Background and purpose: This quality improvement project aimed to reduce anesthesia supply waste through an educational intervention, focusing on decreasing the volume of opened, unused supplies and increasing cost savings. PurposeOperating rooms generate 70% of hospital waste, with anesthesia supplies contributing 25%. Joint Commission infection control standards require disposal of opened single-use devices, adding to financial strain and environmental harm. A review of literature showed that anesthesia providers lack knowledge of waste reduction strategies and cost implications, but educational interventions improve knowledge and promote sustainable practices.
Methods: This project was granted IRB exemption in December 2024. Baseline data was collected over 10 days (2 weeks) in October 2024 across 27 ORs. Opened, unused single use items were collected, photographed and priced using department purchasing data. Findings were presented in January 2025 during Grand Rounds and post-class sessions to Certified Registered Nurse Anesthetists, Student Registered Nurse Anesthetists, and anesthesiologists, incorporating photos, baseline data, and sustainability recommendations from the American Society of Anesthesiologists’ “Greening the OR” document. Reinforcement was provided through emails and flyers. Post-intervention data was collected over an identical time-period in January, using uniform methods.
Results: Results showed a 48% reduction in waste volume, from 404 to 194 items, with monetary loss decreasing from \$1,163.10 to \$414.55, yielding \$748.55 in savings. This results in an estimated yearly savings of \$18,713.75.
Conclusions: Healthcare waste is unsustainable both financially and environmentally, and this project provides a practical, replicable strategy to reduce its impact. Despite limitations such as the brief timeframe, education was associated with meaningful reductions in supply waste and supports the integration of sustainability-focused education into anesthesia practice.
AUTHORS CONTRIBUTIONS
All authors were equally responsible for study design, data collection, manuscript creation and revising. All authors read and approved the final manuscript.
FUNDING
Not applicable.
CONFLICTS OF INTEREST DISCLOSURE
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
INFORMED CONSENT
Obtained.
ETHICS APPROVAL
The Publication Ethics Committee of the Association for Health Sciences and Education. The journal’s policies adhere to the Core Practices established by the Committee on Publication Ethics (COPE).
PROVENANCE AND PEER REVIEW
Not commissioned; externally double-blind peer reviewed.
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
DATA SHARING STATEMENT
No additional data are available.
ACKNOWLEDGEMENTS
Not applicable.
| [1] |
Denny NA, Guyer JM, Schroeder DR, et al. Operating room waste reduction. AANA J. 2019; 87(6): 477-482. PMid: 31920201
|
| [2] |
Herr MMH, Segura LG. Sustainable anesthesia: limiting waste, maximizing resiliency. APSF Newsl. 2023; 38(3): 96-99.
|
| [3] |
Reynier T, Berahou M, Albaladejo P, et al. Moving towards green anaesthesia: are patient safety and environmentally friendly practices compatible? A focus on single-use devices. Anaesth Crit Care Pain Med. 2021; 40(4): 100907. PMid:34153533 https://doi.org/10.1016/j.accpm.2021.100907
|
| [4] |
American Society of Anesthesiologists. Greening the operating room and perioperative arena: environmental sustainability in anesthesia practice. 3rd ed. Schaumburg (IL): American Society of Anesthesiologists; 2024.
|
| [5] |
McGain F, Muret J, Lawson C, et al. Environmental sustainability in anaesthesia and critical care. Br J Anaesth. 2020; 125(5): 680-692. PMid:32798068 https://doi.org/10.1016/j.bja.2020.06.055
|
| [6] |
Qin CX, Merkel KR, Yesantharao LV, et al. Poor cost awareness among anesthesia providers for medications, supplies, and blood products. Jt Comm J Qual Patient Saf. 2020; 46(9): 524-530. PMid:32682692 https://doi.org/10.1016/j.jcjq.2020.06.007
|
| [7] |
Gasciauskaite G, Lunkiewicz J, Spahn DR, et al. Environmental sustainability from anesthesia providers’ perspective: a qualitative study. BMC Anesthesiol. 2023; 23(1): 377. PMid:37978425 https://doi.org/10.1186/s12871-023-02344-1
|
| [8] |
White SM, Shelton CL, Gelb AW, et al. World Federation of Societies of Anaesthesiologists Global Working Group on Environmental Sustainability in Anaesthesia. Principles of environmentally sustainable anaesthesia: a global consensus statement. Anaesthesia. 2022; 77(2): 201-212. PMid:34724710 https://doi.org/10.1111/anae.15598
|
| [9] |
Sullivan GA, Petit HJ, Reiter AJ, et al. Environmental impact and cost savings of operating room quality improvement initiatives: a scoping review. J Am Coll Surg. 2023; 236(2): 411-423. PMid:36648269 https://doi.org/10.1097/XCS.0000000000000478
|
| [10] |
Patel SD, Smith-Steinert R. Greening the operating room, one procedure at a time. J Clim Change Health. 2021; 2: 100014. https://doi.org/10.1016/j.joclim.2021.100014
|
| [11] |
Parilli-Johnson C, Pitman JS, Barbee K, et al. Implementation of a Power Down Initiative in 34 operating rooms. AANA J. 2024; 92(4): 257-268.
|
| [12] |
Institute for Healthcare Improvement. How to improve: model for improvement. [cited 2025 Oct 21]. Available from: https://www.ihi.org/resources/how-improve-model-improvement
|
| [13] |
The Joint Commission. Endotracheal tubes - clean, disinfect and store. 2013 [cited 2025 Oct 21]. Available from: https://pdfcoffee.com/standards-interpretation-joint-commission-pdf-free.html
|
| [14] |
The Joint Commission. Laryngoscopes-blades and handles: how to clean, disinfect and store these devices. 2013 [cited 2025 Oct 21]. Available from: https://pdfcoffee.com/standards-interpretation-joint-commission-pdf-free.html
|
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