While taking care of the population’s health, hospitals generate mountains of waste, which in turn causes a hazard to the environment of the population. The operating room is responsible for a disproportionately big amount of hospital waste. This research aims to investigate waste creation in the operating room in order to identify design opportunities to support waste reduction according to the circular economy. Eight observations and five expert interviews were conducted in a large sized hospital. The hospital’s waste infrastructure, management, and sterilization department were mapped out. Findings are that washable towels and operation instruments are reused; paper, cardboard, and specific fabric are being recycled; and (non-)hazardous medical waste is being incinerated. Observation results and literature findings are largely comparable, stating that covering sheets of the operation bed, sterile clothing, sterile packaging, and department-specific products are as well the most used and discarded. The research also identified two waste hotspots: the logistical packaging (tertiary, secondary, and primary) of products and incorrect sorting between hazardous and non-hazardous medical waste. Design opportunities include optimization of recycling and increased use of reusables. Reuse is the preferred method, more specifically by exploring the possibilities of reuse of textiles, consumables, and packaging.

Though the transition from disposable to reusable surgical gowns holds substantial promise, successful implementation faces challenges. This study investigated tactile and thermophysiological comfort in surgical reusable gowns, comparing them with their disposable counterparts. Parameters such as surface roughness, compression, heat flux, and material rigidity were tested using a Fabric Touch Tester. Additionally, the water vapour permeability and static charge of the gowns were assessed. Thermophysiological comfort of the gowns was evaluated by measuring the temperature and relative humidity (RH) on test subjects during wear trials where they were engaged in an activity that mimics a surgeon’s performance. Skin temperature was monitored using iButton sensors and a thermal camera, and the impact on heart rate during the task was analysed. Following each test, participants provided subjective feedback through a questionnaire. The results indicated that reusable gowns boasted a smoother texture, translating to reduced friction on the skin and better heat transfer compared to the disposable fabrics, as indicated using FTT. They also exhibited higher water vapour permeability compared to their disposable counterparts. The wear trials revealed minimal differences in comfort between disposable and reusable gowns. While performing the activity, an increase in body temperature led to decreased RH, yet this rise did not adversely affect subject comfort, as validated using heart rate and questionnaire survey data. From a comfort point of view, switching from disposable to reusable gowns would not have drawbacks, meaning hospitals should be able to switch provided logistics and costs can be managed.

In the transition towards a circular economy, also critical sectors such as the healthcare sector need to be reviewed. A large portion of hospital waste consists of low-value, disposable consumables. Currently, the circular design strategies of reuse, maintenance, and repair in healthcare are predominantly applied to high-value products. This study proposes four reuse value-chain models specifically for small, low-cost medical consumables. Reuse models are distinguished on reprocessing location (internal or external) and product usage (shared or personal). Business model evaluation and value propositioning are used to gain understanding of the models and a co-creation session with a MedTech company verified these understandings. Our research sought to support manufacturers of reusable medical products by addressing the importance of the fit between the reuse model and the hospital’s context (location, infrastructure, staffing, organisational structure, product volume and type). These context features, as well as the hospital’s interest in reusable products should be documented in the tendering documents of the purchasing process. Internal reprocessing makes the hospital more self-sufficient but requires additional staffing for reprocessing and quality control. External reprocessing decreases the hospital’s workload, but requires the involvement of additional service partners. For all reuse models, continuous communication and collaboration (feedback, training and guidance) between the hospital and value-chain partners are vital.

Purpose: Health organizations play a critical role in society, but they also contribute significantly to global carbon emissions. This study examines the adoption of reusable surgical gowns to reduce operating room waste and emissions. Methods: Two surveys (n_A = 146 and n_B = 55) and a pilot test in two Belgian university hospitals (Antwerp and Ghent) are conducted to assess operating room healthcare professionals’ (HCP) willingness to reuse (adoption intention), and how expectations and evaluation can influence the adoption of reusable gowns. A between-subject design compared perceptions of HCP without recent experience with reusable gowns (HCP A) and participants in a wearing test (HCP B). Results: It was found that participants of the pilot test had greater adoption intention than HCP without recent experience. Moreover, HCP with higher expectations about reusable gowns were also more willing to adopt. Misconceptions about reusable gowns being old-fashioned or inferior were common among those unwilling to adopt. Currently, HCP have lower expectations about reusable gowns compared to the disposables in use, in terms of trust in protection, comfort and usability. However, participants of the pilot test evaluated their trust in protective properties higher than what HCP without wearing the gown had initially expected. Conclusion: Information campaigns on reusables in healthcare and educational insights on their safe use can improve perceptions about reusable gowns as a safe and high-quality alternative. This study’s findings may guide legislative efforts and hospital managers to promote sustainable healthcare practices. Fostering bottom-up readiness among HCPs may influence the hospital’s procurement process. Additionally, further improving the design of reusable products can optimize the user satisfaction. Plain Language Summary: Hospitals and other healthcare organizations are important for our well-being, but they also create a lot of waste. One way to reduce this waste is by using reusable products, like surgical gowns. This study looked at how healthcare professionals feel about using reusable surgical gowns. The researchers: 1) Asked healthcare professionals in the operating room to fill out a survey; 2) Carried out a wearing test where healthcare professionals wore reusable surgical gowns during their shift; 3) Asked the participants of the wearing test to fill out a survey. Here is what they found:People who wore the gowns were more likely to want to use them again.If healthcare professionals expected the gowns to be comfortable and protective, they were more open to using them.Some people who had not tried reusable gowns thought they were old-fashioned or not as good.After trying them, many healthcare professionals trusted the gowns more than they expected to. Sharing clear information and giving people the chance to try reusable gowns can help change opinions. Better design of reusable products can also make them more comfortable and easier to use. These steps can support a shift toward more sustainable choices in healthcare.

This study surveyed 190 healthcare professionals to examine attitudes towards reusable surgical gowns, aiming to reduce medical waste. Comfort (scoring 5.32 out of 7) and misconceptions about gowns serving as personal protective equipment (87% hold this belief) are crucial influencers. External motivators, trust, emotions, and workload also impact perceptions. The study recommends enhancing reusable gown design for comfort, multifunctionality, and hygiene trust. It calls for communication strategies to normalise reusables in healthcare and urges a transition to sustainable practices.

Hospitals have a significant impact on the environment due to their size, energy-intensive processes, consumption of resources and waste generation. A trend of increased reusable products usage and so re-sterilized products is becoming visible. Nevertheless, reusable products have to compete with the added values of single use regarding convenience, effort and costs. Although the concept of reusable sterile surgical instrument sets seems valuable to reduce resource consumption compared to single-use instruments, their use is threatened by multiple inefficiencies. This case study aims to understand why the sterile sets usage is not optimal, what the consequences are for the various departments, what journey they take within the hospital, and how communication occurs regarding these sets. Observations and in-depth interviews were conducted in operation rooms, central sterilization department and the healthcare logistics department of a large sized university hospital. This led to a roadmap of the sterile surgical instrument sets within the hospital through each department involved. Using the roadmap, several critical points are discussed to design optimal reuse contexts in hospitals. In sum, we found that sets are often incomplete due to (i) a lack of turnover time for checking completeness, (ii) difficulty of recognizing specific instruments based on their name, (iii) lack of a good communication system to communicate incompleteness. Additional unwanted waste is created due to (iv) extra sets that are opened as a precaution for missing instruments, (v) unused instruments are thrown away or re-sterilized, (vi) broken sterility due to storage problems, which requires repackaging and re-sterilization.