Optimizing sustainable practices through ASCs.
By Pete Mercer
Sustainability is a hot-button topic that every organization in every industry has to reckon with right now. This is especially true for healthcare. By embracing sustainability, ASCs and other healthcare facilities can not only contribute to environmental preservation but also improve operational efficiency, reduce costs, and enhance patient satisfaction.
Repertoire Magazine recently spoke to Julie Moyle, MSN, RN, Sustainability Strategy Manager for Practice Greenhealth about sustainability in the ASC space, the misconceptions about what sustainability means, and how ASCs can implement greener practices.
About Practice Greenhealth
Practice Greenhealth is a national nonprofit that supports healthcare organizations across the country in building lasting sustainability programs. The team at Practice Greenhealth works in many areas of sustainability, but two of their core areas of focus with their healthcare partners are reducing greenhouse gas emissions and building climate resilience plans.
Through these initiatives, ASCs can work towards reducing their environmental impact and ensuring continuity of care in the face of extreme weather events or supply chain disruptions.
“We work with large healthcare systems, academic medical centers, community health centers, federally qualified health centers, clinics, and ASCs,” Moyle said. “Because the health sector’s impact on the environment is so broad, our programming is equally comprehensive, supporting partners in areas ranging from waste reduction and safer chemicals to climate action.”
Sustainability in the ASC space
As an agile player in the care continuum, ASCs are uniquely primed to foster an environment for sustainability. Because they don’t operate on a 24/7 basis, ambulatory facilities consume less energy and resources than an in-patient facility. Most close at 5 p.m. and aren’t open during the weekends, or working with emergencies after hours.
“ASCs tend to be more agile and flexible. There’s no such thing as ‘it’s not my job’ in an ASC – there is no shift coming to relieve you, so staff incentive is high to get the job done, whatever it takes,” Moyle said.
The procedures performed in ASCSs are typically less intensive than an inpatient surgery in a hospital, which helps with patient turnover and increases overall efficiency. Additionally, most of the patients are considered “walking well,” which means they are generally healthier and lower risk patients than would be seen in a traditional hospital setting. They are intentionally serving this patient population because there are no overnight stays in an ASC, thus a lower risk of any complications. This helps with patient turnover – getting healthy patients out the door improves efficiency and frees up resources and space for the next procedure.
Moyle said, “From room turnover to restocking drugs and supplies to sterile processing and familiarity with biomedical equipment: ASC nurses have a diverse skillset and an expectation that everybody is responsible for the work until the work is done.”
The misunderstood truth about sustainability
As with any major movement, there are a lot of misconceptions around sustainability, especially in healthcare. Moyle argues that a common misconception is that sustainability and climate action aren’t a priority for the healthcare industry, but this couldn’t be further from the truth.
“The climate crisis is a public health crisis and is considered the greatest public health threat of the 21st century, according to The Lancet and the WHO. The healthcare sector is on the frontline of the climate crisis, with patients bearing the shifting burden of disease attributable to climate change along with injuries and illnesses related to extreme weather events.”
Just within the last year, we have seen how drastically significant weather events can affect healthcare – many communities are still rebuilding from the devastation caused by the unprecedented dual hurricanes, Helene and Milton, in the fall of 2024.
A study conducted by Health Affairs found that the health sector is responsible for 8.5% of U.S. greenhouse gas emissions. Moyle said, “When we consider the impact of the supply chain on healthcare’s climate footprint, the energy intensity of the OR, which is three to six times more per square foot than the rest of the hospital, and the inordinate footprint of anesthesia gases, it is safe to say that operating rooms are the epicenter of the healthcare carbon footprint.”
Fortunately, the ASC model is a practical solution for reducing the carbon footprint left by these larger healthcare facilities. Outpatient surgeries allow patients to safely and efficiently receive the care that they need, while also contributing to healthcare sustainability.
Taking the next steps
Taking steps towards sustainability is better than not, so it’s important to find practical solutions for introducing sustainability into the flow of the daily processes. Sustainability strategies should be low cost, practical solutions for your current workflow.
“Implement sustainability strategies that minimize disruption and enhance workflows,” Moyle said. “For example, the process for disposing of a sharp (things like suture needles and scalpels) is the same regardless of whether you are placing the sharp in a disposable container or a reusable container with a point-of-care service. That type of change can generate cost savings from the avoided purchase of disposable containers and avoid tons of plastic from going into the regulated medical waste stream.”
One of the most important components of taking these steps towards sustainability is to take actionable steps forward – starting small can help your team to build functional, effective processes for the facility that will get you started on the right foot. Biting off more than you can chew will likely result in burnout and avoidable mistakes along the way.
“Think about past changes in the practice and what made them successful: education, signage, morning huddles, emails, update boards, and books, and perhaps a fun competition with incentives or prizes? Don’t forget to establish a baseline, share target goals, and outcomes.”
The best way for ASCs to reach sustainability goals is to ensure that everyone is on the same page. Moyle said, “Bringing staff ideas to life will not only turn on the engine of perpetual performance improvement but also enhance staff satisfaction and engagement by being a part of the solution, participating in something greater than themselves, and fulfilling their professional oaths by doing the right thing.”