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Year:: 2021
Contributor:: Hsu, Sarah (Author); Banskota, Swechya (Author); McCormick, Winston (Author); Moretti, Katelyn (Author); Wiegn, David (Author); Martin, Kyle (Author); Mello, Michael (Author); Slutzman, Jonathan (Author); Brown University. Alpert Medical School. Scholarly Concentration Program. Non-Scholarly Concentrator (research program)
Subject:: Emergency medicine; Environmental health; Medical wastes; Medical wastes--Management; Hazardous wastes--Auditing; Infectious wastes

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Abstract:: Background: Healthcare contributes 10% of US greenhouse gases and generates 4 billion pounds of waste each year. Reducing healthcare waste can reduce the environmental impact of healthcare and lower hospitals’ waste disposal costs. However, there is no existing literature surrounding US Emergency Department (ED) waste management. The purpose of this study is to quantify, describe, and compare the amount of waste generated by two EDs (academic center vs. community hospital), identify deviations from waste policy, and explore areas for waste reduction in the ED. Methods: We conducted a 24-hour ED waste audit in July 2019 at Massachusetts General Hospital (MGH), an urban, tertiary-care academic medical center that serves as a Level 1 trauma center, and a 24-hour ED waste audit in Feb 2020 at Kent Hospital, a suburban community hospital in Rhode Island. All waste generated in the EDs during their respective study periods was collected, manually sorted into separate categories based on its predominant material, and weighed. We tracked deviations from hospital waste policy using the hospitals’ Infection Control Manuals, state regulations, and HIPAA standards. Results: During the during a 24-hour collection period, the MGH ED generated 1,481 lbs. total waste, or 4.4 lbs. of waste per patient encounter. Kent ED generated 562 lbs. total waste, or 3.6 lbs. of waste per patient encounter. The majority was plastic (64.6% vs. 61%) at MGH and Kent ED respectively. Only 14.9% of waste thrown in red bags met the criteria for regulated medical waste in MGH, where red bags are kept inside patient rooms. Comparatively, at Kent where red bags are kept outside patient rooms, 51% of waste thrown red bags met the criteria for regulated medical waste. We identified several deviations from waste policy at both institutions, including re-processable items and Protected Health Information thrown away inappropriately in medical and solid waste at MGH and high quantity of unused items at Kent ED. We identified over 200 unused items at both institutions, accounting for 0.1% of total waste at MGH ED and 5% of total waste at Kent ED. Conclusion: The ED generates significant amounts of waste. ED Waste audits are useful for identifying institution-specific waste disposal practices that can be improved to reduce total waste generated, increase adherence to waste policy, and reduce environmental impact. Future studies are needed to identify the impact of waste reduction interventions, such as moving red bags outside of patient rooms, in reducing the amount and carbon footprint of ED waste.
Notes:: Scholarly concentration: Non-Scholarly Concentrator

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Hsu, Sarah, Banskota, Swechya, McCormick, Winston, et al., "Dumpster Diving in Emergency Departments: A Comparison of Waste Production at MGH and Kent ED" (2021). Warren Alpert Medical School Academic Symposium. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:3unxcsrt/

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Warren Alpert Medical School Academic Symposium

The Warren Alpert Medical School Academic Symposium is an annual event at Warren Alpert Medical School of Brown University that provides Year II medical students a venue to present their summer research in a poster format. Participation in the Symposium …
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Dumpster Diving in Emergency Departments: A Comparison of Waste Production at MGH and Kent ED