Abstract
Technical Project Abstract:
Hospitals in the United States generate over six million tons of waste each year, with a large portion coming from single-use metal instruments (Jain & LaBeaud, 2022). At University of Virginia Health, the Emergency Department (ED) relies heavily on single-use metal tools, most of which are made from recyclable stainless steel. Yet, these tools are still discarded into sharps containers and landfilled, instead of being scrapped and reused. My capstone project aimed to create and implement a novel pilot recycling program for single-use metal instruments in the UVA ED to evaluate the environmental and operational viability of diverting waste. Our team performed an assessment of current ED disposal practices, interviewed key hospital stakeholders including surgeons, sterilization staff, and nurses, as well as receiving IRB approval to distribute an ED wide survey. The pilot program was developed to run around two weeks and involve the collection of discarded instruments in a recycling bin with proper signage, cleaning in a STERIS washer-disinfector, and transportation to a local scrap metal facility, Gerdau Metal Recycling. Data collected from the pilot, which included instrument weight, type, and count, will be analyzed to determine the pilot’s effectiveness and help shape next steps for broader implementation at UVA Health. Furthermore, our capstone also considered cost implication and sustainability metrics from a prior capstone groups life cycle assessment (LCA), which determined that hospitals could save ~$2500 per 500 uses and reduce CO2 emissions by 146 kg by switching from single-use to reusable instruments (McComb et al., 2024). By running trials on an intermediate recycling system, this project presents a scalable and feasible solution that reduces negative environmental impact and creates a foundation for future transitions toward reusable medical instrument systems.
STS Project Abstract:
Despite increasing awareness of the environmental harm caused by healthcare waste, the use of single-use instruments in hospitals remains extensive. My STS project focuses on investigating the sociotechnical barriers that prevent healthcare institutions from adopting more sustainable practices, focusing mainly on why single-use metal instruments are favored by all emergency departments including UVA Health, even though their harm is evident. Using the Social Construction of Technology (SCOT) framework, I argue that sustainability efforts in hospitals are not only shaped by environmental awareness and technical feasibility, but by social, institutional and cultural complexities that inhibit systematic change. Specifically, differing priorities between procurement and clinical staff, fret of changing inertia of current workflows, and sterilization doubts, all are reasons why significant change has yet to be made. Through interviews with surgeons, nurses, and sterilization specialists, as well as a deep dive into hospital procurement processes and waste disposal methods, I found that even when individuals were receptive to adopting more sustainable practices, they stated that broader institutional standards left them feeling unsupported. These stakeholder feelings coupled with uncertainty about cost and safety, all lead to a culture that is resistant to change. While most sustainability talks in healthcare focus on more energy efficient technology or eco-friendly materials, my paper highlights that without collaboration across every stakeholder group, even the most technically favorable solutions will not become commonplace. This project emphasizes the need for hospitals to not just address the instruments they use, but the networks of people, processes, and priorities that shape how waste is created and disposed of in the first place.
