Assessing the environmental, human health, and economic impacts of reprocessed medical devices in a Phoenix hospital's supply chain

Abstract Given increasing healthcare costs and decreasing insurance reimbursements, healthcare administrators are now assessing innovative opportunities for optimizing their medical device supply chains. Reprocessed medical devices are receiving increased attention because of their twofold reduction to costs associated with reductions to purchase cost of devices and reductions to regulated medical waste (RMW) costs. From an environmental standpoint, an increasing number of studies are assessing the environmental impacts of medical devices and the processes by which they are utilized. These studies report significant environmental impacts with respect to how medical devices are manufactured, used, and disposed. In turn, these studies also discuss the potential human health impacts with respect to medical devices and their associated lifecycles. Despite a wide variety of devices suitable for reprocessing, to date there have been no studies that evaluate the potential economic and environmental benefits of a reprocessed device. Additionally, there have been no hospital-wide environmental and/or economic assessments of reprocessed devices. The aim of this study was to fill these knowledge gaps by using life cycle assessment (LCA) and life cycle cost assessment (LCCA) to model the environmental and economic impacts of medical device supply chains when varying levels of reprocessed devices are used at Phoenix Baptist Hospital (PBH) in Phoenix, Arizona. The LCA included all cradle-to-grave processes for the seven medical devices. Results of the study showed that if inputs (i.e., ethylene oxide, water, electricity) were optimized, the use of reprocessed devices offers global warming, human health, and economic benefits over the same devices used as disposables. On the other hand, the excessive use of inputs correlated with reprocessed devices having greater overall environmental and human health impacts than disposable medical devices. Additionally, whether used as a SUD (single-use devices) or a reprocessed device, the use of DVT (deep vein thrombosis) compression sleeves corresponded with the highest environmental impacts when devices were compared one-toone. The DVT compression sleeves were comprised of mostly woven cotton; which is a material associated with significant environmental and human health impacts, resulting from its large quantities of lifecycle inputs. This study recommends that the significant proportion of woven cotton in DVT compression sleeves be reduced for a material with less of an overall environmental footprint.