Outpatient Surgery Magazine - Mercy

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Outpatient Surgery Magazine - Mercy

19 Hot Products for Minimally Invasive Surgery p. 29 • Simple Ways to Go Green p. 38Blade-Free Cataract Surgery p. 54 • Save With Low-Flow Anesthesia p. 70Outpatientwwwoutpatientsurgery.netSurgeryRNovember 2010MagazineRoad toRecoverySPECIAL REPORTAs the recession recedes,it’s time to roll up yoursleeves and succeed in thenew surgical economy. P. 22


G O G R E E N A N D S A V EIt’s Easy(On Your Budget)Being Green6 ways to reduce your facility’senvironmental impact andsave money in the process.Irene Tsikitas | Associate EditorGoing green doesn’t have to be some big, expensive to-do like plantingrooftop shrubbery or installing waterless toilets. It can be as simple asretrofitting your facility with energy-efficient lights or using smallermedication vials. Regardless of whether your project is big or small, however,the steps you take to reduce your facility’s environmental footprint will yieldlong-term cost savings. Here are 6 ways going green can improve your bottomline.1Lean supply purchasing. Just-in-time inventory means onlyrather than stockpiling items that may expire or become obsoletekeeping enough supplies on the shelves to suit your immediate needsbefore you can use them. It’s a shrewd, cost-saving materials managementstrategy that many ambulatory surgery facilities have been practicing foryears. It’s also a key component of source reduction — eliminating waste atthe source rather than simply managing waste once it’s produced. Even if youalready practice just-in-time inventory, there are other opportunities forsource reduction, says Catherine Zimmer, MS, BSMT, an environmental consultantfor healthcare facilities in Minnesota.• Skin preps. A lot of skin asepsis products are considered hazardouswaste and therefore increase your red-bag disposal costs. If you’re oftenthrowing out a lot of unused preps, consider purchasing them in smaller containersto avoid having leftovers.• Medications. Purchase appropriately sized vials and containers of drugsfor the doses you usually give at your facility. Monitor drug supplies to makesure you aren’t frequently wasting large quantities because they’ve expired orcame in larger containers than needed.• Hand hygiene supplies. Only purchase and provide antimicrobial soapsin areas where they’re really needed. Research has shown that these soaps3 8 O U T PAT I E N T S U R G E RY M A G A Z I N E O N L I N E | N O V E M B E R 2010


G O G R E E N A N D S A V Edon’t break down at water treatment plants, and there’s concern that they cancause increasing antimicrobial resistance and end up in drinking water or thewater used for plants, says Ms. Zimmer. Putting regular soap in public restroomsand having staff wash up with alcohol-based rubs, which don’t usewater and therefore don’t end up down the drain, are cheaper and more environmentally-friendlyalternatives.• Procedure packs. OR nurses know what gets used and what doesn’t inyour procedure packs. Consult with staff and audit packs periodically to identifyitems that are going to waste and therefore could be eliminated.largest contributors to waste production in the United States, and a sig-2Reprocessing single-use devices. Health care is one of thenificant portion of that waste comes from the many single-use productsand devices facilities use and discard on a daily basis. Since single-usesupplies also weigh heavily on hospital and surgery center budgets, it standsto reason that expanding the life of such devices can both reduce waste andcut costs. That’s precisely what’s happened in the 4 years since theChesterfield, Mo.-based Sisters of Mercy Health System began reprocessingsingle-use devices at more than a dozen of its hospitals and outpatient facilities.Mercy contracts with an FDA-authorized, third-party company that collectsSUDs from healthcare facilities, reprocesses them according to federaland manufacturer standards, validates them for reuse and sells them back tofacilities at a reduced price.Over the past year, Mercy has realized more than $1 million in cost savingson SUDs through its reprocessing program and saved 40,000 lbs. ofwaste from ending up in local landfills, says Stacy M. Howard, RN, MHA,MBA, director of operational support services in Mercy’s ResourceOptimization and Innovation (ROI) division. In the system’s surgical facili-3 9 O U T PAT I E N T S U R G E RY M A G A Z I N E O N L I N E | N O V E M B E R 2010


G O G R E E N A N D S A V Eties and departments,the best cost savingscome from reprocessingsingle-use compressiondevices,ultrasonic scalpels,trocars, tourniquetcuffs, pulse oxymeterprobes, shavers andburrs. Reprocessingcompanies provide anFDA-approved list of SIZE UP YOUR SUPPLIES Purchase items that would end up in hazardouswaste, like aseptic skin preps, in appropriate-sized containers to avoid wastage.items eligible forreprocessing. Ms. Howard recommends that you look at each item, line by line,and determine which would be the most cost-effective candidates for reprocessingat your facility.3Reusable or disposable gowns? A reusable gown can be launderedand reused 50 to 75 times, a process that does consume a lot ofwater but is not as impactful as having to manufacture a new disposablegown 50 to 75 times. A life-cycle assessment of reusable vs. disposable gownsconducted by the Minnesota Technical Assistance Program (MnTAP) last yearshowed that when you consider everything from water consumption to toxicityto greenhouse gas emissions, “reusable gowns come out ahead, both from a costperspective, depending on how your vendor is pricing them, as well as an environmentalperspective,” says Ms. Zimmer, formerly a healthcare specialist withMnTAP. Ms. Zimmer also notes that most professional laundries recycle theirwater, while the petroleum used to manufacture disposable linens can’t be recy-4 0 O U T PAT I E N T S U R G E RY M A G A Z I N E O N L I N E | N O V E M B E R 2010


G O G R E E N A N D S A V ESECOND LIFE Reprocessing single-use devices reduces landfill waste and savesmoney by extending the life of your disposables.cled. According to an MnTAP case study, surgeon RafaelAndrade, MD, at the University of Minnesota MedicalCenter-Fairview was able to save $117 and 60 lbs. of wasteannually by switching from disposable to reusable gownson his cases.4LED lights. Sometimes you have to spend moneyto save money. Five years ago, replacing the 20 100-watt incandescent light fixtures in each of AultmanHospital’s 4 cardiac ORs with longer-lasting, energy-saving(but more expensive) light-emitting diode (LED) lightswas seen as a cost-prohibitive move, says Betsy Pooley,director of building services at the Canton, Ohio, facility.Since then, the cost of LED bulbs and fixtures has gonedown, and a cost-benefit analysis showed that the potentiallabor savings associated with longer-lasting LED bulbsthat wouldn’t have to be replaced on a weekly basis was“huge.” “Once you take into account the labor savings, itreally makes it a worthwhile project” to upgrade to LEDs,says Ms. Pooley. That’s even before you factor in the dollarsyou can shave off your energy bills by replacing 100-watt incandescent bulbs with 7-watt LEDs. Aultman isnow considering upgrading the spot lamps in its main ORswith LEDs.5Direct-to-drain fluid management. Suctioncanisters make up about 40% of the infectiouswaste generated by hospital ORs, according to a2007 MnTAP study (www.mntap.umn.edu/health/91-Canister.pdf). The study determined that direct-to-drainfluid management systems that use no canisters orreusable canisters are the best way to both reduce thisinfectious waste and save on labor, waste disposal andsupply costs. “The fluid management systems that are selfcontainedare really the best bang for your buck,” says Ms.Zimmer. “Not only is it much more cost-effective, but italso minimizes splash injury” to staff by eliminating thestep of opening canisters and pouring them out or addingsolidifying agents.4 1 O U T PAT I E N T S U R G E RY M A G A Z I N E O N L I N E | N O V E M B E R 20102011 ASC SymposiumFebruary 11Fontainebleau — Miami Beach, FloridaThe 2011 ASC Symposium is the premiernational conference addressing high-levelbusiness and legal issues affecting theambulatory surgery center industry.Register at www.mwe.com/info/asc/.For more information and sponsorship opportunities, pleasecontact Jerry J. Sokol at +1 305 347 6514 or jsokol@mwe.com,or Joshua M. Kaye at +1 305 347 6516 or jkaye@mwe.com.www.mwe.com/info/asc/Boston Brussels Chicago Düsseldorf Houston LondonLos Angeles Miami Milan Munich New York Orange CountyRome San Diego Silicon Valley Washington, D.C.Strategic alliance with MWE China Law Offices (Shanghai)U.S. practice conducted through McDermott Will & Emery LLP. Thiscommunication may be considered attorney advertising. Previous resultsare not a guarantee of future outcome.


G O G R E E N A N D S A V E6Electronic documentation. It’s not just medical supplies that eatup budgets and beat up the planet. Think about how much paper yourfacility consumes and wastes in a single day: medical records, meetingminutes, schedules, instructions, memos and forms. Many, if not all, of thesedocuments couldSisters of Mercy Health System’s Savings With Reprocessingbe just as easilyfilled out, submittedand sharedelectronicallythanks to growinginnovations inhealthcare informationtechnology.Consider thecase of MiltonHospital inMassachusetts,which as part ofits overall going-green initiative has computerized everything from medicalrecords to materials management, from nursing documentation to surgeryscheduling. The automated forms and documents have saved the hospital’s surgicaldepartment $28,000 over the past year, says Director of Surgical ServicesLyn Ames, MS, RN, CNOR, NEA-BC.Grassroots effortIf you’re looking for ways to go green and save at your facility, start by raisingthe issue with frontline staff and soliciting their ideas. Whether they see it asan environmental issue or a financial issue, rooting out waste is “an easything to get peopleenergized over,” saysMs. Zimmer. “Thepeople working inthose rooms, theyknow what’s going towaste each day, andthey’re more thanhappy to do somethingabout it if giventhe opportunity.”Once you’ve gotyour going-green initiativeoff theground, be sure toshare the program’sgoals and successeswith physicians andstaff to keep themomentum going. COOL ALTERNATIVE Long-lasting, low-watt LEDs can shave dollars off ofyour energy bills and reduce labor costs associated with frequent incandescentbulb replacements.Ms. Howard says itwas the Sisters ofMercy Health System’s emphasis on the environmental impact of reprocessingthat really helped bring everyone on board. “When you are able to showhow many pounds each facility has saved from their landfill, the numbersare really compelling.” OSME-mail itsikitas@outpatientsurgery.net.4 2 O U T PAT I E N T S U R G E RY M A G A Z I N E O N L I N E | N O V E M B E R 2010

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