At Yale-New Haven Hospital, this problem caught the attention of Dr. William H. Rosenblatt, assistant professor of anesthesiology. In 1991, Rosenblatt began shipping items from Yale-New Haven to a hospital in Leon, Nicaragua, New Haven's sister city. Today, the grassroots movement which started in Rosenblatt's office has grown into a non-profit global outreach program involving over 60 hospitals.
Once medical supplies, such as sutures, bandages, and rubber gloves make a trip to the operating room, they are no longer covered under most manufacturers' warranties, even if they are not used. Due to possible contamination and the threat of liability lawsuits, the medical supplies are discarded. Even if the operation were canceled and the supplies never removed from their packaging, these materials are thrown out and incinerated.
Rosenblatt's system for limiting this waste is simple. When hospitals prepare for an operation, they maintain a surplus of supplies as a cautionary measure. If these extra materials go unused, nurses place them in paper bags following the operation. Subsequently, they are collected, resterilized, and shipped to other countries. Never-opened stockroom surplus is also reused in this fashion. These materials that would have otherwise been incinerated are used in developing nations.
The system has proven to be highly economical as well. Rosenblatt proposed, in addition to the donations, a re-examination of preparation procedures which pointed out many ways to reduce waste at their source. By avoiding excess supplies, Yale-New Haven operating rooms were able to cut waste by 30 to 40 percent, saving the hospital $200,000 to $250,000 per year in purchasing and waste disposal costs. In contrast, the program's total operational cost is just $600.
Rosenblatt's inspiration for Remedy, Inc. began with several trips he made to underprivileged third-world countries with Interplast, a volunteer organization which provides plastic surgery to patients with congenital facial deformities. Of those frequent trips to Central America, Rosenblatt recalls performing surgery under unimaginable conditions. "We were using only the materials we brought with us. You would do things that you would never do here in the United States," Rosenblatt said. "You would reuse the same supplies over and over. Returning to Yale, what was very striking was that things desperately needed in these other countries were being thrown out in bucketfuls everyday."
At Yale-New Haven, nurses, doctors, and administrators openly support the system. "It's become a systematized program. Now it's part of the routine of nurses in the O.R. What we want to do now is become teachers of the program," Rosenblatt said. With this aim in mind, Rosenblatt and his colleague Dr. David Silverman organized Recovered Medical Equipment for the Developing World, known as Remedy, Inc.
Remedy, Inc. helps other hospitals develop similar programs with a teaching kit, which includes an explanation of the procedure, information for nurses, and pertinent protocol and policies. "We've even included several paper bags in the kit to let people know that they can start this program right away - that all you need are paper bags to get started," Rosenblatt said. Remedy Inc.'s popularity has grown rapidly due to hospitals' desire to eliminate excess costs. Although this would seem to limit the amount of surplus available for donations, Rosenblatt says this is not the case. "Some have called this the Shoot-Remedy-in-the-Foot Program," Rosenblatt said, "but by demonstrating this cost-effective method, we were able to attract a larger crowd."
Today, hospitals from Rochester, Louisville, Boston, Indianapolis, and San Diego participate in the program. In addition, institutions in Japan and Australia follow the Remedy Inc. guidelines. Since the hospitals are free to choose where they send their supplies and are responsible for shipping the materials themselves, Remedy, Inc.'s only role is to help form a liaison between the hospital and a given city.
The program's growing popularity has caught the attention of the national media, spurring greater interest in the health care industry. Rosenblatt and the recovery program at Yale-New Haven were recently featured in the New York Times and on Associated Press TV. Although all the fuss crowds his hectic schedule, Rosenblatt will continue to work on behalf of Remedy, Inc. "It's exactly what we need," he said. "I can't tell you how many hospitals and nursing institutions have called showing interest. It's tremendous," he said.
Copyright 1995, The Yale Herald, Inc. All rights reserved.
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