Green Endoscopy Advice

Louisa Thomson
Louisa Thomson • 22 February 2024

I am an Improvement Practitioner working at the RUH, Bath.  Today, we held our relaunch of the Green Endoscopy Group.  Lots of ideas, but we are focussing on some 'quick' wins to be begin with and would appreciate advice from other teams:

1. Reduce plastic/paper Cups: we want to ask patients to bring in empty reusable drinks containers to fill after procedure.  Concerns were raised that patients may fill with water and drink prior to their 'NBM' treatment.  Has anyone tested this?

2. Replace Inko pads and bed sheets (used during upper & OGD procs) with paper equivalent where possible:  advice appreciated.  If you have CO2e for inko pads?

Many thanks - hope to hear from you soon.

Comments (11)

Lloyd Balatongan
Lloyd Balatongan

Hi Louisa, I am also thelead for Green Endoscopy champions here in RDH in Derby. Since I took over, we have made some strides that I could share to you for our GE strategy:
1. Reduce printing of unnecessary reports- we asked our endoscopists to print only 3 copies (we use Medilogik) Consultant, Patient and GP.
2. Information board, one for staff and one or patients about Green Endoscopy and our Trust sustainability strategy. Staff encouraged to write on the suggestion box for their ideas.
3. Remind staff about use of gloves and aprons, reducing those who use them unnecessarily such as checking obs, pushing trolleys etc.
4. Liaise with Trust' sustainability lead for huddles and waste management.
5. Turn off gases (CO2, Entonox) after each lists.
6. Using tap water to top up the irrigation (ask your infection control team first).
7. Swapping plastic cups to paper cups.

These are the ones we have already rolled out and we have several more actions we are currently processing. Hope this helps!

Kay Hudson
Kay Hudson

Hi Louisa and Lloyd, I am also the lead for Greener Endoscopy at WHI in Shipley West Yorkshire. We have introduced similar methods to yourselves. We have been told we can recycle Inco pads if they are not soiled with faeces or blood. After discussion with our waste department we were advised they were happy to take the following items for recycling (anything spiked obviously into sharps bin, anything soiled or infective pt into usual waste not recycling).
Recycling instruments, such as biopsy forceps, snares, mouth guards, polyp traps, water bottles, spray catheters and absorption pads (non-soiled) into recycling bins where both metals and hard plastics are allowed . It is amazing how much we send for recycling now and how the clinical waste has decreased.

Lloyd Balatongan
Lloyd Balatongan

I have contacted a rep in Boston Scientific who kindly referred us to their Sustainability officer. Will meet them on June at the BSG so we could get some recycling plan for our unit. Currently, anything with tissue samples on are not allowed to be recycled in our Trust.

Louisa Thomson
Louisa Thomson

Thank you both. Very helpful. Out of interest, have you calculated any carbon footprint savings so far? We would be keen to collate a list of items and their associated carbon footprint to calculate environmental savings (alongside financial and social). Would be great to share across the network.

Kay Hudson
Kay Hudson

Hi again, we have not as yet. We have only started with the greener endoscopy 2 weeks ago. I know the savings in terms of recycling bags compared to tiger bags is massive so it be interesting.

Melissa  Pegg
Melissa Pegg

I did an eLCA comparing single use flexible rhinolarygoscopes versus a reusable equivalent (in the outpatient setting) for Scottish Health Technologies Group (SHTG) due to be published soon. This was alongside a cost effectiveness analysis. The first HTA in the UK to include an environmental assessment alongside health economics analysis. I will post on here once it becomes available. Kind regards, Mel

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