Title : Cutting cost without cutting care
Abstract:
Healthcare systems face growing concerns regarding environmental pollution, operational inefficiencies, and rising costs, all of which are exacerbated by excessive waste. Single-use medical supplies, such as non-invasive blood pressure (NIBP) cuffs, contribute significantly to both waste and unnecessary spending, especially in perioperative settings. This nurse-driven initiative, which began in October 2024 at UCLA Health's outpatient surgery center, aimed to address these issues by transitioning from disposable to reusable NIBP cuffs. The project sought to reduce waste, cut healthcare expenditures, and improve sustainability, while maintaining high standards of patient care. At the heart of this project was the identification of substantial waste in the form of disposable NIBP cuffs, which were used excessively in the perioperative environment. These cuffs added to supply costs and contributed to landfill waste. The nurses recognized the potential for change and switched to a reusable NIBP cuffs as a solution. Lean methodology and the Plan-Do-Check-Act (PDCA) cycle were employed to assess current practices, engage key stakeholders, and guide the transition to reusable cuffs. The initiative began with the transition from disposable to reusable NIBP cuffs in the Postanesthesia Care Unit (PACU). Key interventions included developing cleaning and storage protocols, securing necessary approvals, and providing education to staff through in-service sessions and visual reminders. The use of reusable cuffs was limited to adult patients, with exceptions made for pediatric, extra-large, and isolation cases. Staff feedback was positive, with 95% of physicians, nurses and other clinicians reporting that reusable cuffs maintained patient safety and quality standards. Financially, the project yielded impressive results. By switching to reusable NIBP cuffs, the surgery center saved $1,283 per month, totaling $15,400 annually in supply costs. The total annual cost of the 120 reusable cuffs purchased for the year amounted to $2,916, which was far lower than the cost of disposables. Additionally, the shift helped divert approximately 912 pounds of waste from landfills annually. The savings and waste reduction observed in the pilot phase led to plans for scaling the initiative across the entire UCLA Health system. The success of this initiative was not only measured in cost savings and waste diversion but also in its impact on hospital-wide practices. The project was eventually adopted as a standard practice at UCLA's outpatient surgery center. The positive outcomes of the initiative prompted presentations to various committees within UCLA Health, and several outpatient departments reached out for guidance on replicating the process within their own areas. The results of this nurse-led project clearly demonstrate the potential of sustainability efforts in healthcare. Nurse-driven changes, when supported by multidisciplinary teams, can lead to significant cost savings and environmental benefits without compromising patient care. As the project continues to expand, future research should explore opportunities to scale similar initiatives across other areas of healthcare to further reduce waste, enhance cost-effectiveness, and promote sustainability in nursing practice.
