theatre nurse promotes green theatre making a caring gesture with hands

The most impactful thing you can do to lower CO2 emissions of your OR

Else de Ridder - Green Care Academy

There are many things you can change in your OR to make it more sustainable (as is evident from the previous blog post, listing 10 (!) things you can do to green your OR). But what is the most impactful thing you can do? 

In this blogpost, I explore how energy consumption can be lowered in the OR. Energy consumption is responsible for about half of the hospital’s footprint. All other processes combined, such as transportation, medication and waste, make up the other 50%. This large impact makes energy consumption an excellent candidate to explore when making the OR more sustainable. One process in the OR is responsible for 90-99% of the energy consumption in the OR department. Optimising this process will immediately save you a lot of CO2 and money! Easy!

To explore this topic, I talked with Niek Sperna Weiland, anesthesiologist at the Amsterdam UMC.

So what is this magical process?

By now you’re probably wondering which process I’m talking about. In the OR, the heating, ventilation and air conditioning (HVAC) system is responsible for about 50% of the OR’s footprint. This system is responsible for filtering, cooling, and heating the air in the OR. Most of these systems run 24/7. They are never switched off. This means that for 24 hours a day, 365 days a year, these systems are providing clean, filtered air to every OR, even when it’s not being used. Switching the system to a lower level of air treatment at night, can decrease the CO2 emissions substantially. Actually, it is one of the most effective measures you can take to lower the CO2 emissions of the OR.

Niek: “By turning the air treatment system down to a lower level for 15 of the 20 ORs at night, we save 400.000 kWh per year. This is equivalent to the amount of energy used by 100 households in one year. This also saves us €40.000 on a yearly basis. This is an excellent way to show that sustainable solutions don’t always have to cost you money - they can save the hospital a lot of money as well!”

Is my system suitable for this?

First, check with building maintenance which system your OR uses. Maybe it is already at a lower level during the night. Maybe your system is not suitable for this. This is sometimes the case with older systems.

Niek: “We knew what a substantial impact this could have on greening our OR. So our Green Team worked together with the building department to discuss the possibilities. We found out that a new system was installed a few years back. This system could be easily adjusted to provide a lower level of air treatment to the OR at night and on weekends.”

Emergency c-sections

In order to always have an OR ready for emergency procedures, it is advised to turn down the air treatment system for some ORs, but not all. 

Niek: “Safety is our top priority in the OR. Therefore, the air treatment system is at a lower rate for 15 of the 20 ORs at night. This means that, in case of an emergency, 5 ORs are always ready to use. In the remaining 15 ORs, the air quality is back to the guideline’s level after 20 minutes. These features also increased the acceptability of this change among the OR personnel.”

How to get started

The air treatment system is a complex process. Many different stakeholders are involved: building management, infection prevention, IT, medical personnel. The first thing to do when starting this project, is to get all the involved stakeholders together. 

Niek: “Have realistic expectations. At first, we thought that the air treatment system for all 20 ORs could be turned off completely at night. In the end, this was neither safe nor practical. Nevertheless, we are very happy with the result we have achieved by implementing this measure.”

Want to learn more about how to set up a team for such projects? This is explored in-depth during the Green Team workshop. The next workshop will be held on Monday October 18th, 2021. Sign up here: https://greencareacademy.nl/shop/Green-Team-Workshop-p285368386