Multicenter study protocol on clinical, environmental, and economic outcomes of hybrid versus disposable surgical trays (project rEUsable)

International Journal of Surgery Protocols, vol. 30, pp. 7–13

Abstract

Climate change threatens global health, while health care contributes significantly to emissions and waste. In the Netherlands, the sector produces 7% of national CO₂ emissions and 4% of waste. Operating rooms account for 20%–30% of hospital waste, mainly from disposable surgical trays. Reusable trays could reduce this impact, but adoption is hindered by financial and behavioral barriers. A system-wide switch could lower costs through scale effects, yet evidence on environmental and financial feasibility remains limited. This multicenter study compares the environmental impact and costs of hybrid (including reusable drapes and gowns) versus disposable procedure trays using Life Cycle Assessment and Health Technology Assessment (HTA). Environmental impact across 17 categories will be monetized, integrating sustainability into economic evaluation to inform health policy decisions. Results will be reported from an EU perspective. Data from three Dutch hospitals will be collected on tray use, costs, and acceptance among health care professionals. The study analyses 3 × 150 surgical cases to assess sustainability, economic feasibility, and implementability. Key deliverables include developing sustainable procedure trays and a piloted method to integrate environmental aspects into HTA, supporting sustainable health care innovation. The project will also produce an EU policy brief to guide hospitals in adopting reusable trays, highlighting environmental and economic benefits. Finally, it will provide insights into promoting acceptance and adoption of reusables to advance sustainable clinical practices.

Authors 10

1. Florine I de Haes

   Amsterdam University Medical Centers

   Affiliation as printed

   Center for Sustainable Healthcare, Amsterdam UMC, Amsterdam, Netherlands

2. Marit van Barreveld

   Amsterdam University Medical Centers · University of Amsterdam

   Affiliation as printed

   Center for Sustainable Healthcare, Amsterdam UMC, Amsterdam, Netherlands

   Department of Epidemiology and Data Science, Amsterdam UMC - University of Amsterdam, Amsterdam, Netherlands

3. Nicolaas H. Sperna Weiland

   Amsterdam University Medical Centers

   Affiliation as printed

   Center for Sustainable Healthcare, Amsterdam UMC, Amsterdam, Netherlands

   Department of Anesthesiology, Amsterdam UMC, Amsterdam, Netherlands

4. Wouter J.K. Hehenkamp

   Amsterdam University Medical Centers

   Affiliation as printed

   Center for Sustainable Healthcare, Amsterdam UMC, Amsterdam, Netherlands

   Department of Gynecology, Amsterdam UMC, Amsterdam, Netherlands

5. Marianne Dougle

   OLVG

   Affiliation as printed

   Department of Anesthesiology, OLVG, Amsterdam, Netherlands

6. Anne Catherine van der Eijk Aachen Central Sterile Supply Department

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Central Sterile Supply Department, Leiden University Medical Centre, Leiden, Netherlands

7. Oliver Findl

   Vienna Institute for Research in Ocular Surgery

   Affiliation as printed

   Vienna Institute for Research in Ocular Surgery, Vienna, Austria

8. Monique Chambon

   University of Amsterdam

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands

9. Frenk van Harreveld

   University of Amsterdam

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, Netherlands

10. Dorien A. Salentijn corresponding

    Amsterdam University Medical Centers · University of Amsterdam

    Affiliation as printed

    Center for Sustainable Healthcare, Amsterdam UMC, Amsterdam, Netherlands

    Department of Epidemiology and Data Science, Amsterdam UMC - University of Amsterdam, Amsterdam, Netherlands

    Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands