An employee-driven plan helped Yale-New Haven Hospital reduce waste—and save money—in the OR and other areas.


Leaders at Yale-New Haven Hospital, New Haven, Conn., have developed a program called WorkSMART to engage employees in green projects that help reduce waste and inefficiencies. In FY12, the hospital saved $2.1 million by making changes in several areas, such as printing, waste, and energy. 

So far, the biggest cost savings have come from the operating room (OR). By sterilizing and repackaging medical and surgical devices designated as single-use, the hospital saved more than $760,000 in FY12.

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Succeeding at Reprocessing

To implement an OR reprocessing program, the team at Yale-New Haven Hospital suggests several strategies.

Build support. “The organization needs to understand the reasons for doing this, such as the need to eliminate waste and improve efficiency,” says Thomas Balcezak, MD, MPH, FACHE, associate chief of staff and chief quality officer. Support from senior leadership is vital. At Yale-New Haven Hospital, two vice presidents chair an organizationwide sustainability committee. 

Physician champions also have an important role to play. It can help to engage high-volume “super users” early on to help create buy-in. 

At Yale-New Haven Hospital, neurosurgeon Maxwell Laurans, MD, took the lead in using reprocessed devices and answering colleagues’ questions. A common concern was around quality, which Laurans addressed. “With reprocessed devices, every product undergoes quality assurance, which is not always the case for original products,” he says. “All reprocessed devices have to prove their equivalences to the original product.”

Start strong. To launch the program, choose devices that are easiest to reprocess and that offer the greatest savings opportunity, Laurans says. At Yale-New Haven Hospital, reprocessed electrophysiology and ultrasound catheters provided $400,000 in savings in FY12. And reprocessed external fixation devices have helped save about $100,000 a year.  

Make it easy. To put reprocessed items in physicians’ hands, place the items closer to surgeons or on top of other products to be chosen first. Outside of the OR, consider hosting vendor fairs to give surgeons and OR nurses an opportunity to ask vendors about reprocessed products.

Assess thoroughly. In assessing the potential cost savings from reprocessing, it is important to take indirect cost savings into account. “When we fill up bins with devices for reprocessing, we get rid of hazardous material at no charge,” says Ron Shalagan, the hospital’s implant and new technology coordinator. 

At the same time, hospitals should recognize that not every item is worth reprocessing. Some reprocessed items, such as saw blades, might cost more than new items, Shalagan says. 

Report often. To provide feedback, the WorkSMART program reports savings and other performance metrics in the OR at least once a month using a scorecard.

Get Employees Engaged

Each month, employees offer green ideas ranging from revised printing policies to energy-saving lighting strategies. Since WorkSMART was launched in January 2009, employees have offered approximately 2,500 suggestions, says Cristina DeVito, MS, sustainability coordinator. 

Employees submit ideas to the steering committee via the employee portal on the hospital intranet. This helps keep sustainability efforts top of mind, says Jillian Jweinat, MS, who helped develop the WorkSMART program while she was an administrative fellow at the hospital. 

To provide personalized feedback, WorkSMART committee members write a note to each employee explaining why an idea was approved (or not approved). The hospital promotes the program through newsletter articles, awards dinners, and green product giveaways such as tote bags and water bottles.  

Laura Ramos Hegwer is a freelance writer and editor based in Lake Bluff, Ill.

Interviewed for this article: From Yale-New Haven Hospital, New Haven, Conn.: Thomas Balcezak, MD, MPH, FACHE, associate chief of staff and chief quality officer; Cristina DeVito, MS, sustainability coordinator; Maxwell Laurans, MD, neurosurgeon; Ron Shalagan, implant and new technology coordinator. From Deloitte Consulting LLP: Jillian Jweinat, MS, consultant in the strategy and operations practice.

This article is based, in part, on a presentation at the American College of Healthcare Executives Congress in March 2013.

Web extra: View a chart depicting the structure of the hospital sustainability committee along with a poster about employees’ roles in reducing waste.

Publication Date: Monday, October 14, 2013