Want to stop the money from hemorrhaging out of your hospital? Try not tossing away that $4,000 bleed-stopping surgifoam sponge without having used it.

The sponge was the most expensive unused item discarded post-op, according to University of California San Francisco research published in the May issue of Journal of Neurosurgery. But it was not alone.

The report looked at 58 neurosurgeries performed by 14 different surgeons at UCSF Medical Center. Across the 36 cranial and 22 spinal procedures, the average cost of unused supplies was $653 – with a range from $89 to $3640. This represented 13.1 percent of the total cost of surgical supplies.

That comes to $242,968 per month and $2.9 million per year.

UCSF neurosurgeon Dr. Michael Lawton was an author of and one of 14 surgeons monitored in the study. He does about 400 surgeries annually and noted that if he saved $1000 an operation that would come to $400,000 a year in waste reduction. “These savings could translate into teaching and research opportunities, and also allow more patients to come in” for treatment, he told KQED.

And savings is just one part of the waste-reduction benefit. There is also reducing the non-trivial environmental impact of medical waste. In the U.S. every day over 2,000 tons of waste comes from operating rooms. The study looked at the waste-profiles of various procedures and determined that spinal operations were among the most wasteful, study co-author James Yoon told California Healthline.

The authors recommended several approaches to tackling the waste issue. One is to make sure that there is price transparency for surgeons, so they appreciate how they stack up against their colleagues in the waste generation arena. Lawson called it a “feedback system.”

Another recommendation is to review the “preference cards” used by surgeons to request instruments and supplies for procedures, Yoon noted. Simply eliminating items that are unlikely to be needed and noting which should be opened before operating would help cut waste. Unused and sealed items can normally be recycled.

UCSF hospitals Gail Lee, who oversees sustainability for UCSF hospitals told the health line that a combination of methods are used to cut down on unnecessary waste in the system. These include reprocessing when possible by FDA-approved third parties. In 2015 the reprocessing efforts had cut landfill waste by 62,000 pounds.

“We continue to do better each year,” she told the health line, “but we recognize there is always opportunity to improve.”

Sustainability in the OR may be challenging, but as cost containment becomes more important in the modern push to improve the efficiency of health care delivery, it is a must. In a 2013 HCB News article on sustainability, author Brian White, president of Stryker Sustainability Solutions, made the compelling case that, “the total value of third-party reprocessing extends beyond cost-savings. Reprocessing programs also divert waste and support sustainability initiatives within facilities. Let's use the operating room as an example. Practice Greenhealth estimates that the OR generates 20 to 30 percent of an average hospital's waste. Today, reprocessing is one of the most significant ways that ORs can reduce their environmental footprint.”

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