Eyeworld

14 | EYEWORLD | JULY 2023 ASCRS NEWS by Cathleen McCabe, MD About the author Cathleen McCabe, MD Medical Director The Eye Associates Bradenton, Florida References 1. Eckelman MJ, et al. Health care pollution and public health damage in the United States: an update. Health Aff (Millwood). 2020;39:2071–2079. 2. Chang DF, et al. Survey of cataract surgeons' and nurses' attitudes toward operating room waste. J Cataract Refract Surg. 2020;46:933–940. 3. Chang DF, et al. Survey of ESCRS members' attitudes toward operating room waste. J Cataract Refract Surg. 2023;49:341–347. 4. practicegreenhealth.org/ sites/default/files/upload-files/ reusable_sharps_containers_ success_story_3.10.pdf 5. Cunningham AJ, et al. Reducing disposable surgical items: decreasing environmental impact and costs at a children's hospital, a pilot study. J Surg Res. 2023;288:309–314. 6. Zygourakis CC, et al. Oper- ating room waste: disposable supply utilization in neurosur- gical procedures. J Neurosurg. 2017;126:620–625. 7. Palmer DJ, et al. Reducing topical drug waste in ophthalmic surgery: multisociety position paper. J Cataract Refract Surg. 2022;48:1073–1077. be any member of the team (physician, nurse, or administrator). Ideally, this person will have a passion for reducing waste and will be able to recruit other members of the team from dif- ferent roles within the OR, such as a surgeon, nurse, administrator, and supply chain manager. The team will identify areas for waste reduction and suggest solutions that can be tested with a pilot study prior to wider implementation. In a practice with multiple specialties and a wide variety of surgeries, this coordinated effort can identify areas where less sustainable choices could be replaced with more sustainable ones already being implemented in the practice. For example, some eye surgeries may be using full body drapes where other specialties or surgeries have transitioned to smaller drapes effective- ly. A sustainability team can look for ways to spread waste-reducing practices more broadly. The same is true when replacing single-use with reusable items. A pilot study followed by broad implementation can happen more effectively when a smooth process has been put in place for evaluation of waste reducing changes. The Outpatient Ophthalmic Surgery Society (OOSS) website is an important resource, along with EyeSustain.org, for information and collabo- ration on sustainability ideas. The OOSS Talks feature allows for real-time feedback from other ASC team members on questions, including those addressing sustainability. In addition, OOSS is investigating recycling opportunities to impact waste reduction in the OR and will have resources available on both the EyeSustain website and the OOSS website. OR waste reduction strategies are often win/win/win efforts, reducing cost, reducing waste, and decreasing the impact of interrup- tions in supply chain for disposable items. Sur- geons, administrators, nurses, and staff respon- sible for ordering supplies and for managing waste disposal may have individual appreciation of the impact of a coordinated effort to improve EYESUSTAIN UPDATE Collaborative strategies to reduce costs and waste in the operating room Implementing sustainable routines in the op- erating room requires practical knowledge and collaborative commitment from the operating room team. This issue's EyeSustain Update high- lights a team approach recommended by Cathleen McCabe, MD, the immediate past president of the Outpatient Ophthalmic Surgery Society (OOSS). Her suggestions weave OOSS' principles of top quality patient care and safety in the efficient environment of ophthalmic ambulatory surgery centers with partnership among the OR staff and the EyeSustain Surgical Pledge. The pledge (eyesustain.org/facility-pledge) can be taken by ambulatory surgery centers, hospital outpatient departments, or any facility that performs oph- thalmic surgery. Its seven principles range from educating staff, reassessing the need for dispos- able equipment, and optimizing surgical packs to using multidose bottles of topical medications. We encourage you to catalyze your own sustainability efforts with Dr. McCabe's practical insights. –Aakriti Garg Shukla, MD, EyeSustain Editor E ckelman and Sherman found that the healthcare sector was responsible for 10% of the total U.S. greenhouse gas emissions, with a substantial proportion attributed to supply chain emissions, which are integral to cataract surgery. Although the healthcare sector is a major contributor to total greenhouse gas emissions in the U.S., accounting for nearly 10% of all emissions, 1 a large percentage of surveyed North American (43%) and European (32%) cataract surgeons stated they were unaware of the impact of OR waste and the healthcare system on the environment. 2,3 Despite a lack of knowledge of the precise environmental impact of OR waste, nearly all respondents felt that OR waste was excessive (93%). 2 What can we do in our own practices to reduce waste? A team approach can be the most effec- tive and the most rewarding when tackling big issues with many involved stakeholders. A good way to start is to identify a sustainabil- ity champion in the practice and to take the EyeSustain Facility Pledge. The champion can continued on page 16

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