Kaiser Permanente | DEHP Minimization in Intravenous (IV) Administration Sets – California and Hawaii Regions

Benefits

  • Environmental and Human Health Impact: Reduced patient exposure to Di ethylhexyl pthalates (DEHP), a chemical shown to cause reproductive and developmental system damage in fetuses and newborns.
  • Business Impact: Cost increase of an average of 5.6 percent annually for first three years.

The Problem

Kaiser Permanente continues to work in partnership with our suppliers to reduce the exposure of our patients to harmful chemicals like the plasticizer diethylhexyl phthalate (DEHP), an industrial chemical used in products from cosmetics to PVC medical plastics, as a solvent and softener. DEHP has been shown by the U.S. FDA, the U.S. National Toxicology Program, and other research organizations to have the potential to cause damage to the reproductive and developmental systems of fetuses and newborns. IV administration is a key point of exposure to DEHP. The sets are used for such purposes as administration of medication, IV solutions, parenteral nutrition, and drawing blood.

The Strategy Selected

In 2007, the National Product Council and the IV Sourcing and Standards Team decided to transition from the Baxter Interlink IV administration sets to Baxter’s Clearlink product line for the following reason:

  • Clinical trials demonstrated that the new products were easier to use
  • Clearlink offered a DEHP-free alternative

Implementation Process

The Team:

  • Dr. John Howse – Co-Chair of the Medical Core Group and chair of the IV SST
  • National Product Council members
  • Neerav Shah – Sourcing Manager, Medical Core Products

At the end of 2008, Kaiser Permanente’s California and Hawaii regions had converted approximately 85% of their IV admin sets to DEHP-free. Next Steps: Work with Baxter and internal Kaiser Permanente stakeholders to trial 500ml and 1000ml DEHP-free pharmaceutical and nutritional solution sets in early 2009.

Challenges and Lessons Learned

  • Clinical trials are necessary to gain buy-in from staff who use these products regularly.
  • It is critical to establish expectations for environmental performance with suppliers, and to continue conditioning and education. If we as a customer does not ask for an environmentally preferable product, suppliers may not develop or offer that product.

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