SHAWNEE MISSION, Kan. — The benefits of reusable surgical gowns and textiles over disposable single-use items are proven: They offer enhanced comfort, cost, performance, and are environmentally preferred. In addition, according to Standard Textile, when hospitals convert their operating rooms (ORs) to a reusable program, they can reduce waste by 90%, since OR waste is primarily infectious (red-bag) waste and costs as much as 30 cents a pound to landfill.
In 2015, most hospitals have joined the sustainability bandwagon and formed green teams or hired sustainability officers whose sole purpose is to implement and measure recycling and waste reduction programs.
Given these facts, sales of reusable surgical textiles should be skyrocketing. The reality, however, is mixed. While some healthcare operators have seen an increase in sales, just as many are experiencing flat or declining sales for reusables in the OR.
But when hospitals do make the commitment to convert, experts say, they love the difference reusables provide.
DISPOSABLES FOR THE OR
“In the U.S., we are caught in a disposable mind-set,” says Angie O’Connor, a former OR nurse who currently works for the Encompass Group as director of clinical resources – acute care. “I remember when HIV emerged and there was a rapid shift to disposables because they were perceived as safer. Now, the overall ratio of disposables to reusables in U.S. hospitals is 80/20.”
The reasons manufacturers of disposables are able to keep single-use disposable items in the OR are varied, and include:
- Enormous marketing budgets that fund a large sales force and advertising to promote and reinforce existing biases for disposables.
- Decades of entrenched bias among users that disposables are more hygienic, safer, more convenient and less expensive.
- The issue of sterilization. Most U.S. laundries aren’t set up to sterilize reusable surgical packs. Barriers to entry include FDA regulation and the cost of sterilization equipment ($150,000 to $200,000 per autoclave). This puts the onus on hospitals to sterilize surgical packs, which most hospitals aren’t used to doing, or may not have the capacity to handle. An exception to this are laundry cooperatives formed to serve member hospitals; cooperatives do not come under FDA regulation regarding sterilization.
- Group purchasing organizations and the power of discounts and rebates. To secure the lowest possible price for goods, and sometimes rebates, hospitals must often agree to purchase a minimum volume of specific products. If eliminating disposable items in the OR jeopardizes the hospital’s pricing on other goods, a conversion to reusables is not likely.
CONVERTING ORs TO REUSABLES
In a nutshell, a successful conversion takes research, work, expertise and a cash investment. Jim Sprout, PrePak business manager for Standard Textile, describes the challenge: “To convert [a hospital to a reusable OR program], the costs come quickly and the benefits a little slower.
“A hospital and their laundry partner need to invest in the textile products, build out a pack room in the laundry, and develop staff expertise for pack-room operations: laundering, inspection and folding, pack make-up, and steam sterilization,” he says. “This is a lot of work and expense.
“However, the results that come after this is accomplished are great and include: a huge improvement in clinical staff satisfaction for gowns they wear; a reduction in more than 90% of medical waste generated by the OR; a reduction in the cost of gowns and towels and covers; increased utilization in previous investments in laundry and sterilization systems; moving good jobs from China to the local community; and a more flexible, responsive, and controlled service,” he says.
The key, according to Sprout, is willingness on the part of the hospital and laundry to invest the upfront time and money required to launch a successful reusable surgical textile program.
Based on interviews with manufacturers of surgical textiles, the following process is recommended to convert a hospital from disposables to reusables.
SUGGESTED CONVERSION PROCESS
Representatives from Encompass Group, Lac-Mac, Medline Industries and Standard Textile contributed to the process outlined here. Special kudos to Shelley Petrovskis of Lac-Mac for her Six-Step Approach. Operators are encouraged to contact their suppliers for support when preparing to sell reusable surgical textiles.
- Research prospects and contacts. Identify the right contact to begin conversations. Who is an ally, and who is an adversary? Environmental services? Is there a green team or environmental staff person? Be sure to enlist the support of staff that will support the environmental and waste reduction benefits offered by reusables. Then proceed to the OR manager or OR staff.
- Start small. You probably aren’t going to convert the entire OR from single-use items to reusables at the same time. Begin with a manageable plan, say OR towels and surgical gowns, or back-table cover or mayo-stand cover.
- Work with your reusable OR supplier. Tap the knowledge and resources your supplier can provide. Any and all reusables suppliers are a resource to you. Consider reaching out to other laundries that have successfully converted hospitals to a reusable OR program for any tips or suggestions they may have.
- Prepare an outline comparing disposable products to reusable alternatives. This comparison should include costs; product and barrier attributes; sterilization; disposal costs; delivery; staffing; and any other services your laundry can provide in addition to a reusable OR program.
- Once you have initial buy-in, establish a multi-disciplinary team.
- Offer the team (green team, clinical staff and decision-makers) a tour of the laundry and pack room.
- Begin a product trial for a few weeks. There may be those against a reusable program, but let them sample it and get their buy-in. Document expectations and how success will be measured.
- Measure the results and analyze.
- Set up a clear process for conducting the actual conversion (one that uses up old inventory, etc.). Make sure the client has customer-service support on-site and/or easy to reach via phone.
- Continue to provide support and education to client, as well as evaluate and measure results.
Check back Wednesday for the conclusion!