Waste audits in healthcare: A systematic review and description of best practices

Abstract

Healthcare generates large amounts of waste, harming both environmental and human health. Waste audits are the standard method for measuring and characterizing waste. This is a systematic review of healthcare waste audits, describing their methods and informing more standardized auditing and reporting. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE, Embase, Inspec, Scopus and Web of Science Core Collection databases for published studies involving direct measurement of waste in medical facilities. We screened 2398 studies, identifying 156 studies for inclusion from 37 countries. Most were conducted to improve local waste sorting policies or practices, with fewer to inform policy development, increase waste diversion or reduce costs. Measurement was quantified mostly by weighing waste, with many also counting items or using interviews or surveys to compile data. Studies spanned single procedures, departments and hospitals, and multiple hospitals or health systems. Waste categories varied, with most including municipal solid waste or biohazardous waste, and others including sharps, recycling and other wastes. There were significant differences in methods and results between high- and low-income countries. The number of healthcare waste audits published has been increasing, with variable quality and general methodologic inconsistency. A greater emphasis on consistent performance and reporting standards would improve the quality, comparability and usefulness of healthcare waste audits.

Lifecycle of surgical devices: Global, environmental, and regulatory considerations

“…The relative percentage of wastes with particular physicochemical characteristics and total quantities produced are site specific. 62 Local reconciliation and planning at the hospital and regional level along with national data reporting are therefore critical for waste minimization and accountability. 63 In many countries, hospitals and clinics are legally responsible for minimizing waste and occupational exposure, segregating waste into proper receptacles, treating potentially infectious waste, and ensuring documentation of waste fractions produced and their proper storage, transportation, and disposal.…”

“…These properties define appropriate methods of decontamination, recycling, and disposal. The relative percentage of wastes with particular physicochemical characteristics and total quantities produced are site specific 62 . Local reconciliation and planning at the hospital and regional level along with national data reporting are therefore critical for waste minimization and accountability 63 …”

Past, present, and future of sustainable intensive care: narrative review and a large hospital system experience

“…Waste in critical care has been of the topic of great interest to researchers and practitioners alike [ 17 , 22 – 25 ], with various case studies published showcasing wasteful stocking and disposal practices. For example, Hunfeld et al [ 21 ] reported that individual units used per ICU patient per day to be high as 108 disposable gloves, 57 compresses, 34 liquid medicine (infusion bags), 24 syringes, 23 tubes and connectors, 16 disposable clothing, 14 cups and containers, 11 tablets and capsules, 9 surgical masks, and 8 bed liners.…”

Single-Use Reamer Shafts for Intramedullary Nail Fixation: An Addressable Source of Extraneous Cost and Medical Waste in Orthopaedic Surgery

“…1 There is an increasing amount of literature on the management of health care waste with a recent review of musculoskeletal literature reporting 49 original articles on the topic, which emphasizes the growing importance of this topic to both surgeons and health care facilities. 2,3 Because hospitals face increasing scrutiny to contain burgeoning health care costs and waste generation, identifying and reducing the sources of extraneous costs and waste is growing increasingly important. 4,5 A large proportion of the cost and waste generated by hospitals originates from operative procedures giving surgeons the opportunity to be important stewards of hospital resources and drivers of cost and waste reduction.…”

“…1 There is an increasing amount of literature on the management of health care waste with a recent review of musculoskeletal literature reporting 49 original articles on the topic, which emphasizes the growing importance of this topic to both surgeons and health care facilities. 2,3…”