Specialist surgical departments in Wrexham Maelor and Ysbyty Gwynedd have received The Professor Sir Mansel Aylward Innovator Award from the Bevan Commission after initiating a trial to streamline their working practises which has reduced carbon emissions by 88%.
The project has been led by Hand and Orthopaedic Surgeons Preetham Kodumuri at Wrexham Maelor Hospital and Edwin Jesudason at Ysbyty Gwynedd. The project came about when both consultants worked together to participate in the Green Surgery Challenge instigated by the Royal College of Surgeons and Centre for Sustainable Health. The combined projects’ primary aims were to reduce costs, save energy, reduce carbon footprint and recycle more clinical waste.
After reviewing the amount of waste created create each month, Mr Kodumuri and Mr Jesudason developed a ‘lean and green’ model for the Carpal Tunnel release procedures under local anaesthetic which involved reducing the number of sterile instruments, while also reviewing the operating practises.
By reducing the number of instruments from 30 to just seven, it meant less needed to be re-sterilised. They also reduced the size of the drapes used in theatre to reduce wastage, as only a small drape was required for the hand area, while also reducing the number of items disposed of and moving minor procedures out of main theatres and into clinical rooms.
Although the operating rooms form a small physical footprint within a hospital, they are responsible for 20-30% of the hospital’s material waste and energy use. By moving small simple procedures into clinical outpatient rooms and out of theatre, reductions were made to both carbon footprint and energy use.
These changes were applied over a 15-month trial period and when compared to how they were working before, the new approach was proved to reduce CO2 emissions by 90%, clinical waste reduced by 85% and costs by 80%.
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 reduced from £17 to £4 per pack, while 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.”
Since the successful trial with carpal tunnel surgery, the team are applying the same intervention to all local anaesthetic hand surgery and 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.
“This is one of many examples of action being taken across Wales to tackle the climate and nature emergencies. I would encourage everyone to consider ways to reduce their impact on the environment to help create a cleaner, greener Wales.”
