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PHSA Recycling Champion: Stephan Malherbe

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Recycling champion: Stephan Malherbe
Health authority: Provincial Health Services Authority
Facility: BC Children’s Hospital
Position: Clinical Associate Professor in UBC Department of Anesthesiology, Pharmacology, & Therapeutics
Anesthesiology, BC Children’s Hospital
Date interviewed: September 28, 2016

Stephan is Recycling Champion in the OR at BC Children’s Hospital. We chatted on the phone about his presentation to surgical staff titled, Operating Room Waste & Sustainable Anesthesia: A case for greening the OR. This eye-opening presentation covers everything from the environmental impact of hospitals and operating rooms to the financial costs of not reducing waste. Stephan shows us how we can reduce waste and cost, resulting in benefits for patients and the environment.

Q. Tell us what inspired you to create a case for greening the operating room (OR)?

“Back in 2012, I read a few articles in two different journals. One was a series of articles on anesthesia and the environment in a very prominent anesthesiology journal, and the other was an article titled, People, planet and profits: The case for greening the operating room, in the Canadian Medical Association Journal [PDF attached below]. I realized that I had a responsibility to raise awareness about the environmental impact of my anesthesia practice. It inspired me to prepare a presentation to my colleagues at our weekly anesthesia grand rounds.”

Q. Since your first presentation in 2012, you have shared the case for greening the OR with many different audiences, and you continue to do so. What do you want health-care staff, in particular those in ORs, to know?

“The current trend of waste production and energy consumption in health care in the developed world is not sustainable! My main objective is to raise awareness of the huge amount of waste that we produce and the significant impact it has on our environment. Climate change is the biggest global health threat of the 21st century. Unfortunately it will have the greatest effect on those who have the least access to the world’s resources and have contributed least to its cause. We have a responsibility to make health care more sustainable — particularly those of us who practice in the developed world.”

Q. How have audiences reacted to the presentation?

“Mostly positive. Many people have been inspired to recycle more and also to reduce the amount of waste they produce in the operating rooms. Ultimately, the goal is to reduce the environmental impact of our practices.”

Q. Have you seen any changes in the OR at BC Children’s? Or any other Lower Mainland ORs?

“The volatile anesthetic agents that we use in the operating rooms have serious effects on the environment. One specific drug, Desflurane, has been the most widely used anesthetic agent but unfortunately also has the highest global warming potential. In many hospitals in the Lower Mainland, there has been a cultural shift to using volatile agents with far less global warming potential, such as Sevoflurane and Isoflurane.”

Q. What is the link between environmental initiatives in the OR, like waste reduction, and patient care?

“I often quote an editorial from the journal Anesthesia and Analgesia: ‘Responsible health-care workers put patients first. The patient is more than the human being under our care. The patient includes the family, the neighbours, the community, the country, the world and all of humanity. Accepting responsibility for environmental stewardship puts patients first.'”

You and your colleagues can find out more; watch Operating Room Waste & Sustainable Anesthesia: A case for greening the OR here.