Driving the sustainability agenda in the medical sector is complicated. Matthew Durbin, co-founder of Tone Product Design, explains that there’s a lot more product designers can do to build a better future.
The pandemic heightened everyone’s awareness of the impact the medical and healthcare sectors have on the environment, and the carbon emissions that arise from single-use items. But often healthcare organisations have conflicting priorities when it comes to reducing their carbon footprint, including balancing commitments to improve quality and cutting costs.
A raft of papers have been published recently that establish the medical and healthcare sectors’ contribution to damaging and degrading the environment. One such report showed it generates 5% of global annual emissions – the equivalent of 514 coal power plants.
When the overall goal of everyone involved is to protect people and improve their wellbeing, changing the world in a way that compromises public health makes little sense. Going back to the drawing board to think of ways in which we can cut healthcare-related emissions does not need to conflict with other important requirements – it should enhance and improve the solution.
Making disposal considerations a priority
It’s not all doom and gloom. Healthcare organisations all over the world have started to act, and there’s been a determined push to design solutions that accelerate recycling and reuse, reduce raw material use, and to get closer to net zero.
But in a highly controlled and safety-conscious industry, reusing, recycling and disposing of medical devices is far from straightforward. For obvious reasons, patient safety and reducing the risks of healthcare-associated infection often trump environmental concerns. But it is possible to come up with solutions that provide health systems with significant carbon savings, and reduce the volume of waste that is incinerated or ends up in landfill.
It’s heartening to see heavyweights including The Royal College of Physicians encourage the procurement of more environmentally sustainable products that also ringfence quality, safety and usability.
The Royal College of Physicians warns against selecting the cheapest short-term option, but instead recommends identifying and considering the ‘whole lifecycle costs and environmental impacts’ of a purchase, advising that the NHS should ‘leverage its aggregated purchasing power’ to positively influence the industry.
But, as medical device design has advanced, so too has it become more difficult to reprocess the materials used. And as requirements around cleaning, sterilising and disinfecting have become more complex and protracted, it’s often seen as easier and more cost effective to simply throw the item away. As a result, we’re seeing more single-use products around.
Usability versus sustainability
Small, portable electronic and electro-mechanical devices have made huge improvements throughout the healthcare sector when it comes to efficacy and usability. Eliminating opportunity for error or misuse, for example, often involves cutting down on operational steps, which ups device complexity – posing more problems for the recycling potential. Separating materials for recycling can be difficult, and if medical devices come into contact with potentially infectious waste and have to be incinerated or disinfected prior to disposal in a landfill site, recycling is all but impossible.
At inception stage, medical device designers need to bring issues such as reducing, reusing, processing, recycling, remanufacturing, recovery and disposal to the top of the agenda. Of course patient care and efficacy are all-important, but that doesn’t mean we should push the health of the world in which we all live – and hopefully thrive – out of the picture at design stage.
Better strategies may include designing for separation, waste management and recycling. Or constructing for reuse and durability. But, of course, all these considerations need to be weighed up against the level of risk to the patient and the healthcare professional.
Significant reductions in greenhouse gas emissions can be achieved by considering and analysing a range of materials and manufacturing techniques. But looking at the packaging, distribution, use and disposal in a more holistic fashion can change a device’s sustainability credentials to an even greater extent.
Developing for reprocessing
For medical devices, human factors engineering is a mandatory part of the approvals process, but it’s often overlooked when it comes to end of product life – and more designers are now pushing for change in this area.
The correct design strategy for minimising medical device waste is somewhat dependent on product value. Lower-value products looking to reduce, recycle and dispose can design for separation, waste management and recycling, for example. For higher-value products there’s an opportunity to develop with reprocessing and durability in mind or to take a hybrid route.
A hybrid design strategy, where reusable components are coupled with disposable elements, provides the ability to reuse parts of the device – this is especially useful when considering devices where the largest component doesn’t come into contact with biological mechanisms and is reusable without the need for disinfection. As designers, we need to consider the total lifecycle of these products, minimise non-renewable materials and consider alternative approaches.
For example, we recently designed a product called Releaf Freedom, which allows everyone, but especially elderly and less able patients, to urinate comfortably whether standing or seated, giving them the independence and dignity of being able to manage going to the loo without help from a carer. The two-part architecture involves a disposable biodegradable bag and a reusable handle. Many other products in this sector are entirely disposable, meaning that a vast amount of plastic is wasted after just one use. The Releaf Freedom handle can be reused hundreds of times, vastly reducing the waste generated.
At the moment, we’re still taking too much of a linear rather than a circular approach. But if designers think very carefully from the start about materials, and align with supply chain partners that make sustainability a priority, we can take the incremental steps that will ultimately add up to meeting the sustainability agenda.