University Hospital Bonn: For More Circularity in Hospitals

Resourcify and the University Hospital Bonn Revolutionise Waste Management in the Operating Theatre Through Digitalisation

Hamburg, 11.04.2023 – The University Hospital Bonn (UKB) and the waste management platform Resourcify look back on the successes of their cooperation to promote circularity in hospitals. In September of 2022, UKB launched new pilot projects in cooperation with Resourcify to reduce waste generation and to recycle medical waste.

Hospitals are the fifth largest producer of waste in Germany, with approximately 1.2 million tonnes per year, and inevitably have a variety of waste streams. These include packaging, medical devices and hazardous materials. Usually, materials that come into direct or indirect contact with patients are not recycled but are instead incinerated.

In order to have a better overview of these waste streams and to open up opportunities for more circularity, the UKB has already been using Resourcify's digital waste management software with great success since 2019. In 2022, three pilot projects have been launched to extract recyclables from medical waste.

The goal is to establish a circular recycling solution that is easy to implement and helps UKB move closer to their sustainability goals. Recycling reduces the amount of plastics and metals that usually end up in incinerators. At the same time, UKB can manage this service through Resourcify's recyclables management system to keep the overall effort as low and transparent as possible.

Circularity in the Hospital: from Soda Lime to Fertiliser

Since September, the Clinic for Anaesthesiology and Surgical Intensive Care Medicine (KAI) at the UKB has been working with the medical technology company Dräger on the pilot project "Upcycling: from soda lime to crop cultivation" to process used soda lime so that it can subsequently be reused in industry and agriculture, for example as fertiliser. Cartridges filled with soda lime are used during surgery under general anaesthesia with a respirator to filter CO₂ out of the patient's exhaled air. After use, these normally count as hazardous chemical waste, which has to be collected separately and disposed of as a costly waste. At the UKB alone, this produces roughly five tonnes of hazardous waste per year, resulting in emissions of approximately 25 tonnes of CO₂.

The new project will be scientifically monitored using life cycle analyses (LCA), which will enable both the ecological and economic comparison of the previous disposal with the upcycling process. The staff of the anaesthesia department now collect the cartridges in special containers, whose collection needs can be transmitted to the facility management via a QR code. The containers are then taken to the waste management warehouse. From there, they are collected by the manufacturer Dräger, which processes the soda lime together with its own production waste into fertiliser and recycles the cartridges.

Resourcify supports UKB with the help of the QR code solution in handling internal transportation to ensure that the process runs smoothly.

Recommended read: Case study about waste management at University Hospital Bonn.

Sterilisation Leads to Electrical Waste

In the surgical centre, the recycling programme for electrically operated disposable instruments from the operating theatre, which was specially financed by the UKB, was introduced at the same time. The so-called "stackers" are usually considered contaminated after use and must accordingly be collected as hospital waste (AVV 180104 or, in the case of infectious patients, also AVV 180103*). This results in about 105 kilos of medical electronic waste per year. The used disposable instruments are now collected in a special bin after being wiped with disinfectant and taken for in-house sterilisation. In the department of microbiology, there are automatic sterilisers that are used exclusively for waste or other equipment that does not come into contact with patients. This ensures decontamination of disposable instruments for material recycling without jeopardising patient care. After sterilisation, the UKB can dispose of the disposable instruments as electronic waste AVV 160214.

Resourcify takes care of the positioning and collection of the box pallet, ensures proper recycling at the recycling partner and digitises the processes and collected data. The digitalisation helps to maintain transparency of the rather unusual process and to motivate the staff through newsletters to continue sorting the disposable instruments accurately.

By the beginning of March, over a period of nearly six months, 239 kilograms had already been collected and recycled in the Surgical Centre (OPZ) alone. The goal is to recycle the entire instrument. Using a shredder light fractioning process, the instruments can be divided into the individual fractions as efficiently as possible and processed into secondary raw materials made of metal and plastic.

Take-Back Systems for Aluminium Foil

In January of 2023, the take-back system for aluminium packaging of suture material from Ethicon, a brand belonging to Johnson & Johnson Medtech, was launched at the Surgical Centre at the UKB. This process was developed by Ethicon together with TSR Recycling GmbH & Co.KG (TSR) and Resourcify to promote the circular economy. The vision behind this is to recycle this packaging instead of incinerating it in the future. For this purpose, the aluminium foils are collected by the medical staff in the designated grey containers and handed over to the clinic logistics. The order for collection is placed as usual via the Resourcify portal and DHL Express takes the boxes to the recycling partner TSR in a CO₂-neutralised state. Johnson & Johnson's metal-containing production waste is also disposed of there in order to collect a volume that is useful for recycling. TSR then takes care of the recycling and distribution of the secondary raw materials.

For every kilogram of material collected, recycling can save approximately 18 times the amount of CO₂ equivalents compared to incineration. The proceeds from the sale of the aluminium are donated annually to Operations Smile. For over 30 years, Johnson & Johnson has supported the charity in driving change in healthcare systems around the world and restoring smiles to children with cleft lip and palate through professional surgical intervention.

"All in all, the recycling process is currently much more expensive than the conventional recycling method. The process can only be realised because the UKB has an internal facility for decontamination and the project is thankfully funded by the university. For this reason, we are working in parallel with other partners to overcome bureaucratic and logistical hurdles in order to make it possible for other hospitals to recycle the products more efficiently in the long term."
– Meike Lessau, Circularity Manager, Resourcify

"Sustainable action has taken on a central role for us at the University Hospital Bonn. Looking at the impact of healthcare on the climate, we in Bonn see it as our social obligation to act in a sustainable and climate-friendly fashion and to conserve resources for future generations. We recognised great potential in this area several years ago and digitised our waste management system to prepare it for the future. In addition to separating waste as effectively as possible, new recycling models and take-back systems also play a decisive role. We work with our partners every day to develop new solutions to avoid waste, conserve resources and close loops. Unfortunately, legal requirements from earlier years still limit our options, which is why we would like to see more support from politicians and decision-makers. In order to avert the threat of climate change, we need to significantly increase our speed and promote innovation."
– Michael Schmitz, Head of Department Infrastructure Service, Staff Office Sustainability and Waste Officer, University Hospital Bonn

About Resourcify

The easy-to-use SaaS solution makes recycling more efficient and transparent. It helps companies recycle more, reduce costs and turn waste into recyclables. Since the end of 2018, the platform has processed more than 2 million waste disposal orders per year from customers such as Syntegon, Hornbach and McDonald's in over 7 European countries. In addition, recyclers are using Resourcify to improve their customer service, boost their sales, and attract and retain more high-revenue customers.

About the University Hospital Bonn

The UKB cares for around 500,000 patients per year, employs 8,800 staff and has a combined turnover of 1.5 billion euros. In addition to the more than 3,300 medical and dental students, a further 580 women and men are trained in numerous health professions each year. The UKB is ranked first among university hospitals in NRW in the science ranking, has the third highest case index in Germany and was the only university hospital among the 35 in Germany to increase its performance in the Corona years 2020 and 2021. Find out more at www.ukbonn.de.