The OR is a prime location for sustainability efforts.

The operating room (OR) generates an estimated 42 percent of a hospital's revenue, but it's also the source of 20 to 30 percent of a hospital's total waste volume despite its relatively small footprint, according to a study by the McKesson Group.

A few years ago Practice Greenhealth, Reston, Va., recognized that the pervasive OR waste also represented an opportunity. It launched its Greening the OR initiative in April 2010 with about 50 participants.

When the program reaches its fourth anniversary in a few months it will count about 425 hospitals as participants, with countless more using the free program's tools without officially signing up, says Laura Wenger, R.N., executive director, Practice Greenhealth.

The mission is to raise awareness and educate hospitals about how they can develop a more sustainable OR. Reducing the glut of medical instrument packaging, smarter waste segregation and recycling are cornerstones of the program.

"It costs the hospital 10 times more to haul away one bag of medical waste that has to be specially handled and treated compared with clear bag waste. If the waste is properly segregated up front, they have significant savings out the back door," she says.

Greening the OR targets other areas for cost-savings and waste-reduction, including:

  • Single-use device reprocessing;
  • Energy-efficient LED lighting;
  • HVAC setback systems;
  • Reusable surgical instrument cases.

"We try to look at greening the OR from a holistic perspective and not just waste, although reducing waste is definitely a large opportunity," Wenger says. Blue wrap many times is mistakenly thrown into the regulated waste stream by clinical staff or it cannot be recycled, depending on local recyclers, she says. With pressure from hospitals, that is changing.

Practice Greenhealth will recognize the top-performing hospitals at the CleanMed conference in Cleveland, June 2–5. For more on the initiative, go to