Savings in Circulation

Nearly every HealthTrust member is reprocessing single-use devices or supplies in some capacity. Some reprocess almost everything available for the service; others focus on a few specific products or categories.

Device reprocessing includes sorting, cleaning, testing and sterilizing medical items to allow safe and regulated reuse in hospitals. This lowers costs and reduces medical waste.

According to a NAM Perspectives article, U.S. hospitals saved more than $398 million through this practice in 2024, while avoiding 113 million pounds of CO2 equivalent emissions (comparable to emissions from almost 6 million gallons of gasoline).

What to reprocess?

Beth Israel Lahey Health (BILH) reprocesses many sequential compression devices, air transfer mats, advanced bipolar energy devices and other medical equipment used in surgery, according to Jeffrey Keane, BSN, RN, CNOR, the organization’s Director of Perioperative Projects, Perioperative Services. BILH has been reprocessing for about 15 years. Prior to that, their single-use devices ended up in landfills.

BILH now works with HealthTrust on-contract supplier Encore Medical (Contract #145833) to reprocess hot shears for Intuitive’s da Vinci robotics since they received 510(k) clearance to reprocess them. “Down the road, there will be more reprocessing opportunities for other da Vinci technologies,” Keane adds.

“Trinity Health is reprocessing manifolds, trocars, scaffolds, sensors and other items in the electrophysiology space,” explains Alex Johnson, Senior Sourcing Manager, Trinity Health.

“These items fit into categories HealthTrust sees as having higher reprocessing levels,” says Joe Bibelhausen, Contract Director at HealthTrust Performance Group. These categories encompass 81% of all HealthTrust reprocessed spend: electrophysiology (38% of all reprocessed spend), pulse oximetry (23%) and advanced energy (20%).

The process to reprocess

When launching a reprocessing program, suppliers work with hospital staff and clinicians on awareness and education to increase program visibility.

“Suppliers place related collection bins in the operating rooms and sometimes outside it, depending on the items being reprocessed. All 46 BILH operating rooms have bins,” says Keane. Any single-use devices or supplies used on a patient in surgery are collected in the bins, and the vendor collects them weekly. BILH uses a teal bin for used mechanical handles, advanced bipolar, trocars, staple handles and the like. “Supplies touching the patient’s unbroken skin or not in contact with mucosa can be collected outside the OR. The supplier reprocesses what they can and disposes of the rest,” adds Keane.

To buy reprocessed devices and supplies, hospitals must add their used items to the supplier’s inventory, but may not get back the exact items they used. “The company alerts us each week about what we’re eligible to buy back,” explains Tia Jordan, BSN, RN, CV-BC, Regional Value Analysis Consultant, Trinity Health of New York.

The FDA requires that all reprocessed items be returned in different packaging and labeled as reprocessed.

Reprocessed vs. original equipment

CHRISTUS Health purchases up to 80% reprocessed items in some categories, according to Marty Higgins, MS, RN, CNOR, Service Line Director, Perioperative, Supply Chain Management. CHRISTUS saved more than $3 million last year across 30 hospitals. The nearly 6-year-old program is growing as it expands the number of reprocessed SKUs and hospitals in their system.

“Reprocessed sterile products may be up to 25% less expensive,” Keane says, though some members shared even higher savings levels compared to purchasing new products.

Maintaining efficacy & patient safety

Some surgeons are concerned that reprocessed items may be less effective or cause patient safety issues. The members interviewed say that’s not the case. “When reprocessing originally started, it wasn’t as regulated as it is now, so the quality of products was not what it is today,” explains Higgins. According to its website, the FDA regulates reprocessing to ensure there are no increased patient safety risks and that products meet the same standards as items from original equipment manufacturers (OEM).

To combat early skepticism at BILH, surgeon champions trialed reprocessed equipment to ensure efficacy. Any reported issues were monitored and brought to the reprocessing supplier, as well as discussed with Perioperative leadership and Risk Management to identify potential issues, explains Keane. They have not experienced many problems, and BILH clinicians know that their concerns are taken seriously.

“Failure is more common with reprocessed items, but if you look at the data and compare failure rates, OEM has failure rates, too. Between OEM and reprocessed, there’s only a small difference,” Johnson says.

In fact, reprocessed items are tested more extensively. “Manufacturers make 1,000 original items and test one,” explains Jordan. “With reprocessed items, they check each product instead of batch testing them, weeding out smaller issues that could lead to failures. The failure rate is low.”

The members interviewed say there were no infections associated with using reprocessed equipment.

Tips to implement reprocessing

Leadership buy-in is critical to developing a reprocessing program, including representatives from each clinical area. These stakeholders should become superusers and train physicians and other clinicians. Set high service expectations with your reprocessing supplier; if there are problems early on, clinicians may not continue with the program.

Know that OEM suppliers may not be keen on hospitals purchasing reprocessed equipment, says Johnson. OEM will likely encourage new equipment purchases over reprocessing. Contract terms may limit the percentage of reprocessed items purchased to maintain tier status and favorable pricing. So, work with HealthTrust to get the best terms.

Take advantage of the sustainability resources on HealthTrust’s Knowledge Insights Portal, suggests Jennifer Westendorf, DNP, RN, CNOR, Assistant Vice President, Environmental Performance & Surgical Services at HealthTrust. Plus, the Awards Summary attached to each contract has category and Surgical Advisory Board feedback. Members can always lean on their HealthTrust Account Managers for help and post questions to the online member community, the HealthTrust Huddle.

Lastly, start small and build some wins, Westendorf says. “All suppliers are open to allowing members to tour their facilities to see the reprocessing operation,” she explains. “It’s a comprehensive process of cleaning, inspecting and sterilizing. Often it helps to create buy-in when physician champions see the process at the supplier’s facility.”

YOUR TURN
Explore how your organization can start reprocessing or expand an existing program through HealthTrust contracted suppliers. Contact your HealthTrust Account Manager to start the conversation or email sustainability@healthtrustpg.com

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