The impact of plastics on the environment and their significant contribution to hospital waste has renewed demand for reusable medical equipment. Northern Sydney Local Health District (NSLHD) is working to reduce single-use plastics to support its target of net zero emissions by 2035.
Hospital holloware refers to a variety of equipment and supplies are used in medical procedures, including bowls, kidney dishes and gallipots. Traditionally made of stainless steel, Royal North Shore Hospital (RNSH) phased out metal holloware in 2018 in favour of single-use plastic holloware.
The ‘Steel got it!’ project aims to reduce the use and environmental impact of single-use plastic holloware in RNSH operating theatres. The project involved the calculation of the environmental, social and financial impacts of transitioning back to reusable metal holloware. This information was used to develop a business case for additional staff resources in the sterilising department.
Addressing the impact of single-use plastic holloware
The project team undertook stakeholder mapping to determine relevant staff and roles for successful implementation of the project. The team then surveyed these staff members on their experiences, preferences and perception of both single-use and reusable metal holloware. Using annual quantities and spend data, the team calculated cost comparisons between single-use plastic and reusable metal holloware.
RNSH has continued to store reusable metal holloware dating back to the 1960s, which is available for use at no cost. However, some pieces are no longer compliant with hospital infection-control policies. The project team approached a steelworking company to modify the existing bowls and ensure compliance. Lifecycle analysis data for the single-use holloware was provided by the supplier, and this was used to calculate the estimated annual CO2e emissions.
Significant diversion of waste from landfill annually
A transition to metal holloware is not expected to impact the quality of patient care, however staff satisfaction is likely to increase. 86% of staff surveyed expressed concern about the use of single-use plastic holloware and 91% stated a preference for metal holloware over plastic. Based on the financial and lifecycle analysis data collected, a transition back to metal holloware would divert an estimated 4.25 tonnes of clinical waste from landfill annually, which equates to approximately 21,000kgCO2e.
Annually, RNSH uses 51,786 single-use holloware items at a cost of over $100,000. The cost to the district of disposal of the clinical waste generated is estimated to be an additional $4,000 annually. The business case for reintroduction of metal holloware is currently under consideration by the RNSH executive team. An education and awareness program will be rolled out prior to metal reusable holloware re-entering circulation, and a post-implementation survey will be conducted among staff to evaluate the change.
Commencing a staged rollout, for example with only one type of holloware or one rotation of bowls, may have proved beneficial as a trial before submitting a business case. This would allow troubleshooting of issues on a smaller scale as they arise, and potentially decrease the perceived burden of change for sterilisation staff. Where existing metal holloware is available but non-compliant with infection control policies, physical alteration is a viable option.
This project was part of the NSLHD Net Zero Leads Program.
