Circular Economy in Medical Devices reprocessing: a roadmap for new solutions

Circular Economy in Medical Devices reprocessing E-Modules

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“Circular Economy in Medical Devices reprocessing: a roadmap for new solutions” E-Modules

General Announcement

Every day, tons of healthcare waste are produced worldwide, aggravating the health of our planet. Combined with new forms of waste related to the pandemic, this reality is seriously compromising the quality of living beings.

As responsible for this, we must act to change it. We must move towards a Circular Economy – renew, remake, share – instead of a linear economy – take, make, dispose.

New design strategies can be adopted to implement Circular Economy in the healthcare

A circular economy would curb waste production in healthcare, which depends on the value and the critical degree of the medical devices, resulting in lesser waste and longer equipment’s durability.

Servitization is an important strategy in the implementation of a Circular Economy, transforming all aspects, from design to delivery, transportation and recycling.¹⁰

Due to Healthcare-associated infections, lower costs of acquisition, and no reprocessing, a recent trend toward the use of single-use MD has been observed.¹¹ However, this strategy of single-use is not in line with a Circular Economy. Alternative reprocessing methods, namely low temperature instead of steam, could improve efficiency.¹²

Unsolved issues related to externalization of medical device reprocessing with its pros and cons do require a judicious evaluation through Health Technology Assessments.¹³

To that end, we are proud to be focusing on the role of Medical Device reprocessing as a circular economy solution.

By Carlos Palos

SCIENTIFIC DIRECTOR

Lindsey Wuisan

CIRCULAR ECONOMY IN HEALTHCARE SECTOR:

AN INTRODUCTION

LEARN MORE

Jeremy Faludi

THE ROLE OF MEDICAL DEVICES REPROCESSING IN CIRCULAR ECONOMY

OPPORTUNITIES AND PITFALLS

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Victoria McCreanor

ECONOMIC CONSIDERATIONS FOR MEDICAL DEVICES REPROCESSING TECHNOLOGIES

IN CIRCULAR ECONOMY

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May Karam

MEDICAL DEVICE REPROCESSING IN A CIRCULAR ECONOMY

ONSITE VS OFFSITE

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Jonathan Hart

HEALTH TECHNOLOGY ASSESSMENT IN THE CIRCULAR ECONOMY

OF MEDICAL DEVICES

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DR. CARLOS PALOS

ASP SUMMIT - SCIENTIFIC DIRECTOR

INFECTION CONTROL & ANTIMICROBIAL STEWARDSHIP

LISBON, PORTUGAL

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WEBINAR #1

CIRCULAR ECONOMY IN HEALTHCARE SECTOR:

AN INTRODUCTION

Lindsey Wuisan

Expert on Circular Economy, Environmental Policy and Management

Circular Economy Lisbon, Portugal

SYNOPSIS:

During the first webinar, Lindsey Wuisan (MSc, NL/PT) will kick-off the series by giving a general overview of Circular Economy (CE) and the opportunities for the healthcare sector. The presentation will start with the environmental imperative and an introduction to the concept and main principles. Furthermore, key strategies to implement CE in practice will be presented as well as the opportunities (and risks) for the healthcare sector. Lastly, inspiring examples of circular initiatives in the healthcare sector will be shared.

DATE: 25^th of May

You can see factsheet & recording

Introduction to the concept of

Circular Economy and the key principles

Key strategies

to implement CE in practice

Inspiring examples of circular initiatives

in the healthcare sector

Benefits for

the healthcare sector

In a linear economy, the overexploitation and use of (natural) resources lead to significant environmental harm.
The healthcare sector also has a significant ecological footprint and generates a lot of waste, largely due to widespread use of single-use disposables (materials and devices).
A CE is a regenerative system in which the use of natural resources is minimized, waste and pollution are prevented, through innovative business models and sustainable modes of production and consumption.
In a circular economy, emphasis is on upstream design solutions that extend product lifetime (design for reuse, repair, remanufacturing) and enable high-quality recycling, while regenerating ecosystems.
The healthcare sector can reduce its ecological footprint by using fewer disposables and adopting circular practices. These contribute to sustainable development, create socio-economic opportunities, improve public health and cut costs at the same time.

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WEBINAR #2

THE ROLE OF MEDICAL DEVICES REPROCESSING IN CIRCULAR ECONOMY

OPPORTUNITIES AND PITFALLS

Jeremy Faludi

Assistant Professor of Sustainable Design Engineering

TU Delft, Netherlands

SYNOPSIS:

Medical Device industry values safety, as it should. But throwing away entire products just to avoid cleaning them creates air pollution, water pollution, and other waste that damages people’s health.

Don’t just treat the patient in the room, treat the other 8 billion patients in the world as well.

DATE: 23^rd of June

Reusing products can save large amounts

of impact & money than merely recycling

Barriers to circular economy

in Medical Devices

How to improve the industry?

by integrating sustainability into product & service development

How to improve the industry?

by green purchasing

A circular economy is more than just recycling. Before that, we need to reduce consumption, repair, reuse, refurbish, and remanufacture, to save both environmental impacts and money.
Barriers to circular economy medical devices are real, but they can be overcome. We need to overcome them because healthy people require a healthy world.
Current economics drives manufacturers toward planned obsolescence, but they must switch business models and design methods to drive the circular economy.
Purchasers have leverage, both in buying more sustainable products based on LCA or other quantified impact assessments and subscribing to new business models like product-service systems. If companies don’t offer them, push them to provide the data and/or the business models.

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WEBINAR #3

ECONOMIC CONSIDERATIONS FOR MEDICAL DEVICES REPROCESSING TECHNOLOGIES

IN CIRCULAR ECONOMY

Victoria McCreanor

Health Economics Research Fellow

Greater Brisbane, Australia

SYNOPSIS:

When considering which sterilizer is right for a particular setting, there is more to think about than the up-front costs of the sterilizer system itself. Concepts used in health economic evaluation can be used to assess the longer term costs and benefits of different options, including environmental considerations, in different settings. This webinar will cover an overview of health economic evaluation concepts, factors related to the sterilizer system, the instruments/devices being sterilized and wrap up with how to bring it all together.

DATE: 22^th of September

Introduction to

health economic evaluation

Sterilizer

factors

Instrument

factors

How to evaluate

the economics in your context?

Important to look beyond the up-front costs of the sterilizer
There are large differences in energy and water consumption: important in current environment
Effect of different sterilizing processes on instruments important consideration (affects costs and carbon footprint)
Consumables/disposable items also contribute to carbon footprint
Principles of health economics can be used to evaluate decisions your context

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WEBINAR #4

MEDICAL DEVICE REPROCESSING IN A CIRCULAR ECONOMY

ONSITE VS OFFSITE

May Karam

EORNA President Infirmière de bloc Opératoire Diplômée D'etat (IBODE)

Paris, France

SYNOPSIS:

We have to be aware of the importance of having to preserve our environment.

It is time to change our working methods including in the healthcare sector to reduce the carbon footprint and preserve our planet.

Sterilization and the Operating Room are side-by-side when it comes to Patient Safety. One does not work without the other and both are critical in a hospital.

In general, large hospitals have their own sterilization department. There are also outside facilities that provide this service and work as a sterilization department.

Would it be interesting to have a sterilization service onsite, close to the operating room and the health care services, or to outsource this service to facilities far away from the hospital?

The question is not new and both solutions have advantages and disadvantages because we must take into account the economic aspect, the modalities to continue to ensure safe and quality patient care. But let’s not forget that the issue is not only about organization and the place where the MD reprocessing will be done. It becomes imperative to pay attention to avoid waste, to adapt our methods in the operating room and in the sterilization department and to work in a circular economy perspective, for the patient, the health system, and for our Planet.

DATE: 27^th of October

Sterilisation :

its importance for patient safety and how are we proceeding today

On-site sterilization :

advantages and disadvantages

Off-site sterilization :

advantages and disadvantages

Suggestions

for the Planet on MD Reprocessing strategies

CSSDs play an important role in patient care, patient safety and infection prevention: Reprocessing of MDs is an indirect patient care that must be provided by skilled personnel. It is extremely important to provide a high quality and reliable process by applying validated and up-to-date procedures.
On-site CSSD has advantages, especially for large healthcare facilities with a large volume of MD to be processed. The proximity of the CSSD saves time for the MD processing since there are no transportation to consider. However, this entails enormous costs in terms of equipment, materials, personnel and maintenance.
Off-site CSSD is less costly for small health care facilities which have less volume of MD to be processed. However, it is important to organize it very carefully, considering all the steps of the process to avoid problems such as reprocessing errors, loss of MD or delays in delivery.
In a nutshell, either choice can be beneficial to a healthcare facility. The important thing is to adapt the best solution to the needs, to forget about prejudices and to be objective when taking decisions.
The health of the Earth is deteriorating! It is becoming urgent to “think green” and to act for a positive change in our way of life and in our workplace. We realize how important it is to “think green” in CSSDs by saving costs, stopping the waste and finding sustainable solutions for reprocessing RMD. Several examples in healthcare, showcase the impact of Circular Economy on this cost reduction (SUD, medical waste, water, energy, etc.). There is also literature and governmental directives (eg. ISO14001) to guide us, but what is important is that each of us becomes an actor in this change.

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WEBINAR #5

HEALTH TECHNOLOGY ASSESSMENT IN THE CIRCULAR ECONOMY

OF MEDICAL DEVICES

Jonathan Hart

Biomedical Engineer at Direzione Sanitaria Campus Bio-medico, Rome

Roma, Itália

SYNOPSIS:

As waste management, pollution and climate change are global issues at all levels, circular economy is, for all sectors including healthcare, a necessary solution and an opportunity for sustainability. The success of circular economy models in healthcare requires, in order to be developed and adopted, a joint effort on the part of the industry, policymakers and users.

Role of Health Technology Assessment

in Healthcare Circular Economy

Circular economy for meeting supply chain

and service requirements

Priority setting and balancing of circular vs.

linear economy principles

Single use vs. reusable:

which and how to choose?

HTA is a multidimensional methodology that allows a comprehensive and evidence-based approach to a circular economy in healthcare.
HTA is a useful tool for appraising whether devices or solutions that are proven to be environmentally sustainable are also clinically effective and acceptable.
It is important to assess how circular economy models (with smaller CO2 footprints) compare to current practice in terms of clinical outcomes and effectiveness, as well as efficiency and organizational factors. Life cycle analyses and economic evaluations alone do not provide conclusive evidence to decision-makers.
HTA can help define requirements that need to be met by industry, institutions, and healthcare professionals in developing and applying circular economy solutions to healthcare.
There is a growing awareness among healthcare professionals and scientific societies of environmental issues. The circular economy is becoming not only the goal in new business models but also the means to achieve economic sustainability and meet service requirements.

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References :

1. Pichler P, Jaccard IS, Weisz U, Weisz H. International comparison of health care carbon footprints. Environ Res Lett. 14(6):064004. 7.

2. Health Care Without Harm, Arup. Health care’s climate footprint. Health Care Without Harm; 2019.

3. Global analysis of healthcare waste in the context of COVID-19: status, impacts and recommendations. Geneva: World Health Organization; 2022. License: (CC BY-NC-SA 3.0 IGO).

4. Benson NU, Bassey DE, Palanisami T. COVID pollution: impact of COVID-19 pandemic on global plastic waste footprint. Heliyon. 7(2):e06343.

5. https://www.who.int/news-room/fact-sheets/detail/health-care-waste.

6. BMJ 2021;375:n2734 http://dx.doi.org/10.1136/bmj.n2734

7. https://ellenmacarthurfoundation.org/topics/circular-economy-introduction/overview

8. WHO Europe. Circular Economy and Health: opportunities and risks. Geneva, 2018.

9. G.M. Kane, C.A. Bakker, A.R. Balkenende. Towards design strategies for circular medical products. Resources, Conservation and Recycling, Volume 135, 2018, Pages 38-47, https://doi.org/10.1016/j.resconrec.2017.07.030)

10. Andrea J. MacNeill, et al. Transforming The Medical Device Industry: Road Map To A Circular Economy. Health Affairs, doi.org/10.1377/hlthaff.2020.01118

11. Ciocîrlan M. (2019). Low-cost disposable endoscope: pros and cons. Endoscopy international open, 7(9), E1184–E1186. https://doi.org/10.1055/a-0959-6003

12. McCreanor, V., & Graves, N. (2017). An economic analysis of the benefits of sterilizing medical instruments in low-temperature systems instead of steam. American journal of infection control, 45(7), 756–760. https://doi.org/10.1016/j.ajic.2017.02.026

13. HTA 101: Introduction to Health Technology Assessment. https://www.nlm.nih.gov/nichsr/hta101/ta10103.html

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