The health care industry contributes significantly to greenhouse gas emissions, accounting for about 8% of U.S. emissions. Lowering the industry’s environmental footprint while reducing costs and improving patient care is the new trifecta for supply chain leaders and their allies among hospital leadership and medical professionals.
In one effort, a health care system of more than 50 facilities engaged Advantus Health Partners to limit waste from electrophysiology (EP) labs. By capturing used equipment, reprocessing it and buying reprocessed items at steep discounts from original equipment manufacturing (OEM) prices, the health system set out to tackle waste reduction.
In just one year, the team achieved its initial goal of a 30% reduction in OEM spending on items such as catheters, cables and platinum tips from EP labs. Within three years, they not only diverted over 2 tons of waste from the landfills and saved the equivalent of over 3,000 pounds of CO2 – but they also tripled their cost savings – while sustaining the quality of care and winning advocates for sustainable practices among hospital leaders and clinicians.
The Challenge of Applying Sustainable Practices in Electrophysiology
An EP study helps physicians diagnose abnormal heartbeats or arrhythmia. During the procedure, a health care provider inserts electrodes into a vein in the groin or neck, then uses catheters and wire electrodes to measure the heart’s electrical activity.
Historically, most used equipment was discarded. But there’s an alternative: Shipping used equipment to a qualified vendor for reprocessing and returning it to the supply chain.
Program Manager, Supply Chain Clinical Transformation
Advantus Health Partners
When the health care system engaged Advantus Health Partners to help reprocess EP equipment, Yolanda Davis stepped in as program manager. Davis is part of the Advantus Health Partners supply chain clinical transformation practice and has years of experience as an EP lab clinical coordinator and manager.
Her first step was bringing together and engaging hospital and supply chain leaders, clinicians and frontline staff who operate the sophisticated equipment and treat patients to:
- Analyze current practices and vendor relationships.
- Create sustainability goals.
- Plan process changes to hit their targets.
They also identified any obstacles to their success and strategized how to overcome them. Davis said the EP reprocessing team:
- Held a series of “science and safety” sessions to educate staff about the rigorous standards for reprocessing EP equipment. This addressed doubts among some health care professionals about the safety and quality of reprocessed items.
- Rolled out a strategy called “PIA-ITB,” for “put it all in the bin.” This directed lab staff to take all equipment and put it into the vendor-supplied bin for sorting later.
To accomplish the latter, they gathered everyone from site supply chain managers to lab staff and made sure that the reprocessing vendor’s bin was the only one available in the labs.
“Because if there’s confusion, you’re going to take the path of least resistance, and that’s the trash can,” Davis said.
Vendor contracts for reprocessing were already in place. However, some hospitals needed assistance from the team to adjust their procurement processes. This adjustment was necessary to meet vendor deadlines for resupplying their labs and capturing savings.
Savings from Reprocessed EP Equipment Quickly Add Up
Davis said that Intracardiac echo (ICE) ultrasound catheters, used in various EP procedures, may cost between $2,000 and $3,500 for an OEM item. Davis said a reprocessed catheter can cost 50% to 60% less, saving a facility as much as $1,800 or more for one item.
“If a site uses a minimum of five a week, that could potentially be a savings of $36,000 a month using reprocessed ICE ultrasound catheters,” she said. “Many EP programs use five a day. In addition, other catheters and cables are used for EP procedures, so the potential savings are remarkable.”
In the case of the extensive health care system, early efforts centered on a few facilities and expanded from there. In the initial effort, three hospitals together saved over one million dollars in one year.
Reprocessing Programs Require ‘Measure As You Go’
Davis said that monthly reports to hospital leadership on the EP reprocessing program contributed to building momentum and increasing support for the project. Reports included such measures as:
• The volume of equipment diverted from landfills.
• Reductions in carbon emissions from reprocessing.
• Cost savings from purchasing reprocessed equipment.
The reports helped spur the team to persist in identifying ways to increase the volume of equipment they kept out of the trash stream and the cost savings they secured through purchasing reprocessed equipment.
Advantus’s overall approach to building a successful EP program was purposeful planning, alignment, implementation and follow up, all of which are required and dependent on the other.
Keys to Achieving Clinical Transformation Goals
To be successful, sustainability programs must engage everyone with a stake in:
• Improving patient outcomes.
• Lowering health care costs.
• Reducing environmental impacts.
That includes hospital leadership, supply chain management, vendors, physicians and other health care professionals. Advantus Health Partners catalyzes these teams, helping them stay trained on their goals and successes.
“The clinical review of products and technology is just as important, if not more important, than just the cost savings,” Davis said. “We help strategize by looking at various data points to help facilitate and identify the hospital’s or health care system’s ability to standardize and reduce variation in waste as well as identify savings. We also help lead the assessment of clinical implications of product decisions.”
It’s hard work, she said, but rewarding when the hard work contributes to better patient outcomes, lower health care costs that can be passed along to payers and patients and measurable environmental benefits for generations to come.
