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Cost consciousness is becoming increasingly important for anesthesiology practice. Supply, drug, and gas waste are all areas where significant improvement in waste and cost reduction can be made.
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Anesthesiologists should understand the environmental impact of their practice in order to make appropriate choices for supply and gas use. These choices may reduce environmental hazards, improve global health, and decrease health care costs.
Ecological and Economical Practice for Anesthesiologists
Section snippets
Key points
In the interest of patient safety, many would likely argue
Disposable supply waste
Patient safety, ease of use, and purchase and maintenance costs are all factors that influence the selection and purchase of medical supplies. Disposable devices are increasingly replacing reusable devices in the United States and elsewhere [3]. Provider preference is often based on apparent convenience or qualitative marketing claims, which do not reflect the available scientific information [5]. This is challenging especially in light of the few modern studies that compare reusable with
Pharmaceutical waste
Another area with potential for significant waste and cost reduction is in the use of pharmaceuticals. Again, the potential cost containment must not come at the expense of patient safety or reduction in quality of care. However, an awareness of pricing and the usage of certain typical sterile injectable drugs can significantly reduce cost without negatively impacting patient care [1], [9], [10]. Price labeling of muscle relaxants combined with the education of providers in a study from 1998
Inhalational anesthetic gas waste
All currently used inhalational anesthetics (halogenated compounds and nitrous oxide [N2O]) are known to be destructive to the ozone layer [11]. The fact that they are used in relatively small amounts (compared with global carbon dioxide [CO2] emissions) and are deemed medically necessary has led to a paucity of investigations in this area [12]. This information is not at all new; in fact, the first published warning of ozone-layer destruction by anesthetic gasses was in 1975 [11]. There are
Future practice
With the current uncertainty regarding the future of health care compensation, it is important for anesthesiologists to be aware of ways to improve the economy of their practice. This economical interest is in harmony with a global health endeavor of reducing pollution of our environment. Using anesthesia practices that reduce waste overall is beneficial toward reaching both goals.
Because of the infection and contamination concerns, supply recycling may not be as viable of an option in the
Acknowledgments
The author would like to acknowledge Joel O. Johnson, MD, PhD, for his advice and editing.
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Cited by (3)
Lean Six Sigma and anesthesia
2019, Brazilian Journal of Anesthesiology
Funding Sources: University of Wisconsin and University of Wisconsin Medical Foundation.
Conflict of Interest: None.
Copyright © 2013 Elsevier Inc. All rights reserved.