Over the summer, UCSF Health’s Sustainability Department has been hard at work. The Labor and Delivery (L&D) unit and the operating rooms (ORs) are widely regarded as the most significant producers of hospital waste.
Led by Sustainability Intern, Hannah Kelley, and Midwife, Laura Weill, L&D has been developing a more sustainable approach. The team has made moves to implement structured staff education programs that focus on developing green initiatives to reduce waste and costs.
Starting in July, there’s been a sustainability presentation at the beginning of each Birth Center Nurse Staff Meeting. The first meeting highlighted the positive environmental impacts of emptying the contents of full Foley catheters in the toilet before throwing them away.
Simple Solutions with Foley Bags
In the past, Foley catheters were thrown away in the red bag medical waste bin, which is steam sterilized before being put in the landfill. Steam sterilization is an energy-intensive process that costs six times more than disposing of waste in the regular trash bin. As the steam sterilization cost is based on the weight of the contents, emptying the bags prior to their disposal is an efficient way to drive down costs and environmental footprint.
The practice of disposing of the Foley catheter bag in the red bag medical waste bin with 500 cc of urine, for example, weighs 1.35 lbs, which costs $1.74 to dispose of.
With an average of 300 births monthly, the cost of disposal of Foleys would be over $500 monthly and over $6000 a year. By emptying the Foley before throwing it away, UCSF would be saving over $400 a month and over $5000 a year from waste disposal costs.
Currently, emptying a Foley bag with urine into the red bag produces 1.02 kg of CO2
which yearly adds up to 3672 kg of CO2.
This is equivalent to the carbon emissions from charging a smartphone around 450 thousand times. It’s also equivalent to driving from San Francisco to New York City three times.
The L&D department nurses have been trained to empty the Foley into the toilet before tossing it into the red bag. After testing out this workflow, nurses report that emptying the bag only takes 10-35 seconds.
With the success of the L&D department, UCSF Health Sustainability hopes to expand this workflow to other departments across the medical centers.
By emptying Foley bags before disposal, L&D nurses can save $6,000 a year and reduce COs emissions by 3672 annually.
Strategic Monitor Belt and Pressure Cuff Usage Saves $11,500
The second staff meeting in August focused on reducing blood pressure cuff and monitor belt waste. As it currently stands, multiple blood pressure cuffs and monitor belts are used per one patient; one is used in triage, one in L&D, and another one in postpartum. This leads to unnecessary waste and cost for the unit, as well as a bigger environmental footprint made from the negative impact of single-use plastic and packaging.
The proposed amendment suggests using one cuff and one pair of monitor belts
per patient to reduce material waste (sparing about 512 lbs per year), save staff time, and cut costs for the unit. Additionally, this will improve continuity and reduce the error margin.
Reusing these blood pressure cuffs can also save UCSF money. Each blood pressure cuff costs $1.59 on average. Currently, over $12,000 is spent on blood pressure cuffs when accounting for at least 3 blood pressure cuffs per patient.
However, if only one blood pressure cuff were to be used per patient, costs would be cut to just $5,700 per year on average; over $6,500 would be saved per year on just blood pressure cuffs.
Similarly, if only one pair of monitor belts were used per patient, around 583 pounds of waste per year could be saved. The cost of a pair of monitor belts is $1. Currently, UCSF spends $8,600 on monitor belts yearly, a number reflecting the use of multiple belts per patient.
If only one pair of monitor belts per patient were used, it would cost $3,600 per year on average, saving almost $5,000 per year on just monitor belts. In total, over $11,500 would be saved yearly on blood pressure cuffs and monitor belts.
Other positive impact from the low-waste initiative includes less time spent
switching equipment between triage, L&D, and postpartum, and alignment with the UCOP
Sustainable Practices Policy goal of reducing waste production.
One blood pressure cuff and a pair of monitor belts per patient is now a common
practice for L&D that the Sustainability Department hopes to expand to other departments.
Together, these first two staff meetings have already identified simple, but powerful
ways to cut waste, save money, and lower UCSF’s carbon footprint in L&D.
By rethinking how we manage supplies and disposables, we can reduce thousands of pounds of waste and save over $16,000 a year, while actively working to support better patient care.
These changes demonstrate how the little things really do matter; everyday practices in the Birth Center can add up to a big impact for both the hospital and the environment.
