Medical waste management: a case study in a small size hospital of central Italy

Purpose – A measurement campaign was carried out for assessing the waste flow in a pilot hospital of a region in central Italy, with the purpose of having a complete overview of the waste stream and of the personnel behavior in managing and handling waste flow both internally and in outsourcing. The main aim of the work was to provide instruction for decreasing waste quantities, improving segregation and decreasing costs and environmental risks. Moreover an analysis of the effectiveness of outsourcing the waste management service in terms of cost reduction and efficiency improvements and of the limits has been performed. Design/methodology/approach – A self-assessment model was proposed for evaluating waste generation patterns, quantities and sources and identifying anomalies. The research team comprised the hospital administrator, the head physician and charge nurse of each hospital ward, the administrative in charge of the waste management documents, the head of the hospital pharmacy, the responsible for the external outsourcing company in charge of waste collection and disposal, and the research team of Universita` Politecnica delle Marche. The data were obtained through the questionnaires elaborated by the group and submitted to a selected sample of personnel; they were asked to provide information on waste management practices (generation, collection, segregation, cleaning, storage) and quantities. Findings – Anomalous behaviors were identified in the high amount of solid waste going into the medical waste stream; corrective actions have been proposed and their effectiveness has been monitored after implementation. The measures allowed a reduction of medical waste from 13 to 15 percent in two analyzed wards with a significant reduction of waste management costs. Originality/value – This work has been requested and supported by the management of the healthcare structure analyzed, and represents a first step in the implementation of a policy that considers waste management as one of the fundamental processes for the proper functioning of the hospital.