1 week Ago
Surgeons at two North Wales hospitals have been recognised for sustainability projects that cut departmental costs by two-thirds. The specialist surgical departments at Wrexham Maelor Hospital and Ysbyty Gwynedd were awarded the Professor Sir Mansel Aylward Innovator Award by the Bevan Commission. The accolade was given after the departments initiated a trial to streamline their working practices, which led to an 88 per cent reduction in carbon emissions.
The project was spearheaded by hand and orthopaedic surgeons Preetham Kodumuri at Wrexham Maelor Hospital and Edwin Jesudason at Ysbyty Gwynedd. The consultants collaborated to participate in the Green Surgery Challenge, instigated by the Royal College of Surgeons and the Centre for Sustainable Health. The primary aims of the combined projects were to reduce costs, save energy, lower the carbon footprint, and recycle more clinical waste.
After assessing the monthly waste generated, Mr Kodumuri and Mr Jesudason developed a 'lean and green' model for carpal tunnel release procedures under local anaesthetic. This involved reducing the number of sterile instruments and reviewing operating practices. By cutting the number of instruments from 30 to just seven, less needed to be re-sterilised.
They also reduced the size of the drapes used in the theatre to minimise waste, as only a small drape was required for the hand area. The number of items disposed of was also reduced, and minor procedures were moved out of main theatres and into clinical rooms. Despite operating rooms occupying a small physical footprint within a hospital, they are responsible for 20 to 30 per cent of the hospital’s material waste and energy use.
By moving small, simple procedures into clinical outpatient rooms and out of the theatre, reductions were made to both carbon footprint and energy use. These changes were done over a 15-month trial period. READ MORE: When compared to previous practices, the new approach reduced CO2 emissions by 90 per cent, clinical waste by 85 per cent, and costs by 80 per cent.
Mr Kodumuri said: "As a surgeon, I feel we have a responsibility to understand the impact of our clinical activities on the health of the environment and consider ways to reduce this impact. "With most of our clinical waste being generated from single-use items, it is important to consider how this can be reduced. "Our practices clearly demonstrate how small changes can offer huge impacts.
" By reducing the size of the standard procedure pack, re-sterilisation costs were cut from £17 to £4 per pack, and wastage was also reduced from 3.5kg for the standard procedure pack to 1.2kg for the 'leaner' pack.
Mr Jesudason added: "The key to making a real impact is being brave enough to make changes, trial the adjustments, and demonstrate the impact. "Since we carried out our pilot, we have not only had our achievements recognised through award wins, but we have also been invited to present our findings at surgical conferences in Europe and the USA." Following on from the trial with carpal tunnel surgery, the team are applying the same intervention to all local anaesthetic hand surgery.
They are also promoting this process to other surgeons, both within their health board and beyond. Huw Irranca-Davies, cabinet secretary for climate change and rural affairs, said: "The approach taken by the surgical teams at Wrexham Maelor Hospital and Ysbyty Gwynedd is inspiring. "It demonstrates how small changes can have a big impact when it comes to both saving energy and waste.
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