Multicenter study protocol on clinical, environmental, and economic outcomes of hybrid versus disposable surgical trays (project rEUsable)

Climate change threatens global health, while health care contributes significantly to emissions and waste. In the Netherlands, the sector produces 7% of national CO₂ emissions and 4% of waste. Operating rooms account for 20%-30% of hospital waste, mainly from disposable surgical trays. Reusable trays could reduce this impact, but adoption is hindered by financial and behavioral barriers. A system-wide switch could lower costs through scale effects, yet evidence on environmental and financial feasibility remains limited. This multicenter study compares the environmental impact and costs of hybrid (including <i>reusable</i> drapes and gowns) versus disposable procedure trays using Life Cycle Assessment and Health Technology Assessment (HTA). Environmental impact across 17 categories will be monetized, integrating sustainability into economic evaluation to inform health policy decisions. Results will be reported from an EU perspective. Data from three Dutch hospitals will be collected on tray use, costs, and acceptance among health care professionals. The study analyses 3 × 150 surgical cases to assess sustainability, economic feasibility, and implementability. Key deliverables include developing sustainable procedure trays and a piloted method to integrate environmental aspects into HTA, supporting sustainable health care innovation. The project will also produce an EU policy brief to guide hospitals in adopting reusable trays, highlighting environmental and economic benefits. Finally, it will provide insights into promoting acceptance and adoption of reusables to advance sustainable clinical practices.