Design for sustainable healthcare. Cutting the impact of medical products through disposable packaging

The pandemic emergency has highlighted a critical issue in the health sector: the environmental impact caused by the use of disposable products, currently based on the use of plastic polymers, which are difficult to recycle and not compostable. According to the National Institute for Environmental Protection and Research, the numbers generated by the Covid-19 emergency would amount to between 150 and 450 thousand tonnes (ISPRA Report, Waste consisting of used PPE, May 2020). Researchers at the University of California, San Francisco Medical Center, estimated the waste of $2.9 million in neurosurgical supplies in one year in one department alone (Allen, 2017). The incompatibility between the health need to use these devices and the environmental need to reduce products with a high polluting potential, poses the Design Discipline with a challenge that research must be able to meet through the development of real and sustainable solutions. In an attempt to respond to these critical issues, this paper reports on research conducted on single-use surgical products, in particular on the redesign of a single-use procedural kit, with the aim of rethinking design from a systemic sustainability perspective. The research was conducted through desk research, based on a literature review of reports and documents demonstrating how to achieve sustainable healthcare. At the same time, through field research and the HCD approach, using a number of specific tools in the different phases of the design process, it led to the definition of a product capable of satisfying both the needs of healthcare professionals, doctors and nurses, who are the direct users, and the needs of hospitals and companies responsible for the disposal phase. The result is a framework for identifying the most challenging surgical departments. The research required a multi-disciplinary approach to develop new sustainable layouts starting with the details, requirements and needs for the design of an adaptable and versatile procedure kit were highlighted. The design solutions that led to the realisation of the prototype are: design of a biodegradable EPP tray, functional for disposal by incineration; design of a recyclable PETG tray, divided into 3 compartments. The first one contains instruments that need to be ready to use. The second contains instruments at risk of falling/breaking. The third compartment contains instruments that are not always used. The three compartments are fixed on a cardboard layer that replaces the individual compartmentalisation per instrument, making the kit customisable for any type of single-use procedure, as well as being able to make the PETG tray sterile. The project will reduce production costs by using less plastic material to be thermoformed and a single negative for the production of the customisable tray, leading to the creation of a new product/service flow, centred on: returning packages to the manufacturer, placing them in the additional instrument tray, so that they are not necessarily ready for use; reducing the amount of biohazard waste burnt in the incinerator. The use of an organic-based tray minimises pollution; advantageous recycling of trays and procedural tools that were previously discarded in general waste or even biohazard. From an environmental point of view, there are benefits to be gained from reducing incineration by reducing unused waste. A biodegradable tray to handle infectious supplies and disposal in an incinerator can minimise air pollution. Other time-saving benefits come from the individual packaging of additional customisable instruments. This solution has reduced the possibility of having to open a second kit to obtain a duplicate instrument.