Prioritizing sustainability as part of caring for patients & communities
The World Health Organization (WHO) estimates that 24% of deaths globally are linked to the environment and according to the National Academy of Medicine, about 80% of health outcomes are driven by factors beyond healthcare, including the physical environment.
“The impact to human health from these outcomes, combined with the increase in extreme weather events, supply chain disruptions and financial risks, have led many healthcare organizations to make sustainability a strategic priority,” says Jennifer Westendorf, DNP, RN, CNOR, Assistant Vice President of Environmental Performance & Surgical Services at HealthTrust. “Implementing strategies to mitigate environmental impact is another way health systems can demonstrate care for the communities they serve while also enhancing their resiliency.”
Where to focus
Health outcomes are also influenced by behaviors and social determinants of health (SDOH), which the WHO defines as the conditions in which people are born, grow, live, work and age—along with their access to power, money and resources. In addition to health, Westendorf encourages healthcare organizations to consider sustainability’s role in brand reputation and risk mitigation to boost resiliency, recommending the operating room as a strategic starting point.
The Association of periOperative Registered Nurses (AORN) indicates that the perioperative space is a substantial contributor to a hospital’s overall carbon footprint, producing about 70% of hospital waste and using considerable energy.
“Those who work in the perioperative space are well aware of the waste that is generated during each procedure—from sterilization wrap to unused products on procedure trays,” Westendorf says. Anesthesia gases make up 51% of this footprint, representing 5% of a hospital’s total emissions, according to AORN.
Through her work with HealthTrust’s Surgical Advisory Board and Environmental Sustainability Council, Westendorf shares that many member organizations are focusing their perioperative efforts on reducing environmental impact through the following strategies:
- Expanding their reprocessing programs
- Retiring the use of desflurane
- Decommissioning nitrous oxide medical gas pipes and replacing with e-cylinders
- Utilizing low-flow anesthesia techniques
- Minimizing waste in turnover kits and procedure trays
Clinical insights to assist
HealthTrust has developed several Health Information Briefs available on the Clinical Knowledge Insights Portal. There, members can find briefs on related topics, including:
- Reprocessing of Single-use Devices
- Desflurane Elimination as a Sustainability Initiative
- Low-flow Anesthesia: Sustainability Initiative
- Decommissioning Piped Nitrous Oxide: Sustainability Initiative
Removing DEHP
DEHP [di(2-ethylhexyl) phthalate] is a plasticizer used in medical devices for flexibility. Support for the removal of DEHP and other ortho-phthalates in intravenous tubing and intravenous solution containers is continuing to spread at the state level. In September 2024, California signed into law a bill that, beginning January 1, 2030, prohibits the sale, distribution or manufacturing of intravenous solution containers with intentionally added DEHP. Effective January 1, 2035, the bill prohibits the sale, manufacturing or distribution of intravenous tubing made with intentionally added DEHP in the state of California.
Similar legislation is found in North Carolina and New York; is currently pending introduction in Michigan and Massachusetts; and is expected to be reintroduced in Pennsylvania. HealthTrust is monitoring the legislation and discussing supplier readiness for state timelines. Members can find a Health Information Brief on DEHP in the HealthTrust Clinical Knowledge Insights Portal.
Get involved
Those with sustainability initiatives are encouraged to start or join discussions on the HealthTrust Huddle. Items tagged “sustainability” are shared with the HealthTrust Environmental Sustainability Council.
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