Saving our planet as well as our patients

How Keck Medicine is greening our operating rooms

Earth Day is coming up in April. This is a good time to think about ways we can all be more sustainable, whether we are cutting back our plastic use, rethinking how we use energy or growing food in backyard gardens. 

Keck Medicine of USC is also dedicated to sustainability. You may not think about hospitals as places that need greening, however the health care industry in the United States is responsible for 8.5% of total greenhouse gas emissions — gases that trap heat in the atmosphere and contribute to ozone layer depletion and global warming. 

Operating rooms in particular have traditionally produced relatively large amounts of greenhouse gases due to the anesthetic agents used during surgeries. Through a series of targeted initiatives, Keck Medical Center of USC has significantly and meaningfully reduced these emissions. 

Due to the leadership of anesthesiologist Arash Motamed, our medical center is the first we know of in the United States to fully discontinue the use of nitrous oxide from anesthesia practice. Nitrous oxide is a common anesthetic gas, however, it is a very potent greenhouse gas and lasts some 100 years in the atmosphere. And due to the way the gas is typically delivered to operating rooms — through a central piping system — up to 95% of the gas may leak out of the pipes before it reaches the patients, going directly into the atmosphere. 

To put this in perspective, every hour of nitrous oxide used in an operating room is equivalent to driving a gasoline-powered car 120 miles, explains Dr. Motamed, who also serves as medical director of sustainability at the health system. 

Before we eliminated nitrous oxide, we first got rid of another, more environmentally harmful gas used for anesthesia, desflurane, for which every hour of use was equivalent to 400 miles of driving. 

Today, our operating rooms use an anesthesia gas that produces only a fraction of the greenhouse gases previously released into the atmosphere with no sacrifice to patient care and perhaps, anecdotally, even an improvement in patients’ recovery time after anesthesia. 

Additionally, we’ve implemented a software upgrade that adjusts the flow of anesthesia, further reducing waste, while also saving us thousands of dollars. The technology upgrade has reduced our greenhouse gas emissions by an additional 50%. 

As a result of these initiatives, we’ve eliminated emissions equivalent to a car driving around the globe 10.7 times. 

And this isn’t the end of our sustainability efforts. We have eliminated 10,000 units of battery waste in the operating rooms and diverted 48,000 pounds of waste from biohazard disposal, which significantly lessens the impact of waste processing on our environment. 

The journey to eco-friendlier operating rooms has taken the combined efforts of Dr. Motamed and many of our health care providers, as well as sustainability leaders from across the health system and university, including Miguel Gonzalez, Angela Wan, RN, Bhavna Sharma, PhD, and Makaya Tome. 

I am grateful for their efforts and for three sustainability groups that draw on expertise from across the university: the Sustainability Steering Committee, the Keck USC Sustainability & Healthcare Initiative group and the Keck OR Sustainability Team. 

I know many of you are dedicated to helping our planet. And we can all feel good knowing that Keck Medicine is committed to not only our patients, but to our environment. 

Topics