"Bring your own" reusables to surgery: an environmental sustainability quality-improvement initiative

Operating rooms (ORs) produce more than 30% of a hospital's total waste, with plastic accounting for 20% of that waste. Our project aimed to reduce OR plastic waste by encouraging patients at London Health Sciences Centre sites to bring reusable bags for their belongings and reusable water bottles.

We used the Plan-Do-Study-Act (PDSA) quality-improvement method, conducting 3 PDSA cycles, first at Nazem Kadri Surgical Centre, and then at Victoria Hospital and University Hospital. Educational interventions informed staff and encouraged patients to bring their own reusable items. Outcome measures included environmental carbon footprint savings, waste savings, and cost savings over a 1-year period. Process measures included the percentage of patients who brought their own reusable bags and water bottle, the percentage of plastic belongings bags purchased, and the percentage of patients informed to bring their own reusables. Balancing measures assessed patient satisfaction and administrative workflow changes.

In PDSA cycle 3 at University Hospital and Victoria Hospital, 60.0% and 78.0% of patients brought their own reusable bags for belongings, and 15.7% and 57.8% brought a reusable water bottle. There was a 45.7% reduction of plastic bags for patient belongings purchased annually, which equated to a reduction of 2141 kg of carbon dioxide equivalents, 10 393 km driven equivalent emissions, $1259.55 saved, and 252 kg of waste saved. Most patients and staff agreed that bringing reusable bags for surgery is easy.

This quality-improvement initiative achieved high patient uptake of reusable items and resulted in substantial reductions in plastic use, waste, and associated carbon emissions. Transitioning to reusable bags for patient belongings and reusable water bottles is an environmentally friendly initiative to reduce the carbon footprint of an OR.