Mim Lambros, an equipment planning specialist, is repurposing furniture throughout LG Health facilities.
Every April, people worldwide come together to celebrate Earth Day, bringing attention to new ways we can better treat our environment. People working in health care have an important role to play, as the sector is responsible for about 8.5 percent of greenhouse gas emissions in the United States, among other impacts on the changing climate.
Penn Medicine has made big institutional investments as it works to become the most environmentally friendly health care system in the country, a goal that’s part of the new strategic plan for 2023-2027, “Serving a Changing World.” These sustainability efforts include commitments to all new green buildings, purchasing solar energy that will provide 70 percent of the power needed for the University of Pennsylvania and Penn Medicine’s Philadelphia facilities, helping to reach the institution's shared goal of carbon neutrality by 2042, and more.
Meanwhile, those big institutional commitments to sustainability are getting help from individuals and teams at every level and every location at Penn Medicine, who are finding new, creative ways to do their part every day. While thinking globally, they are acting locally as they make environmentally friendly changes in their day-to-day work—from paperless offices to refurbishing single-use medical devices.
“There’s so much that can be done to be sustainable, and it’s a matter of finding the easy wins and getting to work,” said Greg Evans, corporate director of Sustainability at the University of Pennsylvania Health System (UPHS).
Reducing medical supply waste through creative reuse
Many surgical supplies need to be thrown away after use. It is even more wasteful if sometimes expired supplies can’t be used for patients at all—unless those supplies find new purpose as training materials.
Every few months at Penn Presbyterian Medical Center (PPMC), clinical nurse educator Melissa Esterly, MSN, RN, CNOR, leads Gateway to the OR, a training program which teaches new operating room nurses key skills for this specialized role. For the past two years, Esterly has conducted these trainings while reducing waste at the same time.
Gateway trainees learn how to properly open sterile surgical equipment, set up a sterile field, drape a patient, and more. The hands-on lessons require real surgical supplies, including sterile drapes, sponges, sutures, and suction equipment.
About two years ago, Esterly began asking her colleagues to save their materials whenever a procedure had been canceled or when disposing of expired products. Now, Esterly has bags and bags of opened, expired, or unused supplies that have been collected by her colleagues after they can’t be used for patients anymore, but can still have a second life in Esterly’s training courses.
“I really hate waste, so this was something that meant a lot to me,” Esterly said. “Now everyone knows to bring me their materials for my classes, and it feels good to be able to make an impact.”
Esterly’s effort is just one of many ways Penn Medicine is reducing the environmental impact of ORs. Other initiatives include fine-tuning the flow of anesthesia gases, which act as greenhouse gases in the atmosphere; reducing disposal of “red bag” waste that is soiled with blood or bodily fluids and causes more pollution than regular trash when transported and incinerated; and more.
A paper-free program
Being a digital workplace makes it easier to reduce paper waste. According to Craig Wynne, MD, a professor of General Internal Medicine, in the past year the division has turned off all automatic printing of lab and radiology orders as part of its growing no-print initiative. Over the last three years, there has been a progression in reducing their overall printing.
“These are small but important wins that we can build on,” said Wynne. “Health care providers should be champions of reducing waste and creating a greener environment.”
PPMC has also gone paperless in key ways. About a year and a half ago, the hospital’s surgery team decided to digitize its three-page pathology specimen requisition form to cut down on paper waste. Now nurses simply put the order into the computer, which generates a sticker that goes onto the specimen for digital tracking.
Individual departments’ and hospitals’ efforts to reduce printing got a boost from new contactless check-in processes that Penn Medicine began to roll out system-wide last summer, designed to make care easier for both staff and patients, that also reduce paper use through fully digital check-in and consent processes.
Reduce, reuse, and recycle medical devices
An LGH nurse demonstrates the use of a collection bin for pulse oximeters that can be refurbished by the manufacturer instead of thrown away after a single use.
A wide range of single-use medical devices are commonplace in patient care—used once and then thrown away. They’re meant to ensure sterile processes, but they make a lot of trash.
But Penn Medicine staff are focused on a better way to both protect patients and the earth. The Value Analysis team at Lancaster General Health (LG Health) has partnered with Stryker Sustainability Solutions to work on reprocessing certain single-use devices such as pulse oximeters. Collection boxes have been placed in every bay in the Lancaster General Hospital emergency department, in every patient room, and in other locations throughout LG Health facilities. Stryker takes the collected items back to a reprocessing plant to be taken apart, fully sterilized, put back together, and then tested to make sure they are up to standards. LG Health can then buy back the equipment at a discounted price. LG Health will also receive monthly reports indicating what is available to buy back, how much money was saved, and how many pounds of trash was kept out of landfills. In 2023, the Women and Babies Hospital at LG Health had 1,931 pounds of waste collected and reprocessed.
“Everyone is seeing these collection boxes daily and we hope that it encourages people to think about what they can recycle at home or work,” said Haleigh Clise, MSN, RN, ONC, and value management program manager at LG Health.
The “reduce, reuse, recycle” ethos doesn’t end there. Mim Lambros, an equipment planning specialist, is repurposing furniture throughout the hospital. Instead of discarding slightly worn furniture, Lambros collects it and keeps it in storage for future use. When items are damaged, Lambros does what she can to fix them—including ordering new parts or getting items reupholstered. When someone in the organization needs “new” furniture, they reach out to Lambros, and she works her magic to use what they already have.
“I have a passion for keeping trash out of oceans and landfills,” said Lambros. “I’m so proud of the work we’ve done so far.”
Explore more coverage of sustainability at Penn Medicine
How Penn Medicine is going green for good health: To improve health while addressing climate change, Penn Medicine is investing in major initiatives to become the most environmentally friendly health care system in the country.
Surgery and anesthesia teams address climate impacts in the OR: From anesthesia gases that have outsized greenhouse effects, to medical waste disposal, operating rooms at Penn Medicine are greening health care.
Health research on a warming planet: Climate change affects human health, from viral transmission to the effectiveness of medications. Researchers at Penn Medicine are discovering how and seeking solutions.
How the next generation of physicians will combat climate change: Through a new Planetary Health curriculum, Penn medical students are learning about the impact of climate change on human health.