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Perioperative and O.R. Design and Management

 
  • Consciously designing sustainable operating room and health care facilities can limit an institution’s environmental impact.
  • LEED certification focuses on six areas of green design and operation: sustainable sites, water efficiency, energy and atmosphere, materials and resources, indoor environmental quality, and innovation and design.

APPENDIX B: Anesthesiology Sustainability Checklist

As an Individual:

1. Reduce Inhaled Anesthetic Atmospheric Waste

  • Utilize low fresh gas flows
  • Avoid high impact inhaled anesthetics: Desflurane, Nitrous Oxide
  • Consider intravenous and regional techniques

2. Reduce IV Pharmaceutical Waste

  • Use prefilled syringes
  • Use appropriate sized vials for an individual patient
  • Dispose of unused medications and vials according to regulations

3. Reduce Anesthesia Equipment Waste

  • Only open equipment intended for immediate use

4. Solid Waste Segregation

  • Avoid default of placing all waste into a biohazard or sharps bins
  • Recycle batteries

5. Linens

  • Consider reusable linen and minimize excessive use of reusable and disposable towels and blankets

6. Leadership

  • Develop/join a Sustainability Committee at a department, hospital, or society level and advocate for a sustainability officer
  • Educate staff and advocate for improved sustainability at your institution

As a Team:

1. Reduce Inhaled Anesthetic Atmospheric Waste

  • Avoid high impact inhaled anesthetics: Desflurane, Nitrous Oxide
  • Invest in WAG trapping (for volatiles only) or WAG destroying (all inhaled anesthetics, including Nitrous Oxide) technology for the Anesthesia Machine

2. Reduce IV Pharmaceutical Waste

  • Work with pharmacy to reduce pharmaceutical waste and improve pre-filled syringe availability
  • Dispose of unused medications and vials according to regulations

3. Reduce Anesthesia Equipment Waste

  • Only open equipment intended for immediate use
  • Consider purchase of reusable or reprocessed equipment over disposable
  • Reprocess or recycle suitable disposable equipment
  • Adjust stock levels to minimize discarding expired items
  • Reformulate prefabricated kits to eliminate unnecessary items
  • Reformulate anesthesia supply carts to eliminate unnecessary items
  • Donate expired or unused open equipment

4. Solid Waste Segregation

  • Segregate waste according to type (pharmaceutical, solid, biohazard, etc.)
  • Avoid default of placing all waste into a biohazard or sharps bins
  • Recycle batteries
  • Consider intraoperative recycling program for clean plastics, paper and cardboard

5. Linens

  • Consider reusable linens
  • Minimize excessive use of reusable and disposable towels and blankets

6. Electronics

  • Avoid excess electronics without proven benefit to patient care
  • Use a certified sustainable electronics recycling vendor to dispose of old equipment
  • When negotiating equipment upgrades/contracts, request vendors take back old equipment for refurbishment and donation, or request vendor use a certified sustainable electronics recycling vendor

7. Leadership

  • Collaborate with hospital leadership to embed pollution prevention as part of the core business mission, to improve the health of our patients, employees and the surrounding community
  • Become involved in environmental preferable purchasing
  • Educate staff regarding the health, safety, and cost benefits of environmental projects
  • Evaluate new equipment, facility, and behavior options for improved sustainability
  • Consider strategic sustainability research projects that will lead to financial and environmental savings for the hospital