Interviewee: Ann Mead, RN
Role: Clinical Nurse, Perioperative Unit; Co-founder of Nurse Sustainability Subcouncil
Turning Observation into Action
Ann Mead’s sustainability journey began with a simple yet profound observation she had seen replicated in various units in different hospitals where she had worked. She noticed plastic wash basins, originally intended for patient bathing, were being repurposed as containers for temporary storage or transport of supplies to patient rooms. These basins were routinely discarded, sometimes multiple per patient, along with the unused clinical supplies they were storing after patient was transferred or discharged. This practice represented both significant waste of time, effort and environmental contamination, as well as unnecessary financial loss. This discovery prompted Ann to tackle the issue of room clutter and unnecessary waste, applying lessons learned from previous attempts at other institutions to a pilot on a particular unit where several key factors helped to implement and measure success. Her approach targeted waste at its source, demonstrating how frontline observations can spark meaningful systemic change.
Overcoming Inertia in Healthcare Systems
The project sought to address the common customs nurses in healthcare systems throughout the world develop to ensure they are prepared for unpredictable scenarios and to minimize steps and efforts to bring needed supplies to the bedside. Ann worked with Sarah Carruth, a colleague, sustainability advocate and leader on an in-patient pediatric medical-surgical unit in a large urban hospital to develop a two-pronged intervention – strategically reducing stock availability while simultaneously implementing behavioral nudges to transform long-standing nursing practices around room preparation. Nurses accustomed to stocking rooms with supplies before a patient arrives, or when entering the room for a procedure or to assume care for the shift were accustomed to bringing potentially needed items, often in excess, into the room where the unused items remained until the patient discharge. Sarah and Ann addressed this by reframing the narrative to something most nurses were looking to avoid – reducing room clutter. The team focused on the multiple, unneeded supplies that remained disorganized in piles in and around the wash basins and the trash these items generated when the patient left the room. Signage in the supply room and regular work phone group texts at the start of shifts reminded nurses to skip the storage bucket and to bring only what is needed to the bedside.
At the same time, Sarah and Ann met with the hospital’s supply chain team to understand the PAR system which flags a replenishment to “PAR” of supplies once they reach a certain level. Sarah reduced the PAR of the unit’s wash basin supply by half, to make the basins less available as a storage unit in patient rooms. The supply chain team was fully on board with the intentions to reduce waste and cost and shared their reports on the use and costs of wash basins and other supplies most frequently wasted which allowed the team to track their efforts with objective, quantitative data.
A pivotal moment came when the team discovered that after three months, the PAR reductions and education realized a 72% reduction in the use, costs and pounds of trash generated from wash basin use. After reducing the PAR by half again, the team has seen another 30% reduction of wash bin use, though still seeing a steady, if not more frequent restock of wash basins. Using this data, the team adjusted and reinforced the educational response. Sarah also began to measure during the course of a month the amount of unused supplies brought to patient rooms in wash basins and other plastic containers and left behind at discharge in order to quantify waste and demonstrate to colleagues the amount of unneeded supplies they’ve been transporting to rooms.
The Power of Grassroots Collaboration
Ann recognized early on that sustainable change required more than just policy adjustments—it needed buy-in from those who would implement it daily. Ann found champions for clutter reduction in nurses that had a passion for making their work more sustainable and had already made a volunteer commitment to the hospital’s Sustainability Council. These nurses had rapport with their colleagues and used their roles to emphasize the importance of sustainable practices on their unit. Frontline equipment technicians who were already taking initiative became unexpected champions of the effort owning their role in the intervention and driving adoption among their nursing peers.
What made the impact of Ann and Sarah’s initiative resonate was their ability to build a coalition with different departments of the hospital that may not always work directly with the staff nurse role. For example, forging a critical partnership with the supply chain team, who agreed to send reports monthly on use and cost of wash basins and other top supplies thrown out at discharge, makes regular data collection relatively easy, in order to continually analyze and adapt interventions. Colleagues from the hospital’s research center, whose research focused on issues of climate and sustainability, assisted in analyzing simple data to demonstrate the project’s results.
The hospital’s Magnet designation also proved instrumental in bringing the initiative to the unit. Unit-based Shared Nursing Leadership (SNL) councils implement nurse-led activities to improve quality, safety, staff morale and other improvement initiatives that are measured and shared. With buy-in from Sarah’s unit-based SNL council, the team could move forward with implementation and messaging to their colleagues.
Measurable Impact and Scalability
The results of Ann and Sarah’s intervention were both immediate and scalable in the short term. A relatively simple, high-impact intervention, that if carried out throughout the year, on 10 similar units of the hospital, and with additional measurement of supplies wasted with wash basins could have a deep and lasting impact on resource stewardship. Ann and Sarah have since shared their initial results with the SNL councils of other units and started a conversation about the reasons those units feel they are generating clutter and wasting supplies. Through these conversations and her experiences implementing similar clutter reduction interventions, Ann began to generate the following key interventions to scale the reduction of supply waste:
- Restock and Reorganize supply storage areas – to bring needed supplies as close to where they are needed as possible
- PAR reduction – in combination with colleague awareness brings less supplies to places where they are needed less
- Admission and Transfer Supply reports – ask what supplies are coming with a transferring patient and meet them on admission before pre-stocking unneeded and extra supplies
Every hospital unit has a unique blend of factors such as floor layout, health concerns cared for and patient population, that affect the type and quantity of supplies they use and how they distribute them throughout their care area. When taking the clutter reduction initiative from unit to unit, nurses can identify their unique reasons for supply clutter and waste and adapt these simple nurse-controlled interventions to realize fast and impactful results.
Additionally, the use of the Magnet program if and when available, can be a powerful way to support initiatives with resources to measure and share results, and to validate these efforts, particularly when sustainability is integrated into a clinical advancement ladder that rewards nurses for taking a lead in this area of work. Working with the existing Professional Practice Department, which manages her hospital’s Magnet designation, Ann created a Nurse Sustainability Sub Council, making it an official system-side SNL Council through which nurses can received dedicated, compensated time for their efforts and legitimacy needed for forming necessary collaborations.
The project’s success has also shifted perceptions about sustainability, proving that environmental responsibility can align with—and even enhance—clinical efficiency.
A Blueprint for Bedside Innovators
Ann and Sarah’s experience offers invaluable lessons for nurses looking to drive similar changes. Ann emphasizes starting with highly visible problems—like the ubiquitous wash basin—that make abstract concepts like supply stewardship and waste concrete and relatable. Empowering unlikely allies, such as equipment techs who intimately understand supply chain inefficiencies, can accelerate adoption more effectively than top-down mandates.
Ann also stresses the importance of leveraging existing structures, whether it’s a Magnet council or another established committee, to provide legitimacy and resources. Most importantly, she encourages celebrating imperfect progress. “Even one less bin in the trash matters,” she notes. “You’re modeling change whether people acknowledge it [to you] or not.” Her mantra—”Small wins fuel big change”.
Conclusion: Ripple Effects of Practical Leadership
Ann’s story exemplifies how frontline nurses can drive systemic change by connecting waste reduction to core clinical values. Her approach succeeded because it worked within—not against—existing workflows and incentives. By demonstrating how sustainability could save time (through less room cleanup and less room stocking) and money (through reduced waste), she made the case for change in terms that resonated across all levels of the organization.
The replicable model she developed—now being adapted for other high-waste items—proves that the most impactful sustainability solutions often come from those who know patient care best. As healthcare faces increasing pressure to reduce its environmental footprint, Ann’s work stands as a testament to the power of practical, nurse-led innovation.
