Greening the operating room is just one subset of potential hospital sustainability initiatives, but it has high potential for cost-reduction and environmental impact. Key initiatives involve changes in the purchasing and storage of OR equipment and reducing regulated medical waste through proper disposal, reuse and recycling. Below is a list of best practices in OR sustainability.

  1. Dedicate a Green Team focused on sustainability in the operating room. Create a multidisciplinary team to oversee sustainability initiatives in the OR. Participants may include representatives from nursing, materials management, anesthesiology, environmental services and surgery, among others.
  2. Educate OR staff on the benefits of sustainability. Spell out to operating room staff the importance of sustainability. Getting buy-in up front will help to ensure the program’s success.
  3. Tackle waste. Conduct a waste audit to help identify ways to streamline medical waste disposal. Preventing items from unnecessarily being placed in the regulated medical waste stream, which is more costly to dispose, can result in significant savings.
  4. Purchase reprocessed medical devices.
    Partner with an approved third-party processor to purchase reprocessed medical devices, and reprocess eligible devices.
  5. Secure OR fluid management systems.
    Fluid management systems capture liquid waste in reusable containers during surgery and direct the waste directly to the sewer. These systems help to reduce regulated medical waste disposal.
  6. Talk textiles.
    Use of reusable surgical gowns and other textiles within the OR reduces the volume of waste disposal.
  7. Manage the flow of gas.
    Inhaled anesthetics produce greenhouse gas emissions. Examine the use of inhaled anesthetics and use products with a lower environmental impact when clinically appropriate.
  8. Recycle.
    Assess products used in the OR to determine whether they can be recycled. Place a recycling bin in the OR for recyclable material such as plastics, glass and paper.
  9. Reduce blue wrap use.
    Use reusable rigid containers for OR kits when possible to reduce the need for blue wrap, and cut back on the resulting disposal costs.
  10. Purchase reusable sharps containers.
    Reusable sharps containers eliminate the need for the continued purchase of disposable sharps containers and reduce regulated medical waste.
  11. Reformulate OR kits.
    Reassess OR kits for items that often go unused and placed into the medical waste stream. This process can reduce supply costs and medical waste disposal costs.
  12. Implement HVAC setback mechanism.
    Heating, ventilation and air conditioning setback in the OR is an energy-saving strategy, reducing the amount of fresh air flow to the OR when not in use.

Sources: “Greening the OR” implementation modules, Practice Greenhealth, 2011–2013; “Operating Room HVAC Setbacks,” American Society for Healthcare Engineering monograph, 2011; Sustainability Roadmap for Hospitals: A Guide to Achieving Your Sustainability Goals website, American Hospital Association; “Greening the Operating Room: Reduce, Reuse, Recycle and Redesign,” American Society of Anesthesiologists, 2012