Walter Reed National Military Medical Center, BETHESDA, MD  –   Walter Reed again received the 2024 Greenhealth Partner for Change Award, and the 2024 Greening the OR Recognition Award from Practice Greenhealth.

Practice Greenhealth describes itself as “the nation’s leading organization dedicated to environmental sustainability in health, delivering environmental solutions to more than 1,000 U.S. hospitals and health systems.”

According to Practice Greenhealth, the Partner for Change Award “recognizes superior performance in environmental sustainability, covering a range of different sustainability programs and activities. Winners have also made substantial progress on mercury elimination.”
The Greening the OR Recognition Award “honors facilities that have made substantial progress in reducing the impact of the surgical environment,” Practice Greenhealth explains.

Last year, Walter Reed earned the Greenhealth Partner for Change Award for its “ongoing commitment to improving its environmental performance and efforts to build sustainability and resiliency into the medical center’s operations and culture,” explained Army Maj. (Dr.) Renuka Rees, a pediatrician previously assigned to Walter Reed during last year’s award rating period who was also instrumental in helping to stand up Walter Reed’s diverse sustainability team. She said Walter Reed earned for its continuous strides in health-care sustainability. Rees is now chief of the Pediatric Clinic at Brooke Army Medical Center in Texas.

Walter Reed sustainability team includes members from the hospital’s facilities staff consisting of engineering and construction, housekeeping, hazardous materials, regulated waste management, and operations and maintenance. The team also includes individuals from Walter Reed’s Nutrition Services, Operating Room (OR), and other activities. Naval Facilities Engineering Systems Command’s (NAVFAC) utilities and waste management staff members are also on the team.

“Whether it is increasing awareness of the sustainability committee, providing education on the relationship between health care and the environment, or changing practices to help reduce the hospital’s environmental impact, Walter Reed continued to make strides in health-care sustainability,” Rees added. She explained that Walter Reed’s OR and anesthesia team played major roles in the medical center receiving this year’s awards. “I appreciate all of [their] hard work in making the ORs more sustainable. Their ideas and determination helped Walter Reed earn the [awards].”

Rees said the OR and anesthesia team “deserve huge kudos for reducing the use of desflurane in the OR. By taking a number of desflurane vaporizers out of the OR, paired with education on [desflurane’s] negative environmental impact, this helped reduce [its] use.”

“The award is a testament to our commitment in implementing environmentally responsible practices and reducing our ecological footprint,” added Army Lt. Col. Angela Howell, department chief of Perioperative Nursing Service at Walter Reed.

“One of the major initiatives we have implemented in our operating room is the smoke-free initiative,” Howell added. The primary reason behind implementing the smoke-free operating room is to address health risks associated with surgical smoke,” she continued.

“During approximately 80 to 95 percent of surgeries, electrosurgical devices are used to cut tissue. Unfortunately, the use of these energy-generating devices results in the production of smoke, which contains chemicals. Studies have shown that exposure to surgical smoke can have significant health implications. One study found that exposure to surgical smoke is equivalent to smoking 27 to 30 unfiltered cigarettes, while another study reported that cauterization of just one gram of tissue is equivalent to smoking six to 10 unfiltered cigarettes,” Howell explained.
She said Walter Reed and the OR staff are taking proactive measures to eliminate surgical smoke, including implementing effective smoke evacuation systems and other practices to ensure the safety and well-being of patients and staff.

“By working with the Quality Directorate, we can further enhance our smoke-free initiative,” Howell added.

Howell explained that other measures being taken in the OR to promote sustainability include waste diversion, waste collection and cost avoidance.

“Waste diverted and waste collected focus on items not going to the landfill but given a second life, meaning that items are collected for reprocessing in the carbon neutrality of our supply chain through the use of a device with a lower carbon footprint,” Howell shared. The total pounds diverted in 2023 was 800 pounds, resulting in a reduction of 1,476 metric tons of CO2. Types of waste collected include various items such as pulse oximeters, sequential compression sleeves, pneumatic tourniquet cuffs, EDG leads and cables, hysteroscopic tissue removal, laparoscopic ligatures, trocars, suture passers, and ultrasonic scalpels.”

“Cost savings come as a result of OR purchases of reprocessed items such as tourniquet cuffs, [special tissue removal devices] and ligatures. This is a direct correlation to decreasing operational costs for the facility. The total potential savings based on all items collected is about $130,000 a year. In 2023, Walter Reed purchased about $25,000, meaning Walter Reed still has $120,000 in operational cost savings yet to be realized,” Howell explained.

“I recommend the entire facility be engaged in the recycling initiatives,” Howell added. She explained that this can be done by increasing the number of recycling bins throughout the facility so patients, staff, and visitors can recycle bottles, cans, glasses, and other recyclables. She added that while Walter Reed has made efforts to improve sustainability, more can be done. “It is my belief that every department should recycle. Our planet needs us to recycle,” Howell stated.