HEALTHCARE & SUS TAINABI L I T Y
been identified as operating theatres’ major energy-consuming component, accounting for up to 64% of daily contribution.12 The environmental impact of medical gases – anaesthetic gases in particular – are a critical area of focus for healthcare organisations. While these products may be an important component of improved patient outcomes and experience for an extensive range of surgical procedures, they have also been the subject of increasing scrutiny for their environmental impact potential on global warming. Concern about greenhouse gas emissions and the healthcare organisations’ carbon footprint have drawn urgent attention and focused policy development. But now, innovation in anaesthetic gas capture addresses the carbon footprint of these important surgical agents, with the future potential for a circular economy model to be applied to these gases. Given that many facilities are gearing up for a greener future at an organisational level, personal commitment and determination from staff is a significant driver of sustainability initiatives in hospitals and specifically operating theatres. The operating theatre environment generates a substantial amount of plastic waste which is also a focus for environmental reduction as per the NHS’s Long-Term Plan. Recyclable materials, biodegradable alternatives, and reduced usage of waste-producing and/or non- recyclable goods are increasingly common in surgical settings.13
Green initiatives
introduced by operating theatre staff have had dramatic results and inspired other teams to bring their personal commitment for greener healthcare communities into the workplace.14
Full circular economies at the next level
A circular economy refers to keeping resources in use for as long as possible by means of recovery and re-use and brings multiple benefits, not least cutting carbon emissions and increasing employment.15 In healthcare, a fully circular economy is
Figure 1 Representation of full circular economy for inhaled anaesthetics
a closed system of production, use, and return from manufacturer, to customer, to reprocessor.16
have multiple target areas that extend far beyond reducing waste and include: l Renewable energy l Energy efficiency l Material efficiency l Care, repair, maintenance, upgrade, and remanufacture of durable goods
In addition to reducing carbon emissions and positively impacting climate change, these systems have the potential to create jobs and make healthcare more affordable.17 Circular economy innovation has already been embraced by healthcare equipment manufacturers. CT scanners, for example, each of which are 1.5 ton-giants that cost up to £210,000 new, are being returned to the manufacturer, refurbished, repurposed, and put back into use.18,19 Increasingly, healthcare organisations have commitments to reducing their carbon footprint and economic waste by requiring that new equipment can be upgraded and repaired, in addition to meeting energy efficiency standards.20
like circular economies are more effective than individual efforts due to scale impact, allowing the system to achieve improved economic and environmental outcomes
through improved start-to-finish processes and clinical experiences.21
Circular economy solutions
Anaesthetic gas capture Until now, circular economy principles in healthcare have applied exclusively to durable goods such as testing equipment and machinery. Recent innovation in medical anaesthetic gas recapture technology called the CONTRAfluran Anaesthetic Gas Capture System, from Baxter and ZeoSys Medical GmbH, is changing anaesthesia for patients, providers, and healthcare providers while pivoting towards a greener future for healthcare facilities.
Anaesthetic gas capture allows hospitals to efficiently collect and contain exhaled anaesthetic gases, preventing their escape into the air. This could reduce the NHS carbon footprint by at least 60,000 tonnes of CO2
per year one.22 The process helps
hospitals move towards environmental sustainability targets though the utilisation of versatile technology that easily integrates into existing anaesthesia systems in a variety of clinical settings.
System-level strategies
This process is achieved through what aims to be a fully circular economy. Special canisters which attach to anaesthesia machines are delivered to hospitals alongside the anaesthetic gas bottles. The canister is placed into the sensor unit, and as surgeries progress, the exhaled gas is captured into the canister instead of being released into the atmosphere. The sensor indicates when the canister is full and should be replaced, and Baxter will then collect the filled containers for reprocessing.
The captured gas is sterilised, extracted, separated and purified. The purified gases will serve as new activated pharmaceutical ingredient (API). Once regulatory approval is granted, the purified anaesthetic gas is re-bottled and delivered to hospitals under this dedicated license. The full process including reuse of captured gas is already approved in two European countries, Germany and Austria. The ultimate vision is both recyclable packaging, as well as reusing
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WWW.CLINICALSERVICESJOURNAL.COM MARCH 2021
©Baxter
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