A large hospital can rack up $15 million in wasted surgical supplies annually, researchers find. At least some of these materials could be recycled for use in developing countries, they say.
It’s not that surprising that millions of dollars in surgical supplies are opened in operating rooms but go unused every year in the average teaching hospital.
What is surprising is the amount of that waste—about $15.4 million a year in any large hospital—and that at least some of these supplies could be used in developing countries where they are in short supply or unavailable.
These are the findings of a team of Johns Hopkins and other surgeons who calculated the value of materials they retrieved from their hospital’s waste containers sent to Ecuador over a three-year period. Their paper on their project is published in the World Journal of Surgery.
In most U.S. hospitals, “surgeons open big packs of supplies on the back table of an operating room, pre-packaged for the average surgical case, but for whatever reason, there’s usually a lot of stuff that you don’t use,” says Richard Redett, MD, a pediatric craniofacial surgeon at Johns Hopkins Medicine in Baltimore, MD.
The packages are constructed for operating room efficiency so that anything a surgical team might need is right there. But they are not designed for economy. Instead of being recycled, many of those extra items, such as surgical gloves, cauterizers, urinary catheters, gowns, sutures, and hemostatic clips are thrown out.
Redett, who travels to two countries a year to perform cleft lip and palate surgeries, decided to calculate the value of those supplies when they were reused during a Johns Hopkins program called Supporting Hospitals Abroad with Resources and Equipment (SHARE), which is funded by community grants and student donations.
For every $2.14 of medical supplies sent abroad through SHARE, the surgeons found, there was one less year in which a child had to live with a disability, such as a cleft lip or cleft palate.
Redett says that figure is based on calculating the conservatively estimated value of 19 most-commonly used supplies, including towels, syringes, gauze pads, and face shields. If the value of all the supplies that were recycled were counted, the amount would be double, he says.
“I’m sure that hospital administrators, if they read a paper like this, they would want to find out how much is unused [in their hospitals] and they might say we need to make our operating room packs much smaller, and that may be a side effect of this study,” Redett says. “We’ve been fortunate that we’ve been able to take this waste and put it to good use.”
The Hopkins researchers conducted their study through SHARE, which they started in 1991 to recover and clean unused medical supplies for use in developing countries. They worked at two charity hospitals in Guayaquil, Ecuador, which had the ability to re-sterilize all of the equipment that was brought from Johns Hopkins, in case supplies that were opened were contaminated.
From September, 2010 to November, 2013, some 25,938 pounds of clean and unused medical supplies were recovered from Johns Hopkins Hospital alone. The materials sent to Ecuador did not touch any U.S. patient, but were merely opened in preparation for patient care. It would be safe to reuse some types of equipment used in surgeries, Redett says.
Millions of children live their entire lives with serious disabilities, often because of a lack of surgeons or healthcare facilities, he says. “This only addresses one of the problems, which is a lack of supplies, but that’s a big problem in many developing countries.”
“You have to go the extra step to recycle anything, including medical supplies,” Redett says. “But I think what we demonstrated is that when you go that extra step, and it doesn’t take much, you can turn these supplies around and really help a lot of people out.”
In the United States, infection control protocols are the strictest in the world, even though they don’t always have to be, Redett says. “We can afford to not reuse a lot of supplies, so we don’t.”
“But a lot of orthopedic devices, like nails and rods that are put into patients and taken out of patients in this country are thrown away. But in developing or low-income countries, they are sterilized and reused. They’re perfectly fine. They can be easily sterilized, but we tend not to do that in this country. Instead, a lot of those are just thrown out after they’re used for a patient.”
A similar program is underway at Duke Hospital in Durham, NC, in a program called Remedy at Duke.