The return of reusing SUDs may have a prequel in haste to reduce waste

Oct. 26, 2022

As the discourse about reusing single-use devices continues to simmer even as healthcare professionals verbally spar over economic benefits, product durability, procedure quality and patient safety, a growing movement is emerging outside of healthcare that may render it all moot.

The movement stems from environmental calls for banning the use of single-use plastics to keep these products out of landfills after disposal.

Think of it as a preventive measure to prevent another preventive measure. After all, if device manufacturers don’t have access to single-use plastics to make SUDs, then healthcare organizations won’t have to worry about deciding whether to re-use SUDs.

Healthcare Purchasing News pondered whether this movement outside of healthcare may develop traction and transition to inside healthcare, asking relevant experts to share their thoughts.

“Plastics are an important and almost irreplaceable material in the manufacture of many medical devices. To eliminate this versatile resource from engineering and manufacturing toolkits would potentially curtail the many wonderful medical solutions and positive clinical outcomes that could evolve from them.

“A far better approach would be to design in extended usefulness or life cycles for plastic devices (i.e., make reusability a design requirement) and a process for recycling and repurposing the remaining materials. The popular press and scientific literature are full of examples of the repurposing of basic materials. Why not make this a requirement for purchasing medical devices? Healthcare purchasers could influence sustainability beyond the doors of their institutions with such a requirement. The cost savings from ‘optimized’ reusable plastic devices would certainly pay for the adjustments in purchasing and use that would arise with this new approach.”

Richard Radford, CEO, Cenorin LLC

“One of the primary reasons for single-use accessories is patient safety. The amazing advancements in developing plastic accessories was to improve diagnostic and therapeutic abilities and reduce cost. In the cases where reusable devices are utilized, the use of an optimized enzymatic detergent is of the utmost importance. Cleaning with an enzymatic detergent removes organic soils such as blood, mucus, feces or tissue from instrument surfaces, lowering the risk of healthcare-acquired infections not only for patients, but also for healthcare personnel.”

Ron Banach, Director, Clinical Training, Ruhof Healthcare

“Environmental impact is something every industry has been grappling with more and more over recent decades; the healthcare industry is certainly no different. Reducing – or even eliminating – the use of single-use devices is a clear, substantial opportunity to lessen the healthcare industry’s environmental impact and become more sustainable. The obvious challenge here is ensuring that patient safety remains the top priority – a healthcare facility with great environmental and sustainability policies is terrific, but if they can’t ensure the safety of their patients, none of it matters.

“As it relates to achieving a higher degree of environmental conscientiousness via the reduction of single-use devices, the key is to implement methods, processes and solutions that enable proper reprocessing of reusable devices. Tackling concerns around compliance, visual inspection, resource usage, and overall quality of reprocessed devices can help departments ensure patient safety, maintain compliance with IFUs [instructions for use], reduce unnecessary expenditures on resources, hopefully save some money by eliminating what are effectively consumables, and ultimately lessen their environmental impact. In an ideal world (with investments made to help departments achieve these goals), becoming more environmentally friendly should be a win-win-win for the hospital, the environment, and most importantly, the patient.”

Dan Gusanders, President, Pure Processing

“Olympus has aggressive goals to design and manage environmentally friendly solutions for single-use endoscopes. We are exploring partnerships and new ways of thinking about and actioning sustainability.

“Simultaneously, Olympus has added carbon neutrality to its goals and is at work enabling a circular economy as an additional ESG (Environment, Social, Governance) initiative. This ESG goal will apply for all Olympus manufacturing and development sites to achieve the global target of Carbon neutrality by 2030.”

Melinda Benedict, Director, Infection Prevention and Control, Olympus Corporation of the Americas

“We have a moral obligation to leave the world a better place than we found it. We are blessed in this country with resources. We should do all we can to preserve them. To do this we must understand the cost/benefit of our activities. We have an obligation to investigate the total cost of resources used for both reusable and disposable instruments. I believe that currently, this favors the use of reusable flexible endoscopes. With an estimated 75 million U.S. annual endoscopic procedures performed, imagine resources required to build the endoscopes and the mountains of waste that will be created if all were disposable. Looking at the root causes of the need for disposable flexible endoscopes we find two primary drivers. First, failure to properly clean and process reusable endoscopes; second, in the case of ERCP endoscopes engineering design and lastly, industries need to create new markets to ‘sell more products.’ With the exception of those endoscopes with design flaws (some ERCP endoscopes), flexible endoscopes can be effectively reprocessed and rendered safe for use if the reprocessing staff is competent and follows the IFU. AAMI’s ST91 includes new requirements for cleanliness testing and drying both will help improve outcomes.”

“Like any other production system, if the staff is not properly trained, supervised and managed there will be failures in the process. In addition, ST91 calls for detailed event tracking. This is the area that I most often see failure to comply. Many facilities do not track and manage events as they should to improve the system. Often, staff are lax in reporting events, events are not reported with enough details and no one reviews the history to recognize trends. Events tell you where system failure is occurring. Event tracking and monitoring should be the most important task that SPD and Endoscopy managers have. Endoscopes that have design flaws that hamper effective cleaning or sterilization should be and are being corrected. Lastly, there is an incentive for manufactures to create repeat sales. Disposable products do this often at the expense of the environment.”

Gregg Agoston, Vice President, Business Development, SPD Transformation Services, SpecialtyCare

Continue reading …

AAMI redefines, revamps sterile processing practices via ST91
Who owns pre-treatment at point-of-use
Disposables/single-use devices vs. hybrids – which leads by 2035?
Strategies, tactics for high-quality endoscope reprocessing
Forget about using SUDs; what if you no longer could make them?
How might ‘right to repair’ regs impact healthcare?
How to approach patient safety gap with flexible endoscopes

Original photo courtesy Bayhealth SPD, HPN's 2021 SPD of the Year, with affects added by generative AI.
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