Has the Time Come for a Medical Waste Audit at Your Organization?

Health care organizations and medical professionals have shown a strong interest in reducing their greenhouse gas emissions.

Integrating sustainability into all aspects of a hospital’s mission takes focused commitment across the organization, as Massachusetts General Hospital (MGH) leaders can attest. Two years ago, MGH launched its Center for the Environment and Health.

The center integrates sustainability into MGH’s clinical, research and educational activities and is designed to improve the environmental health of the hospital and the health and well-being of the communities it serves. The organization is paring down its fossil fuel use, composting food waste, changing anesthesiology practices and recycling the blue wrap used to protect sterilized surgical instruments before they enter the operating room.

Two hospitalists at MGH saw firsthand just how much waste is generated daily in even a relatively small area like the 21st floor of Phillips House, a 20-single room inpatient area at MGH. Two years ago, they looked on as the cleaning staff conducted a 24-hour waste audit.

The floor’s refuse items were weighed, sorted and catalogued as part of an effort to reduce plastic use. The audit and the doctors’ reaction to what they saw were chronicled in a recent Stat News report.

The final totals showed that more than 370 pounds of waste was produced that day — most of it plastic. In all, plastic waste amounted to almost 18 pounds per patient in a single day. The greenhouse gas emitted to make and dispose of the waste identified in the audit was the equivalent of driving 350 miles, charging 65,000 smartphones or burning 269 kilograms of coal, based on Environmental Protection Agency models.

Health care audits are an increasingly popular way to gauge exactly what kind of waste hospitals produce, notes a 2022 study of audits led by Jonathan Slutzman, M.D., who led the development of MGH’s Center for the Environment and Health. He calls waste audits “the gateway drug for sustainability science” and says they aren’t hard to do but require careful coordination across many hospitals. The effort, he says, can give hospitals the tools to make changes.

The larger aim, he says, is to work with vendors, manufacturers and regulators so that “the easy practice is the right practice.”

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The journal Waste Management & Research earlier this year published a systematic review of best practices for waste audits in health care.