Hospital recycling on increase

Reusing one-time-use tools cuts waste, stirs some concern

  • Dr. Martin A. Makary, a Hopkins surgeon, holds an argon laser probe and a laparoscopic port, unused but with their packaging opened, that he says could be recycled.
Dr. Martin A. Makary, a Hopkins surgeon, holds an argon laser… (Baltimore Sun photo by Kenneth…)
February 25, 2010|By Meredith Cohn |

In a bid to reduce waste and control costs, a growing number of U.S. hospitals are now cleaning and reusing tools such as compression sleeves, laparoscopic ports, and other medical and surgical items labeled for one-time use.

Hospital administrators had been behind the move, called reprocessing, but more recently it's been fueled by environmentally minded workers looking to change the health care industry's status as one of the largest contributors to the nation's landfills. Tons of equipment are tossed every year after being used once, according to some participating hospitals.

About a quarter of the nation's hospitals now do some reprocessing, according to Dr. Martin A. Makary, a surgeon and associate professor of public health at the Johns Hopkins University School of Medicine who has studied the trend.

There is still some opposition from patient advocates and manufacturers who are concerned about safety, despite successful pushes for tougher regulation by the U.S. Food and Drug Administration. A recent Government Accountability Office study concluded the process was safe, though officials acknowledge there isn't much research on the nascent industry.

"Hospitals are taking incremental steps," said Makary, who joined well-known Hopkins safety expert Dr. Peter J. Pronovost in an analysis of reprocessing to be published in the March issue of the journal Academic Medicine. "The opportunities are almost endless."

Makary, who also directs the Johns Hopkins Center for Green Health, said he has visited FDA-approved reprocessing facilities to examine how the equipment is cleaned and recalibrated. The FDA allows about 100 items to be reprocessed, though a few items are the most common, including the compression sleeves and pulse oximeters, which fit on the fingertip and test oxygen levels and heart rates.

But Michael Bennett, president of the Coalition for Patients' Rights in Maryland, said hospitals shouldn't take chances with reprocessing. If they want to reuse equipment, they should find vendors that will sell them durable equipment, rather than items labeled for single use, he said.

"It is unconscionable for a health care worker or an institution to subject an unsuspecting and uninformed patient to unnecessary risk just to save a few dollars," Bennett said. "While there very well may be manufacture or sales self-interest in the 'single use' classification of some devices, would anyone be willing to use a possibly safety-compromised parachute? There are plenty of other areas in health care where money can be saved without jeopardizing patient safety, such as better infection control and fewer errors."

Reusing equipment isn't new. Hospitals used to routinely clean and reuse their own items, but fears about the cleaning abilities of individual facilities led manufacturers to beginselling single-use devices, said Makary. He estimates those items now make up about 15 percent of what hospitals use.

The devices became increasingly sophisticated and costly, pushing hospitals back in the other direction, he said. That FDA regulation also led nearly all hospitals to send the equipment to third-party reprocessors, who sell items back to hospitals for about half the cost of new ones.

Hopkins is now only sending equipment to reprocessors but not buying it back, though officials say they plan to. Savings on waste disposal so far are minimal. However, at the University of Maryland Medical Center, where officials have been buying some reprocessed items for more than a year, the savings have been about $400,000.

The center is proceeding cautiously, for now only buying noninvasive reprocessed devices such as blood pressure cuffs, though officials are exploring more types of equipment, said Denise Choiniere, Maryland's sustainability manager and a registered nurse. She said officials have been visiting reprocessing facilities.

She said the push for reprocessing came from workers who recycle at home and didn't understand why they had to throw away so much equipment, particularly so much that was never used. Items are sometimes dropped or the packaging is opened.

"Safety is No. 1, and we need to make sure there are quality checks in place and what they're sending back is the same quality as new devices," she said. "But it's hard to find someone who doesn't think this is a good idea."

In the past five years, business has been growing and opposition has been fading, according to Lars Thording, senior director of marketing and brand strategy for the reprocessing company Ascent Healthcare Solutions. The challenge now is to make hospital workers understand how much they can reprocess, he said.

The company has 1,900 client hospitals of all sizes, and some are saving $1 million a year, he said.

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.