The Medical Device Reprocessing Department (MDRD) lies below Vancouver General Hospital. They work 24/7, disinfecting, re-assembling and sterilizing all the re-usable medical devices used in the hospital. Albert Csapo, the MDRD manager, gave a tour and spoke about his environmental sustainability initiatives.
Q. Where do the items you reprocess come from?
“We reprocess about 165,000 instruments and 700 scopes each week. Approximately 65% of these instruments come from the Operating Room (OR), but we also reprocess medical devices from other locations, including all areas of the hospital, the Eye Care Centre, The Diamond Centre, 12 community clinics, and other hospitals within VCH, Providence and Fraser Health.”
Q. You’ve done some work to reduce the use of blue wrap. Why is it such a problem?
“Blue wrap is one of the biggest contributors to OR waste, and it can’t be recycled. The Vancouver General Hospital (VGH) can fill 30 garbage bags of blue wrap in a single day; it’s used to guarantee sterile equipment as part of our high standard of care.”
Q. What are alternatives to blue wrap?
“I prefer reusable, hard metal cases, and when I have room in my budget I always add an extra one. In my opinion, they are a better system. They protect the equipment better, and they are better for the environment. The strong metal cases prevent equipment from being damaged in storage. Currently, about 75% of equipment is stored in sterile re-usable metal containers.
“Blue wrap can tear easily, which means that sometimes clean equipment must be processed again to re-sterilize the devices.”
Q. So why aren’t all devices stored in metal cases?
“They can’t be used for everything — some items don’t fit in the cases, and they currently can’t be used for heavy items. They also have a high initial cost and can seem expensive compared with blue wrap. But, if a metal case is used daily, its high initial cost is recuperated in less than three years — and some have been in use for over 30 years.”
Q. What are your other environmental initiatives?
“In addition to recycling mixed paper and mixed containers like the rest of the hospital, we were able to coordinate with a vendor to recycle our 55-gallon detergent drums. We also ensure that any damaged equipment is recycled.
“Also, we recently switched to an electronic filing system, which tracks and stores information about the sterilization cycle for each piece of equipment. We are transitioning to use it as a replacement for binders that store specifications and re-assembly instructions for each device we reprocess on paper. Each desk had its own large binder. Since there are constant updates, it’s much easier and cost-effective to update an electronic system.”