MRHT Orthopaedic Theatres Improve Sustainability and Efficiency with new Surgery-Specific Packs
The Orthopaedic Theatre team at Midland Regional Hospital Tullamore (MRHT) has successfully implemented a nurse-led quality improvement initiative that is transforming surgical workflows, reducing waste, and delivering significant cost savings. The initiative was led by Winston Oliver, CNM2 Orthopaedic Theatres MRHT, in collaboration with the hospitals wider orthopaedic nursing team. It involved the development and rollout of customised surgical packs tailored to specific procedures. The initiative focused on the introduction of specific packs like Hand, Foot, Knee, Scope, and Minor Ortho packs which are designed to include all items required for these surgeries.
Over a 12-month period (August 2024–August 2025), the introduction of just one of the packs - the Hand Pack alone resulted in:
- A 77% reduction in packaging waste, from 335g to 76g per case
- 203 nursing hours saved, by streamlining setup and reducing repetitive tasks
- A 96.7% reduction in sterile item handling, improving safety and consistency
- €15,607 in cost savings, reducing per- case costs from €63.58 to €39.27
“This project has empowered our nursing team to lead meaningful change,” said Winston Oliver, CNM2 Orthopaedic Theatres MRHT. “By applying lean principles, we’ve not only improved efficiency but also contributed to environmental sustainability which is something I am passionate about. It’s a proud moment for our department and a model we hope others will follow
The packs eliminate the need for nurses to collect supplies from seven separate storage areas, significantly reducing setup time and contamination risk while improving stock management.
Brendan Malone, Interim Director of NursingMRHT, praised the initiative: “This is a fantastic example of frontline teams driving innovation. The results speak volumes with better patient safety, smarter resource use, and a greener and sustainable approach to care. I commend Winston and the entire team for their dedication and vision for greener practices.”
Following the success of this initiative they are now developing Shoulder, Intramedullary Nailing, and Minimally Invasive Hip packs, with plans to revise the existing Hip pack. The initiative aligns with HSE National sustainability goals and supports MRHT’s commitment to the Green Theatres movement.
This project not only enhances operational efficiency but also reinforces the hospital’s plans to move towards environmentally responsible healthcare. Incremental changes, when combined, can collectively have significant and lasting positive impacts on our environment.
Pictured in MRHT fomr L-R is MaryJane Burke, Assistant Director of Nursing Peri -Operative Directorate; Grace John, Staff Nurse; Anna Flynn, CNM 1; Valerie Tracey, CNM 2, Leena Skaria, Staff Nurse, Winston Oliver, CNM 2; Sharon Dooley, HCA; Florence Osiadi, CNM 3; Collette Brophy, Staff Nurse; Paul Phelan, Clinical Facilitator; Michael O Hara, MTA; Deirdre Rock, Scheduled Care Lead, Peri-Operative Directorate, Business Manager
