Associate Professor; Associate Medical Director University of California San Diego San Diego, California, United States
Background/Case Studies: The transfusion medicine (TM) laboratory is not a paperless operation. Paper is printed for a variety of purposes, from reproducing antibody panels for patient antibody identifications to printing requisition forms for product order fulfillment. Paper printed with protected health information must be shredded for privacy reasons, posing challenges for recycling and adding to the environmental impact of the laboratory. The purpose of this retrospective study was to describe the paper printing impact of our TM laboratory and to inspire interest in sustainability.
Study
Design/Methods: Our TM service supports a >400-bed academic medical center and outpatient infusion clinic with approximately 25,000 to 30,000 blood components per year. The TM laboratory utilizes multiple printers, which are not shared with other clinical laboratories. Monthly invoices from the health system’s information technology vendor were reviewed for total pages printed in the TM laboratory from January 2019 through December 2022. Printing performed in managerial offices was excluded. When billing cycles unevenly accounted for February and March printing in 2020 and 2021, these volumes were presented graphically as the average over both months.
Results/Findings: The TM laboratory printed increasing volumes of paper each year, totaling >300,000 pages of paper over the four-year study period (Figure 1). During that time, the TM print volumes grew by over 19%, representing approximately 0.3% of the health center’s total print volume. Roughly 97% of TM printing was done in black and white; the remainder was printed in color. Conclusions: Awareness of a TM laboratory’s environmental impact is critical to identifying measures to mitigate it. As the standard pine tree produces approximately 10,000 sheets of paper, our TM service printed the equivalent of roughly 30 trees’ worth of paper during the four-year study period. This is in addition to the impact of ink and toner, which--if not recycled properly--pollute the environment. The plastics used for the cartridge cases also take hundreds of years to decompose.
Of interest, our TM laboratory’s printing volumes increased by 19% over four years, while total transfusions decreased by more than 14% over the same period. More granular analysis of our printing may reveal opportunities to reduce waste. Greater visibility of our environmental impact may also stimulate mitigation measures, such as more double-sided printing, use of digital (not paper) job aids, and maximizing electronic dissemination of information. Sustainability is of increasing importance across health care organizations. Thus, TM laboratories have an opportunity to assess and optimize their environmental impact and to share best practices.
Importance of research: Although the focus of a transfusion medicine (TM) laboratory is providing high-quality, safe, and timely test results and transfusion support for patients, the laboratory’s environmental impact is also deserving of consideration. In this study, we present total paper printing volumes of our TM laboratory, which we suspect most the TM community has not seen before and may find eye-opening. We hope this serves as a call to action and generates ideas about sustainability in our field.
