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BOTA Conference 2022 | SWELOC | Sustainable Orthopaedic Surgery The SWLEOC experience

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Summary

This teaching session by the team from the Southwest London Elective Orthopedic Center will provide medical professionals with up-to-date information on the center's sustainability efforts. Topics to be discussed include recycling projects, the insights gained from pilot surveys on social sustainability, and steps taken to reduce intraoperative waste management. Attendees will benefit from learning best practices related to patient care, environmental sustainability, and overall staff support and well-being.

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Learning objectives

Learning Objectives:

  1. Describe the multi-pronged approach to recycling in a high-volume joint replacement center
  2. Identify how working relationships can contribute to sustainable changes in the workplace
  3. Explain the potential savings in expenditure and reduction in carbon footprint with increased reuse and recycling of assistive equipment
  4. Analyze results of surveys related to supporting staff in implementing sustainable changes
  5. Summarize waste management strategies for improved intraoperative sustainability in healthcare settings.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

team from the southwest London Elective Orthopedic Center On. With that in mind, I'd like to introduce a remarks. I'll routine PS Perrilloux and calm a food. Who? We're going to give her the cereal of talks from what's been going on at Swayed York. So welcome. And thank you very much for joining us guys just bad with me. I'm just going to shine my screen. Hey, you gonna we'll see the screen so I'd like to welcome. It's really alters. Well, it will be talking to be talking about sustainability as well dot So my colleagues and I would go through a series of different talks. So just like to welcome buddy in May, Perry and myself. So the introduction and walking stick recycling will be done by my colleague. Bodies are professional, lead US Southwest and elected with Pedic Center on social Systane ability. We discussed by May who are genius, a little research fellow improving interrupt to police management. It's we'll be done by our Our funny peri is that you know, people research whether it's well I got. And he's also been talking about Ritchie reducing discharge people work. That's when we put patients on that I'll just give a summary off the what would be doing at the Southwest and elected of Music Center. On with that, I'm gonna have straight over to booty, Thank you very hurt you and thank you very much for having me. My name's Bodine and I'll be talking about the recycling project that we have within the center within the therapy team. So swimming is a high volume joint replacement center, and we working really hard to make sure that patients are receiving their elective orthopedic surgery as soon as possible, not only within our sector but actually offering mutual aid to other areas nationally with exceptionally long waiting lists. And we want to also make sure that patients are able to go home as soon as possible after their surgery, and that they're able to safely do so with the appropriate equipment and walking aids. What we found is that there are national shortage is off assistive equipment and walking aids. Not only that, there is a really strong focus now in terms of financial and environmental sustainability and looking at how we might be able to reuse and recycle our equipment. This required a multi pronged approach. So first it was about identifying the appropriate equipment that can be reused and recycled. We labeled that equipment so that stuff and patients were able to easily identify which equipment is able to be recycled safely. We also updated all of our patient information to ensure that patients are very well aware about the fact that we strongly encourage them to bring back particular equipment to the center when they're coming. For there are patient appointments or indeed at any point along their journey. We also placed posters up across the center, especially in our patients when campaign coming back for there are patient appointment, but also for staff to make sure that we are consistently providing that message that we really hoping Teo. I'm recycle and reuse appropriate equipment. We did community engagement, which included social media as, well, a Z, a meeting up with charities and local recycling centers. So this is very preliminary results because we've only started with some of our recycling project. But in terms of the public engagement, it really is at its infancy. But one of the exciting breakthroughs is working with and collaborating with one of the local recycling centers that's got 15 centers across the sector and they really delighted to collaborate with us as part of their commitment to reducing waste and also supporting the NHS. Patients have been brilliant in terms of engaging in this initiative and not only patients that have had surgery with us, but patients in the public that has seen our our social media campaigns. So we developed standard operating procedures for receiving, cleaning and being able to reuse this equipment. So, as I said, this is really preliminary result in prior to a full public launch. But we've managed together data over five months of ingrowing and outgoing walking AIDS. This doesn't include the occupational therapy equipment, and based on that, it's very encouraging to see that based on those returned thus far, we do have the opportunity to save up to 40% and that's prior to an official launch. So in collaboration with patients and recycling centers, we can put unused equipment to good use rather than and ending up in in in your local recycling center to be able to help other patients. But it also goes towards our sustainability efforts to reduce it expenditure, and that's significant impact on the planet at the same time as this. There is a strategy and the NHS now that's recent we recently being publicized. That device, re use and refurbishment is one of those interventions contributing to reaching that nets here is zero NHS supply chain by 2045 on that walking, it's contribute to 60% of the NHS carbon footprint. So they say that if we, um where to drive just 40% increase in returns and refurbishment of walking AIDS in five years, we will help save the NHS 2.4 tons of carbon. And what's really encouraging is are very preliminary results before unofficial launch in the public. We've already managed to achieve that. So I'm hoping that it can just continue to grow from here. Thank you. So you're doing. I'll have her over to my colleagues may and period now, thank you. It often and everyone welcome to our My name is Pair Mining's May and sits therapy onboard with clinical fellows. That's well, you look so just really rightly. Sustainability covers three main pillars. Essentially, we're talking about planet profits and people. So my presentation, very briefly is going to talk about social stability and how this feets into the environment. Um, social Systane ability is defined very broadly is the ability to need these human needs on an ongoing basis. Next light, please. On Dukhan text of healthcare. It is about being able to meet these needs for our patients, but also making sure that our stuff are not forgotten about Walls were doing so. Next light, please. And so ego helping is a relatively new term that we come across. And it basically describes how our relationship with each other in the workplace can contribute to our actions for improving the environment. There is evidence to suggest that actually, good working relationships among stuff are positive values in contributing to sustainable changes within the workplace. Um, next I please. Last year we carried out a small pilot survey, so we focused on a very small aspect of socialist inability across. Well, you look looking at these five different domains. Perceived support is essentially how we perceive the support available to us from other leaks. Commitment is how much we feel a part of our teams helping is the actions that we take voluntarily when, um, other colleagues need help job satisfaction is fairly self explanatory, and ICO helping, as I mentioned, is our collective actions in supporting each other to implement changes within the workplace. Next time, please eso the results from our last year survey in October or largely positive. Actually, most stuff reports that feeling very supported at work next time, please. Even more Encouragingly, they were very eager to help and felt very much a part of the team that they were in Ah, lot of them worlds very satisfied with the job that they were doing next side, please. On doing so. This has showed that this was a very positive predictor off. Some of the success is that we have had in making of environmentally sustainable changes within the within our senator. Following this initial survey, we have carried on with a lot of sustainability work within our department are sensors. Well, y'all coast fortnightly regular sustainability meetings where all the different teams within swelling out come together, which aims to essentially foster sustainable changes across the department. So during these meetings will be discussing and implementing changes all across the center, which can range from, um, small team based projects done by the ward's with the other stuff, which parables. So talk about in second or up to, you know, large center white changes. So in March this year, we carried out very similar survey using an update, a questionnaire, and we sent it out to a much bigger cohort of stuff with ins. Well, yeah, we collected a total of 57 responses across. All are different teams, um, who were working in various roles in various parts of the center next side, please. The responses sort of eco our previous survey, and they were very positive. A majority of stuff felt very supportive at work. The take boxes that you see along the way are essentially improvements that we've had since doing the loss survey in October, which is very encouraging to see um, a large majority of stuff felt very much. Apparently, team next side, please. Um and then side. After that, we can see that most stuff are actually very keen to help each other out, especially involuntarily taking time to help someone else or making sure that a lot of the decisions that we make as a team are not made without thinking about someone else. Next light, please Yep. Next, Um, so majority of stuff were generally very satisfied with the work that they did. Um, next light next one yet so in a week. Oh, initiatives is a new domain that we've looked at only in the cycle which looks at our own individual behaviors towards environmentally sustainable changes in the workplace, which has also been very positive. Um, And then the next side and then lastly, stuff have been, you know, very supportive towards each other in trying to maintain all the sustainable behaviors that we've started to adopt in our workplace Next light. So, based on these results, if you can have the next slides, I very much believe our stuff are very inclined to support each other in the workplace. Having set that there are a few limitations to this survey. You know, we've not collected that much information in regards to confounding factors that may influence the results. Next sides onda. Also, when we're talking about the bigger picture of social sustainability in the workplace, you know, ego helping and ICO initiatives is only a very, very small portion of this. I know, Professor, um, what has already talked a lot about this um, in his talk. There are plenty of other areas where social sustainability needs to be considered, especially in things which is ethical purchasing of goods. Um, you know, maintaining well being of our stuff and also looking in regards to sustainable workforce training. Um, I guess the baseline is, you know, are in conclusion, our survey has very much shown that, um, the working relationships since well, has had a very positive impact on the changes that we've made. Um, and we'll make in the future. Um, and also, this survey has has probably open up many doors for discussions for other ways that are center can improve, improve on social Systane ability within our workplace. Um, 100 over two. Peri. No. Okay. Yeah. Thank you for that. May. Good afternoon, everyone. I'm Peri, one of the other fellows. A swell on moving on from social Systane ability. I just wanted to talk about the work we have done its improved intraoperative waste management. Here. It's well, York. So next light, please, on dissent. Compass is the environmental aspect Of the three pills that may alluded to in the orthopedic literature, waste management has been the main target improving sustainability. And this is particularly important as one third of hospital waist comes from the operating theaters in the NHS. On these offers identified that within orthopedics arthroplasty procedures are particularly baseball. They generate a high proportion of recyclable waste. We're not always correctly segregated. Next line up. These are, um Andi. So what we wanted to do was evaluate our practice here, on down in fluent ways, improve the portion of waste that could be correctly segregated in theaters on reduced avoidable waste. Where possible? Next line, please. These are the bins President outfitters so white for recycling black for normal waste and yellow for clinical waste. Onda, uh, we devise a service evaluation which was completed by six fellows who attended theater observing that the disposal of items in the packaging or so identifying whether items being open on also being used in the procedure. We perform two cycles, the first in October, a very brief cycle, and follow up one in March in April. We've been performing intervention since October. As of last year, Sex life, please. So our first cycle, as I mentioned, was a very brief snapshot cycle where we were just wanted to assess baseline practice next life easier. Six cases were observed 166 consumables Accounted martinated was that there was variability across the disposal of items Next slide. So from this checklist of items that we gathered seven out of the 26 we're being disposed of in different types of bins. Next life, please. So he wants different improve on this and we commence. Um, interventions, Improved way segregation. Also, it's a reduced waste disposal as well. So we created a poster amongst those fellows to classify recyclable waste on display them in all operating theaters here. Asthmay mentioned we started sustainability meetings on a fortnightly basis, where we were educating members of stuff and raising awareness as a whole to regarding waste disposal. We were switching to reusable items where possible on this financial benefits as well. For example, of tonic aids as professor booted already alluded to in previous talk, we also wanted to reduce preemptive open of consumables with for a hand a bird's in the morning as well. Next line, please. So this is the post that we created and displayed in or features next light, please. In our second cycle, it was much more for assessment of our practice and use a much more for a performer following the patient up from when they were being positioned or the way to them leaving the operating theater. And what's the results showed next left easier. Um, we observed 10 cases four total hips and six total knees. Around 3000 consumables were opened off which 98% were being used in the procedure, which was really good off. The items used but also disposed of in a been around three quarters were being correctly segregated. However, with recyclable items, only about 50% were being correctly recycled. What can we conclude in this very simple service evaluation that we did well? Education of staff is a simple, invaluable tool. It's promote sustainable change. We were able to quantify this by performing a quiz assessing staff members knowledge off way segregation before our interventions, but also after, and what it showed was that there was an increase to 85% knowledge of correct sister and correct way segregation knowledge. However, stuff knowledge does not necessarily translate Teo clinical practice, however, with regard to recycling and up quiz, there was an increase in 26% of correct recycling knowledge amongst our staff. However, only 50% as I mentioned, we're being recycled. So ongoing work is required. Improve recycling here, and that's what we aim to do. And there there were limitations. Admittedly, with the evaluation that we performed, the main one being that further cycle would be needed much more. For one, I'm a larger scale to see if our sustainable approach continues to be, um, continues to proceed and the way that we hope it would thank you for that on. But I'm here today to also talk about this quality improvement project that our ward team has done in reducing discharge paperwork for our patients. Next life, please. So this encompasses the environmental but also financial aspects of the three pillars. As with any elective institution, patients are discharged with a significant amount. Paperwork out Discharge Summary consistently has about four sheets. Starwars. He wants to identify a way to reduce the waist on day created on a five size a discharge card. Next line, please um which can be a seen here. Essentially, this summarizes all the key information for the patient, but also has QR codes for the patient's access. The full discharge summary but also physiotherapy. Exercise is a zoo well on, but we gain positive feedback from the patients following its inception. Next line, please. Um, so what we wanted to do was actually calculate the benefit that this would have. So we calculated the theoretical carbon foot and prayed, footprint saving that could be achieved a one year period by switching to this discharge card next life. So what we did was unlike all the patients that underwent knee arthroplasty and last year to see how many we did on stratified carbon footprint and cost saving that could be achieved from using our conventional methods versus our new method. Next, like please, over last year, we operated on about 1500 patients with the other plus D, And so what if we were to operate on another 1500 this year? What this shows is that we could achieve a carbon footprint saving over over a half from 26.9 kg to 12.6 your ethically by switching accordingly. Next slide, please room on. This can also have a carbon cost saving of around 38 lbs a year, which doesn't seem that much. But every little helps when it comes to sustainability. Next slide forward, please. Uh huh. So, in conclusion, this was just a very simple quality improvement project That was an example of how other members of the multi disciplinary team could help with the collective effort to promote sustainability in an institution like hours. Thank you for your time. Today, I'll 100 to Erin for the conclusions. And thanks very much, baby. In May And Perry, I'm just gonna give an overall summary off the work that we've been doing the southwest and, um Electively Pedic Center. So as my colleague said, that southwest uncollectable be sent to be implemented, having bi bi weekly me of meetings for sustainability and the only real aim and purpose of this was to improve sustainability, to provide strategic direction and leadership to ensure that we were meeting the environmental financial institution. Sustainability factors on dejected is we're to uphold the principles of reducing we're using on recycling. But what can we do? So what we can do. So we initiated all these different ours within this Well, not on a with the green initiatives. So this was to rethink, reduce reuse repair revamp, restore refused recycle on research on we embedded sustainability into our government structure. So now it's part of us could governance was disgusting. Like a government meetings. We have our Wednesday meetings in which multidisciplinary teams come together to discuss the different activities off sustainability that they're doing with in that department. So we have X ray department coming together. We have the ward's coming together prepared from parent. Today he's given a quality improvement project and wards of doing our physio teams have been working on, you know, every recycling equipment. So all the different departments are coming together. We don't want to discuss is that governance were adhering to the green initiatives on our aim is to become advocates for the green bean purchasing by switching to energy efficient, safer, clean, recyclable reusable products in order to reduce I are footprint. I was doing this by every processing, such a poor supplies and moving away from that throw a culture so previously hard and and to talk today about the throat culture on our aim is to guide education and power. All start members within within swelling up to about sustainability on then to advocate research into sustainability. So you'll see in the bone and Joint Journal open Doctor Food has had a paper published on sustainability. So pleased you have a root of that one that does come out on. I just, like, say that well, a lot do what? Collaboratively. Together we can meet the energies goals of becoming that zero by 2020 45 I thank you very much. And thank you. Behalf of swelling. Thank you. Thank you very much. Scrutiny in at May Perry. And here, um, for those fantastic talks cover in a while, free of the pillows of sustainability and really highlighting what a difference we can make with simple changes and in getting kind of colleagues partner organizations to thank you very much.