Eco Ninjas’ simple solution for theatre staff identifying each other
Growing numbers of NHS theatre staff have begun attaching name badges on their headgear – so they and their patients know who’s who during high-stakes surgical procedures when everyone is dressed identically in scrubs.
This low-tech solution to the widespread problem of misidentification in theatres could save the NHS and private hospitals at least *£20m a year by removing the need for more than 110m disposable caps, which end up incinerated or in landfill. Members of NHS theatre staff each use up to four disposable caps a day.
The ‘theatre badge hat’ is the brainchild of former NHS nurse Danielle Checketts, founder of Eco Ninjas Ltd, and is part of a growing grassroots movement among clinical workers called the ‘Theatre Cap Challenge.’
Washable name badges clipped onto fabric hats with press-stud poppers
Washable polyurethane name badges displaying a person’s name and role are clipped onto reusable fabric theatre caps with press-studs as clinicians, and others, enter theatre.
The product has been shown to vastly improve communication between staff and patients, improve patient safety and deliver significant cost and waste saving.
One NHS hospital in England – Musgrove Park in Somerset – is using the theatre badge caps while a handful of other NHS trusts are in advanced talks about procuring them.
“The product came about because many staff don’t know who’s who when clinicians are dressed shoulder to toe in sterile gowns as conventional badges can’t be worn on top of sterile clothing,” said Danielle, who experienced this problem herself as a patient at the births of both of her children.
“I have been in theatre as a nurse, a student, a trainer and as a patient, and I haven’t had a clue who anyone was, even after people introduce themselves as part of the safer surgical checklist.
“It’s difficult to remember everyone’s name throughout the day and it’s confusing. There can be up to 15 people in a surgical theatre, including surgeons, students, nurses, radiologists, anaesthetists, reps, not to mention birthing partners. Knowing who is who in that high-stakes setting is incredibly important and communication is linked to improved patient outcomes.”
Disposable theatre caps cost about 18p each. They’re used once then thrown away. By contrast, a washable Eco Ninja theatre badge hat costs £8.50 each and the polyurethane badge costs £2.90.
Cost comparison: disposable theatre caps v reusable theatre badge hats
The cost comparison over a three-year period is as follows:
Assuming 250 working days a year, and the use per theatre staff member of four 18p disposable hats a day on average, the cost for disposable caps over three years works out to be £540.
The cost for each threat staff member for Eco Ninja over the same three-year period for theatre badge hats is £39.80. That’s the price of a recommended four washable theatre hats each and two name badges (two just in case one goes missing). Aside from laundry costs, there are no further costs over the three-year period.
70% of mishaps due to miscommunication
According to the World Health Organization (WHO), 70% of adverse events in surgery stem from miscommunication.
“I’ve seen it firsthand – valuable seconds lost because no one knows who’s who in an emergency. Something as simple as a name badge on a theatre cap solves this problem, improving safety for patients and clarity for teams,” said Danielle.
Eco Ninjas’ solution has been in use since March in a pilot at Musgrove Park Hospital in Taunton, Somerset. The team has reported an increase in mid-surgery communication from 41% to 96% and a cost saving of 48% since adopting the theatre badge hats. This hospital alone expects to save 90,000 disposable caps every year.
A surgeon’s view
Mr Andy Stevenson, an orthopaedic consultant at Musgrove Park, said: “Previously, our theatre hats were essentially single use plastic, thrown away after each operation. By introducing reusable hats, we’re hoping to reduce our impact on the environment, as well as make it easier for colleagues, patients and visitors to be able to know who everyone is and what their job role is.
“These reusable theatre hats can be used hundreds if not thousands of times, and once they wear in a bit they will be more comfortable too.
“In theatre, there can be a really high turnover of colleagues at times, with new people coming and going all the time. This can make it really difficult to know who is who, let alone what jobs they have. Some days, it will be the first time working with half the people in the room.”
Danielle, who is currently in advanced talks with two NHS trusts in the West Midlands with a long-term vision to secure full acceptance across the NHS, said” “This is about shifting from a throwaway culture to a reuse culture, fully aligned with the NHS 10-year Plan and the ‘Green Theatre Checklist.”
It is understood Midland Metropolitan University Hospital (MMUH), in Sandwell, West Midlands, and Worcestershire NHS are interested in adopting theatre badge hats once procurement hurdles are cleared.
At MMUH alone, Eco Ninjas’ solution has the potential to cut the use of at least 250,000 single-use caps every year. When scaled across more than 1,100 NHS and private hospitals, that waste saving becomes truly colossal.
Initially, NHS theatre staff sought to solve the problem by writing their names on flimsy disposable caps. Next came caps embroidered with names for permanent staff, but anyone on shorter-term rotations needed to stick with disposable headgear. Embroidery is also costly and complex to manage for large teams, and staff are understandably reluctant to wash contaminated caps at home.
Theatre Cap Challenge
This perennial headache gave rise to the Theatre Cap Challenge movement, which has now spawned Eco Ninjas’ theatre badge hats with detachable name badges.
“This simple yet powerful design means hats stay in circulation even when staff leave, and visitors or students can use them too, delivering inclusivity, safety and major waste and cost reductions,” said Danielle.
As well as printed badges, in a range of different colours, showing the role and name of clinicians, Eco Ninjas offer blank badges that can be written on by visitors.
‘A mountain to climb’
Danielle added: “We have a mountain to climb persuading individual NHS trusts, each a large bureaucratic organisation with complex procurement processes, to embrace this change”.
“We know we’re doing the right thing. The feedback has been overwhelmingly positive. Now it’s about scaling adoption across more hospitals, because every new site means more staff and patients benefit, and thousands of disposable caps are saved from incineration or landfill.”
