than $100 per year.
Conclusion: Implementation of a program to salvage OR supplies from a single hospital generated a significant amount of usable materials to support surgical care in LMICs with minimal cost and time investment. There is a financial benefit to hospitals in decreasing waste disposal costs and to humanitarian teams in decreasing purchasing costs of supplies. The cumulative environmental benefit of salvaging items that would have been disposed of is significant. Ancillary benefits of providing these materials for disaster relief or short-term surgical missions still need to be quantified to fully evaluate the impact of this program.