256 shades of green.
Article Type: Report
Subject: Diagnostic imaging (Economic aspects)
Diagnostic imaging (Methods)
Medical care, Cost of (Control)
Author: Schwartz, Erin Simon
Pub Date: 04/01/2010
Publication: Name: Applied Radiology Publisher: Anderson Publishing Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 Anderson Publishing Ltd. ISSN: 0160-9963
Issue: Date: April, 2010 Source Volume: 39 Source Issue: 4
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 231310684
Full Text: In these challenging economic times, green practices do not have to be sacrificed for money-saving practices--in fact, green initiatives within an imaging department can result in significant cost savings.

These "Reduce, Reuse, Recycle" principles can be readily applied to imaging departments of all sizes. Note the specific order of these principles. Reduction in resource use is the most valuable (in terms of conservation and preservation), and the most cost effective. An easy first step is reducing usage of disposable items.

Reducing usage

Reducing paper usage is often the fastest change to implement; and it just requires a change in habits. Printing of emails should be kept to an absolute minimum, in favor of archiving for longer-term storage of important items. Electronic signatures should be created and electronic document signing allows one to email an attachment, rather than faxing a paper copy. Newsletters, productivity reports, and meeting minutes should be created and distributed electronically. It is also possible to electronically monitor workflow. Through these basic steps, paper usage in our department has been cut by 50%, saving several thousand dollars in a year. Additionally, most major suppliers now offer at least 30% post-consumer recycled-content paper, often for the same cost per box as 100% virgin paper. Request that your supply manager only order paper with at least 30% (preferably higher) post-consumer recycled content, and use it sparingly.

Disposable cup usage is another area where imaging groups can reduce waste and cut costs simultaneously. A single cup may be inexpensive (usually around 5 cents), however the volume used by employees can result in an expenditure of several hundred or even thousands of dollars per year. This also adds to the cost of waste disposal, especially if your disposal fees are weight-based. Encourage employees to use travel mugs to eliminate disposable cup usage. Over time, the savings can even offset the costs of purchasing travel mugs for your team--and putting your group's logo on the cup can help spread awareness of your efforts to "Go Green." Several vendors offer recyclable plastic or stainless steel options, allowing recycling when no longer useful.

Medical waste reduction

Reducing waste generated from diagnostic and therapeutic procedures offers a large opportunity for cost savings with greener practices. Due to their hazardous nature, the costs for disposal of "red bags" can be upwards of six times that of routine waste. Carefully managed waste practices can result in significant cost savings. Overall at our institution, "red bag" waste has been reduced by more than 62% since 2007.

A well-intentioned, but misinformed, staff of interventional, ultrasound, and/or fluoroscopy suites can inappropriately create hundreds of unnecessary pounds of "red bag" waste by placing items in these bags that can potentially go in regular waste bins (e.g., items not saturated with blood or other bodily fluids) or recycling bins (glass and plastic contrast and other bottles, after appropriate rinsing per pharmacy standards). Consult your institutional or waste disposal provider guidelines for "red bag" vs. general waste items. Involve your sustainability officer or your waste disposal company to monitor compliance.

Electricity usage

Reducing electricity usage in our workplaces and homes provides another significant opportunity for decreasing resource utilization while saving money. By powering off the entire workstation and monitors at the end of the workday (if your PACS is amenable), significant energy savings can be recouped. During a workday, monitors not in use for more than 20 minutes should be shut off. Replacing CRT monitors with LCD monitors can also significantly reduce energy use (and free up valuable desk space).

Turning off unnecessary lights can also lead to energy savings. Motion-detector switches can be considered for locations that are infrequently used, such as restrooms. Task lighting is far more efficient than overhead lighting. A small grow-light in your office or workspace can serve a dual purpose, acting as a task lamp and allowing you to have live plants, which promote better indoor air quality, all with minimal energy use.

Reuse

In medical settings, the reuse component of the green triad can be more challenging to implement. Several companies offer new opportunities for the safe resterilization and reuse of certain medical devices (i.e., expired but unused catheters). For groups with interventional practices, this has the potential to reduce both waste and cost. Ask your sterile equipment supplier if they offer this option.

Recycling

While conscientiously recycling at home, too many of us check our inner recycler at the office door. Every pound of increased recycling volume is a pound of reduced waste and these add up. Place recycling bins in strategic locations throughout your department to increase your overall recycling volume. For most recyclers, glass, plastic (#1 and 2 at the very least, if not #1-7), and aluminum can all be placed in the same container. Most all paper products can be recycled in a single container, often including flattened cardboard boxes.

Most glass and plastic from medications or contrast can be triple-rinsed and safely recycled with co-mingled recyclables. Check with your pharmacy and recycler for guidelines.

Recycling of alkaline batteries is also widely available; place a specific container for batteries in strategic locations to facilitate recycling. Ink and toner cartridges from printers and fax machines can be recycled through your supplier, usually garnering you a credit per cartridge, another direct cost savings, with the indirect cost savings of reducing waste.

Conclusion

By reducing, reusing, and recycling, radiology departments, be they part of large institutions or freestanding imaging centers, can be leaders in the greening of medicine, with the additional advantage of reducing costs.

For more information, here are just a few of the many resources out there that contain additional information. Most have e-newsletters with additional tips on how you and your imaging center can go green:

www.epa.gov/newsroom/gogreen

www.seventhgeneration.com

www.nrdc.org/thisgreenlife

Erin Simon Schwartz, MD

Dr. Schwartz is a Pediatric Neuroradiologist and Clinical Director of Magnetoencephalography at The Children's Hospital of Philadelphia (CHOP), and an Associate Professor of Radiology at the University of Pennsylvania School of Medicine, Philadelphia, PA. Dr. Schwartz is also Chair of the CHOP Radiology Coin' Green Committee and she is the Radiology Department Representative for EcoCHOP. She is also on the editorial board of this journal.
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