Best Practices: Improve device reprocessing through collaborative learning

Five years ago, medical-device maker Ethicon acquired Sterilmed, a company that reprocesses and remanufactures medical devices. The combination helped Ethicon executives recognize the cost-efficiency and environmental benefits that could come from better reprocessing services and more collaboration with healthcare providers.

So Ethicon signed a long-term agreement in September with Salt Lake City-based Intermountain Healthcare, which is well-known in the industry for innovative supply chain practices. Intermountain is working with Ethicon, a subsidiary of Johnson & Johnson, to improve sustainability in a circular approach. Each is assessing the other's processes to find opportunities for improvement.

Reprocessed devices generally cost between 40% and 50% less than new products, according to Kathy Werner, a director with FTI Consulting. The firm encourages hospitals to reprocess any device that can be guaranteed to match the quality of a new product, but that's not happening everywhere. “We don't have them all reprocessing as much as we'd like them to be,” said Werner, who has a background in nursing.

Through the Ethicon partnership, Intermountain has learned how technicians can improve device cleaning to ensure they're in good condition when being sent out to be reprocessed.

Ethicon, meanwhile, is learning how to better design and manufacture devices to prolong their use and allow for more efficient reprocessing by Sterilmed. Both companies are also looking to improve sustainability in packaging.

Ethicon says it now has similar partnerships with more than 20 hospitals and health systems.

But reprocessing has its limits. Overreliance on the procedure can leave supply shelves empty if not enough products arrive at the reprocessor in good condition. That's an opportunity for collaborative learning to drive efficiencies and savings for both sides.

Making sure reprocessing is consistent across a hospital's departments depends on active participation from doctors, who may be unwilling to use reprocessed devices after one negative experience or because they're getting pressure from a manufacturer to buy new products, said Sudhi Rao, a managing director in FTI's health solutions practice.

In that case, providers and vendors must underscore the quality of the reprocessed supplies.

Some have suggested hospitals should charge less for a procedure if a reprocessed product is used, Rao said. But most chief financial officers have rejected that notion because the product meets the specifications of a new device, he said.

He also said identifying reprocessed products for alternate pricing would be complicated.

Sterilmed reprocesses basic single-use devices, including blades, blood pressure cuffs, burrs and cardiac leads. It also reprocesses more-complex devices like those manufactured by Ethicon, such as advanced energy surgical systems, which cut through tissue and seal blood vessels. The devices are cleaned, sterilized, in some cases repaired, and then tested to ensure they are still fully functional.

Intermountain and Ethicon said they've diverted 260,966 device units from landfills and reduced the amount of medical waste going to landfills by some 60,000 pounds, saving nearly 2,000 gallons of gasoline and reducing carbon dioxide emissions by 36,000 pounds.

And while sustainability means higher upfront costs, it's often good business because it cuts waste and improves efficiency in the long run. It's not just good public relations. The Ethicon partnership has saved the health system roughly $250,000 from the reprocessing of advanced energy surgical systems alone, said Steve Bergstrom, Intermountain's director of sustainability. The system has also saved about $27,000 by avoiding landfill costs when devices are reprocessed.

Choosing recyclable products is worthwhile, but they still create waste, Bergstrom said.

“Recycling is a great and noble effort, but it's certainly not going to get us out of the dilemma we're in” by itself, he said, referring to pollution and climate change. “That's why we're looking for a more circular approach.”