PowerPoint Presentation · 2018. 10. 24. · Title: PowerPoint Presentation

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Implementing Successful

Waste Management &

Recycling Initiatives in the OR

© 2014 Practice Greenhealth

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Disclosures

It is the policy of Corexcel to ensure fair balance, independence, objectivity and scientific rigor inall programming.

In compliance with the American Nurses Credentialing Center’s Commission on Accreditation (ANCC), it is the policy of Corexcel that faculty disclose all financial relationships with commercial interests over the past 12 months.

Valerie Sosnowski, No Financial Interests

Mike Mollerdino, No Financial Interests

Matt Waskerwitz, No Financial Interests


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NorthShore University HealthSystem Presenters

• Valerie Sosnowski, MSN, MHSA, RN, CNOR

Clinical Director, Perioperative Services, Highland Park Hospital

• Mike Mollerdino, MBA, CHESP Corporate Director of EVS and Patient Transport

• Matt Waskerwitz, MHSA, MBA Senior Business Director, Perioperative Services


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• Four hospitals, 3M+ sq ft combined

• 10,000 employees

• 2400 Physician medical staff

• 700+ Physician group practice

• 37,000 Surgical cases/year

• 900 Beds / 40+ ORs

• $100+ M Research Institute

• University of Chicago principal teaching affiliate


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Impact of Recycling Program

Solid Waste and Medical Waste

Recycling


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Clinical Perspective

Valerie Sosnowski, MSN, MHSA, RN, CNOR Clinical Director, Perioperative Services, Highland Park


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AORN Position Statement on Environmental Responsibility

“As stewards, perioperative RNs also should actively promote and participate in

sustainability practices that preserve natural resources, reduce waste, and minimize

exposure to hazardous materials.”


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Nurses’ Passion for Recycling

• Desire to incorporate concept of sustainability into practice

• Nurses wanted to take responsibility to care for their environment as they do for patients

• Corporate Green Team established 2009

• Once periop team became educated they willingly joined the cause


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Start-up of O.R. Recycling Program

Leadership commitment

Resource allocation

Collaborative initiative

Onsite assessments by vendor

Goal to minimize disruption of workflows


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What Do We Recycle?

• Blue wrap (100% polypropylene/#5 plastic)

• Plastics/bottles & wrappers

• Disposable tourniquets/SCD sleeves

• Batteries

• Non-corrugated cardboard (i.e: suture boxes)

• Single use devices: – laparoscopic trocars/instruments

– energy devices, (i.e: ultrasonic scalpels)

– arthroscopic devices


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Staff Engagement in Recycling Efforts

• Concern about proper sorting of recycled items

• Concern about increasing room turnover time

• Concern about space for receptacles


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Education

• Education was vital to get staff buy-in

• Data presented

• Signs and pictures posted as educational aids

• Staff input regarding bin location

• Visual aid was provided showing amount of material that would have been discarded into waste stream


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Use of Reusable Positioning Devices & Instrument Trays

• Converted from trays needing blue wrap to covered, reusable instrument trays

• Converted from foam to gel patient positioners

• Converted some OR pads to newer style Tempur-Pedic type material


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Signage Used as “Legend” for Recycling


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Take Aways

• Find a champion for the cause

• It takes a handful of people with a passion

• Involving stakeholders in the process brings results

• Seeing the difference it can make, efforts are driven further!

• Ongoing focus and attention is critical to ensure long term program success


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Support Services Perspective

Mike Mollerdino, MBA, CHESP Corporate Director of EVS and Patient Transport


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Recycling In the OR

• Keys objectives

– Passion (The want to)

– Collaboration (right people at right time)

– Adapting to Workflow (Effortless)


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Misaligned objectives


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Workflow - Effortless


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Containers in the OR


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Placement – Strategy

• Consistent placement in each room to match workflow

•Partnering with OR staff to gather input and increase ease of use.


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Medication Waste - Setup


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Blue Wrap Journey

• Green Committee

• Infection Control

• Vendor (comingled recycling)

• Labor – Logistics


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Blue Wrap

Wrap is collected.

Removed from room prior to

patient arriving

EVS tech sends bags in blue

carts

EVS driver collects

Driver delivers to Skokie Hospital

Vendor recycles blue

wrap


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Blue Wrap - collection

•Pre-case collection which altered workflow


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Blue Wrap - Transport


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Business Perspective

Matt Waskerwitz, MHSA, MBA Senior Business Director, Perioperative Services


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Building a Business Case - Overview

Key steps to getting people to “buy-in”

*This is not a Finance Discussion


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Business Case is Dependent on the Initiative

• All different flavors of initiatives in Healthcare

– No magic Return on Investment Formula

– No magic Break Even Analysis

• The key is to navigate the customer landscape and develop a proposal that meets your customers’ and organizations’ needs


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Clearly define the goal

• Define the goal

• Ensure you are aware of risks/challenges and answer those questions proactively


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Identify a “Champion”

• Important to garner strong support

• In Healthcare…..

– Champion is usually a Clinical Leader

• Physician or Nurse

*The Champion does not drive the effort, but he/she serves as a key supporter


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Develop the Business Proposal

• Identify the opportunity and justification which will clearly capture attention of key decision makers – Ideas (depending on the goal)

• Savings – Straight expense cuts or substituting one method/process for

another.

• Break Even Analysis – Upfront investment with longterm advantages

• Return on Investment – Revenue


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Important Elements to Consider When Developing Business Proposal

• Quality

• Review with the appropriate committees

– Clinical and Corporate Purchasing

• Experiences from other organizations

• Savings Methodology

• Employee Engagement

• Be cognizant of potential impact to revenue


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Ensure Ongoing Success

• When finalizing the Business Case –

– Clearly define the metric for ongoing success

– Determine the milestone at which the organization makes the decision to continue or abort


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Transferability to other Service Lines or Departments

• Our success in the Operating Room is just one example of many


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What should we do?

• Many unknowns will impact healthcare

• Regardless of the direction of healthcare reform

– Quality, Cost Containment, and Environmentally Safe Practices are a certainty!!!


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What’s Next at NorthShore

• Construction Projects and focus on implementing sustainable best practices where feasible

• Organic waste composting program

• Internal durable goods repurposing (furniture, equipment)


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Thank you!!!

We welcome your questions and comments


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References

• AORN Perioperative Standards and Recommended Practices. (2014). Position statement on environmental responsibility. Retrieved from http://www.aorn.org

• NorthShore University HealthSystem Green Team Pulse Page. (2014). Reduce, reuse, recycle. Retrieved from http://pulse/CorporateServices/green

• Ogden, Jennifer. (2009). Blue wrap recycling. AORN Journal, 89(4), 739-743.


http://www.aorn.org/

http://pulse/CorporateServices/green

Documents

PowerPoint Presentation · 2018. 10. 24. · Title: PowerPoint Presentation