Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Cheung A(1), Luk MH(1), Leung KCT(1), Lau CML(2), Fu H(2), Chan PK(2), Chiu KY(2)
Affiliation :
(1) Department of Orthopaedics and Traumatology, Queen Mary Hospital
(2) Department of Orthopaedics and Traumatology, University of Hong Kong
Introduction :
The healthcare sector accounts for a significant proportion of resource consumption in society. The operating theatre consumes a vast amount of both human and material resources required to allow for safe and efficiency running of services. Furthermore, operating theatre related waste has been found to account for approximately 20-33% of total hospital waste. Joint replacement procedures require a huge number of resources in the preparation and processing of reusable surgical instruments and also in the use of disposable items.
In the current era of climate change and the aging population with increasing demands for joint replacement procedures, it is necessary for us to evaluate our current practises and to explore ways to achieve “greener” joint replacement surgery.
Objectives :
1. Evaluate the amount of disposable and reusable item use during knee replacement surgery.
2. Explore strategies to decrease wastage and allow more efficient use of resources.
Methodology :
An audit on the number of re-usable surgical instruments and the amount of disposable waste generated was carried out for 5 total (TKR) and 5 uni-compartmental knee replacements (UKR). All surgical instruments used and disposable waste generated in each procedure was recorded. The number of items unused (overage) was also recorded.
Result & Outcome :
109 instruments were prepared for each procedure, however, on average only 43% of items were used. A bespoke streamlined instrument set was designed consisting of 48 items that was 41% of the original weight of the original set (streamlined set: 6.25kg, original set: 15.3kg). Processing of the streamlined set requires 50% fewer wash and autoclave cycles.
100 disposable items requiring 112 wrappers were used for each TKR and UKR, which generated an average of 14.3 kg and 14 kg of waste respectively. Biohazard waste accounted for an average of 22.8% of the total amount of waste generated from each procedure. 26 pieces of clean blue wrap were used for each TKR, which can be repurposed in the clinical setting.
Use of streamlined tailored sets for routine procedures such as knee replacement can allow for more efficient use of material and human resources.
Substantial amounts of waste are generated from knee replacement procedures. Strategies to help alleviate the impact of waste generated from such common surgical procedures should be developed to lessen the impact of joint replacement procedures on the environment.
