Net Zero Clinical Care 2023

Title: Switching from single-use to reusables in a hospital theatre

Main finding: By preventing the incineration of ~1,900 laryngoscope handles and >9,000 drugs trays each year, Cromwell Hospital will save >3,449 kg CO2e (equivalent to powering 435 homes for an entire year) and £10,000 per year that can be reinvested into patient care.

Background

•Since 2020, single-use products have been used the medical industry to prevent the spread of Covid-19.

•Bupa Cromwell Hospital in London were using single-use laryngoscope handles and drug trays.

The handles which contained lithium batteries had to be incinerated, as per the manufacturer’s instructions

Life Cycle Assessments (LCA) to guide decision making

•The hospital would order 1,900 single-use laryngoscope handles and 9,000 single-use drug trays each year.

•An LCA found:

oA single-use disposable metal handle generated approximately 25 times more greenhouse gas emissions (1.60 kg CO2-eq) than a reusable handle treated with high-level disinfection (autoclave).

•Single-use trays:

ocost twice as much

oproduce 15% more CO2

oconsume 3 times the amount of water

What we did:

•From February 2023, Cromwell Hospital now has 30 reusable handles, which cover 5 operating theatres and areas where anaesthetic services are required, including CT, MRI, endoscopy, and X-ray.

•The reusable handles are identical to their single-use counterparts, except that the rechargeable batteries require charging after 40 uses – these are checked before every procedure and can be recycled at end of use.

•They have also reduced their drug tray stock down to around 100 reusable items.

•An educational campaign was launched initially and a Standard Operating Procedure (SOP) has been put in place for the cleaning of the reusable handles and trays.

Lessons learnt:

•Staff responded positively to the reimplementation of reusables.

•Staff reported that the negative feedback around time required to charge the batteries and having to clean trays and handles was outweighed by the environmental and financial benefits.

•The biggest challenge was ensuring that staff didn’t dispose of the reusables out of habit.

•Pictures were sent of the single use and reusable items to staff via WhatsApp and email, describing their differences.

•This initiative has inspired other similar initiatives; for example, the Green Team have also switched from plastic to reusable glass water bottles.

Net Zero Clinical Care 2023

Switching from single-use to reusables in a hospital theatre

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