Resource title: Assessing the financial and environmental impact of sending phlebotomy trays for unnecessary external steam sterilisation, sexual health team

Project completed as part of the 2023-4 Sheffield Teaching Hospitals Green Team Competition.

Team members: Rachel Darling, Health Adviser

Setting / patent group: sexual health outpatient clinics

Issue:

The sexual health team use blue phlebotomy trays to temporarily store components required to collect patient samples and to place treatments prior to administration. These trays have historically been sent for weekly steam sterilisation. The rationale for this was unclear. Intervention: To stop unnecessary sterilisation of phlebotomy trays in the sexual health unit, by implementing a change to department policy. We reviewed our current practice and confirmed with Infection Control that there was no barrier to stopping this process in favour of cleaning in the clinic.

Outcomes

Clinical/social: Previously there were delays to patient care as staff members had to unpackage newly received blue trays to undertake sampling. Trays are now cleaned with tristel and cloth which were already available within each clinic room and are ready for use at the start of each clinic session.

15 staff members completed the staff survey from 36 eligible clinicians ranging from Support Workers to Consultants. 80% of these team members were agreeable to stopping sending trays for external sterilisation. As the response was not unanimous, I have explained to staff that it has been agreed by infection control that we do not require steam sterilisation and I am available to discuss this further should anyone have any concerns 73% of team members responded that they were very concerned about waste and the environmental impact of our care. 6% were sometimes concerned while 20% had never considered it.

Environmental: 13 trays are sent for sterilisation per week, equating to 21.48 kgCO2e. Projected across a year, this is a saving of 676 trays sent and 1,116.75 kgCO2e. This is equivalent to driving 3,298 miles in an average car. Ending this cleaning will prolong the lifespan of the trays which have been warped and damaged from the sterilisation process, which may lead to additional savings.

Financial: The change has been cost neutral as the department already pays a minimum charge for sterilisation requirements.

Key learning point

This is a very simple change of a practice, challenging an unnecessary process that continued only because it was seen as "routine". Although a small project, it can hopefully be the start of positive change in the clinic. This change required staff engagement, and has brought around a real boost to morale within clinic. Multiple staff members approached me acknowledging how we were moving forward with common sense sustainability plans in clinic. There is a passion at SHS for continuing to question our practices and develop them and I have been approached with further areas for improvement.