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Health care can produce a lot of waste. As part of our environmental stewardship commitment, Providence is working to divert from the landfill/hazardous waste streams and avoid waste altogether, curbing our carbon footprint and cutting costs along the way.
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Avoided waste is waste that health care teams avoid making in the first place, including through reusing items or not purchasing items they don’t need.
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Providence developed a system called OneView to more easily track equipment used in the operating room and cut back on unused and wasted supplies – saving millions of dollars and tons of carbon dioxide emissions.
Providence is a leader in advancing environmental stewardship practices in health care, including our commitment to reducing greenhouse gas emissions across Providence ministries and affiliates. Using the WE ACT framework as a guide, Providence is focused on five key areas of mitigating carbon emissions: Waste, energy and water, agriculture and food, chemicals, and transportation.
Providence’s progress in sustainability means we’ve been able to save and reinvest millions of dollars in renewable energy and waste management projects across the communities we serve.
“You can find waste in every industry, not just the health care sector, but other industries like manufacturing are ahead of the curve when it comes to waste reduction,” says Dave Wilson, senior process engineer for Providence. “We’re still working to identify different kinds of waste and their root causes.”
As part of the WE ACT framework and scorecard, Providence established an initiative to divert more than 50% of our health care waste away from expensive, high carbon-emitting landfills and hazardous waste streams by 2030. That means a broader focus on recycling, composting and donations across health care facilities. It also means focusing on a different waste stream called avoided waste.
Combating waste at Providence
Avoided waste includes supplies that haven’t had to be purchased and items that can be reused. In other words, it’s waste that teams can avoid creating in the first place, like linens that can be washed and reused or perishable medications that are ordered on a better schedule so less gets thrown away.
It is challenging to measure the waste that isn’t created, but the environmental stewardship team at Providence has found ways to do so. For example, they can estimate how many pounds of waste have been avoided by replacing disposable products, and track weight and cost reductions over time. This metric is important because it captures not only avoided carbon emissions but also cost savings that can be passed on to support patient care.
One area of avoided waste has been surgical preference card optimization. Each surgeon has a preference card for every procedure they perform. These cards list all the supplies, instruments, equipment, medication and more needed for the procedure. These preference cards help make sure there are no delays in surgery due to lost or missing material. Because caregivers are busy taking care of patients, over time, these cards become inflated with additional pieces of equipment as care teams add new items without cutting anything back. Unfortunately, opened and unused items usually get thrown away after the procedure, even if they are brand new.
“Patient care and safety come before everything else,” says Wilson. “We want to ensure that surgeons and staff have everything they need to get the job done, but we want to do all that is reasonable to cut back on wasted supplies.”
Implementing OneView to cut down on OR waste
To combat this waste, the environmental stewardship team collaborated with Providence developers to build OneView, a system designed to help surgeons more accurately identify the materials they need for their procedures. OneView brings different sources of data into one place to help make sure the preference cards only contain the items needed for the procedure.
“OneView started with clinicians from one facility asking for help,” says Wilson. “They were struggling with the same problems that surgical teams across the country experience with bloated preference cards. We worked side by side with surgeons who shared what was important to them and enhancements that would make the product better and ultimately came up with a product we can roll out throughout the health system.”
In the first operating room, the team identified more than $1.1 million in savings. In the second, the team found $2 million in savings, including an 850 metric-ton reduction in greenhouse gas emissions per year, a 1-million-gallon reduction in water per year and an energy savings of 495,000 kilowatts per year.
The OneView system is easy to use, offering care teams a streamlined review process to go through their preference cards. The product team also incorporated machine learning and artificial intelligence to better predict the usage of each product.
“OneView was built with the Microsoft tools we already have within Providence and is easy to implement across our system,” says Wilson. “We can just take a laptop to a meeting or meet with surgeons over Teams to review cards and make any changes.”
OneView offers detailed reporting and analysis and has already shown significant cost and carbon savings. The system incorporates environmental impacts for each item included on preference cards, so it’s simple to measure the results of leaner, simpler cards.
“We make the waste visible by quantifying it and have prioritized making data readily available,” says Wilson. “It’s not just about the cost but also environmental and labor impact. We share data that hasn’t been seen before and highlight new kinds of waste we can avoid.”
The team continues to evolve OneView with constant feedback from surgical teams on what is and isn’t working. From there, they were able to move to new sites and operating rooms. OneView has expanded to all eight Providence sites in Oregon and two in Washington. The team is working to deploy OneView system-wide to Providence’s 52 facilities and 663 operating rooms.
“It’s not a silver bullet, but we promote innovation and try to rapidly develop solutions in support of our goals,” says Wilson. “We’ve been able to use technology to find major sources of waste and in collaboration with talented caregivers we have been able to solve how to avoid this waste.”
Contributing caregiver
Dave Wilson is a senior process engineer for Providence.
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Related resources
Environmental Stewardship at Providence: 2023 Year in Review
Partnering for good: How collaboration can reduce emissions
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This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
