Absorbent mats, abundantly used in hospitals, are integral to maintaining hygiene and cleanliness by effectively collecting and retaining patient's bodily fluids. absorbent mats are available as disposable and reusable products. In the Netherlands, predominantly disposable products are used, and approximately 23 million absorbent mats are employed each year. The abundant use contributes to the Dutch healthcare sector’s substantial impact to the country’s greenhouse gas emissions, waste generation, material extraction, water consumption, and land use. Hospitals and policy makers within the healthcare sector striving to implement environmentally sustainable practices, require current data for informed decision-making. Yet, only two studies have determined the environmental impact of absorbent mats; however, critical environmental metrics are lacking and detail on the contributions of life cycle stages are insufficient. This study addresses these issues by conducting a comparative Life Cycle Assessment, examining eighteen environmental metrics of both disposable and reusable absorbent mats. The primary objective is to not only assess the environmental impact across all their life cycle stages but also to facilitate the redesign of these absorbent mats to reduce their environmental impact. An in-depth cradle-to-grave Life cycle Assessment, utilizing the ReCiPe impact assessment method, was conducted to compare and evaluate the environmental impact of three different disposable absorbent mats and one reusable absorbent mat. The identification of major contributors to their environmental impact, combined with the application of eco-design strategies, facilitated the sustainable absorbent mat redesign. The Life Cycle Assessment findings indicate that reusable absorbent mats are environmentally superior compared to their disposable counterparts, even if the impact of disposable absorbent mats is mitigated by sustainable product redesign. The reusable absorbent mat demonstrates a lower environmental impact score in fifteen out of eighteen environmental metrics when compared to the disposable absorbent mats. The environmental impact of absorbent mats is largest in the use stage for reusable absorbent mats, and in the material production and manufacturing stage for disposable absorbent mats. The redesigned disposable and reusable absorbent mat concepts exhibit a reduced environmental impact, among other factors, attributed to product recycling. Both concepts facilitate recycling by utilizing a single material for the entire absorbent mat, namely wood-derived materials for the disposable redesign and polyethylene terephthalate-derived materials for the reusable redesign. This study has demonstrated the versatility of Life Cycle Assessment in aiding informed decisions-making and providing valuable insights for sustainable product redesign. The outcomes of the Life Cycle Assessment suggest that hospitals should transition to the use of reusable absorbent mats. Furthermore, the redesign findings offer valuable insights into the environmental benefits achievable through the recycling of medical products.

Medical device selection is currently based on criteria including clinical performance, usability, safety and procurement costs. Growing awareness of the negative contribution of the healthcare sector to the total greenhouse gas (GHG) emissions demands environmental sustainability to be taken into account as well. Reusable and disposable flexible intubation scopes are of current interest to anesthesiologists because disposables are often utilized due to their presumed superior sterility, cheaper purchasing price and convenience. Knowledge about the life cycle environmental impact of flexible intubation scopes is limited, so research is required to aid in sustainable device selection. Therefore, the goal of this study is to compare the environmental impact of disposable and reusable flexible intubation scopes and design a sustainable concept to enable data-driven selection of sustainable flexible intubation scopes. A cradle-to-grave comparative life cycle assessment (LCA) was made to quantify the environmental impact of reusable fiberoptic bronchoscopes (FOB) and disposable flexible video endoscopes (FVS) at 450 patient intubations. The largest contributors to the life cycle impact of the flexible intubation scopes were identified and used to generate a sustainable concept. The LCA results suggest that the reusable FOB has a lower life cycle impact in comparison to the disposable FVS, so selecting a reusable FOB is preferable from environmental perspective. Most life cycle emissions of the disposable FVS are caused by the material production of the device and manufacturing of the printed circuit board, while the disinfection process contributes most to the life cycle of the reusable FOB. The final concept of the sustainable flexible intubation scope contains plastic optical fibers and a thicker sleeve around the bending section of the insertion tube to make the device more durable and thus extend its lifetime. In order to minimize the environmental impact of flexible intubation scopes, it is recommended to develop flexible intubation scopes with plastic optical fibers, select low-impact materials for the device and revise the products’ life cycle at the product system level (e.g. disinfection process). Every small contribution towards a more sustainable healthcare system counts.

Technological developments in the medical world introduce a shift in responsibilities of the surgical team members which might result in waste of talent and skills. The latter might result in disengagement and decreased productivity and thus in illness-related absenteeism. The people pillar of sustainability aims to create a healthy workplace and thus to manage illness-related absenteeism. The objective of this research was to optimise the responsibilities of the surgical team members in minimally invasive surgery (MIS) in order to achieve a balanced and sustainable employability of the surgical team to counteract waste of talent and skills. Empirical data was collected in two different steps. In the first place, an overview of the surgical phases during the MIS procedure and an overview of the tasks performed by the perioperative nurses were made. In the second place, two different methods were used to obtain data. First, seven video recordings of a laparoscopic gynaecological procedure were analysed to obtain the distribution of the responsibilities and the percentage of (technical) tasks for each phase and the entire MIS procedure. Second, interviews with fourteen perioperative nurses were conducted to map the peak moments of a MIS procedure and to evaluate the impact of the technological developments on the nurse's workload. As a result, a fluctuation of the total duration of all tasks during the procedure was shown. A percentage higher than 70% was measured in the start phase. The perioperative nurses experienced low peak moments during 66% of the entire surgical procedure. A high impact of the technological developments was experienced by the nurses. The physical activity for MIS and robot-assisted surgery (RAS) was lower than a conventional open procedure (OS). The total duration of the technical tasks was highest in the second phase of the MIS procedure. The nurses indicated that this phase took longer compared to the same phase in OS procedures because of the amount of equipment that has to be connected. In conclusion, an unbalanced employability was recognised during MIS and technological developments had a high impact on the activities of the perioperative nurses. This research has several recommendations. First, a more sustainable employability will be achieved when two perioperative nurses will be scheduled for three surgical procedures during 66% of the MIS procedure. Second, deployment of a technical perioperative nurse will decrease the amount of workload. Last, by giving the perioperative nurses more responsibilities in MIS, the talent and skills will not be wasted leading to a more balanced employability of the surgical team members.