J.J. Szeto1, C. Chapman2, C.Z. Shen1, H. Kim1, J. Tchou3,4, C.C. Duffy5 1University Of Pennsylvania, Perelman School Of Medicine, Philadelphia, PA, USA 2University Of Pennsylvania, Penn Medicine Center For Healthcare Innovation, Philadelphia, PA, USA 3University Of Pennsylvania, Division Of Breast Surgery, Philadelphia, PA, USA 4University Of Pennsylvania, Department Of Surgery, Philadelphia, PA, USA 5University Of Pennsylvania, Department Of Anesthesiology And Critical Care, Philadelphia, PA, USA
Introduction:
The operating room (OR) accounts for 30% of hospital total waste production. This waste is divided into regulated medical waste (RMW) consisting of contaminated waste with blood or other potentially infectious bodily fluids and non-contaminated municipal healthcare waste (MHW). The World Health Organization estimates 80% of healthcare waste is medical waste (MHW), with RMW accounting for only 10%. Despite this, many health systems handle and dispose of substantial volumes of RMW. Incorrectly categorizing non-contaminated MHW as RMW has significant environmental and cost implications. This study aims to evaluate whether educational signage and a new bin system in the OR can enhance correct separation of waste.
Methods:
We conducted an in-situ simulated intervention study in the OR of a tertiary university referral hospital at the University of Pennsylvania. OR personnel were recruited voluntarily and provided written consent. Participants took part in 2 simulation scenarios, where they disposed of common OR waste including materials containing blood, urine, or feces into designated bins while solving complex puzzles that simulated a surgical procedure. The simulations concluded once all waste was correctly disposed of. In the control simulation, participants were provided with 2 large red bins and 1 large gray bin. In the intervention simulation, 2 large gray bins and a small red bin attached to one of the gray bins were provided for waste disposal and signage was available to guide proper waste disposal. Post-participation surveys were completed assessing satisfaction and knowledge. Outcomes measured included accuracy of waste disposal.
Results:
Twenty-three OR personnel participated in this study over 6 hours. There was a 75% reduction in waste sorted incorrectly between the control and intervention simulation, with 90% reduction of general waste being sorted into the red waste bin (Table 1). Post-participation survey revealed an opportunity for further education on waste disposal with participants enjoying participating in the simulation. Key learning points identified by participants included the difference in disposal between light and heavy soiling of blood and the distinction that bile, feces, and urine can go into general waste safely.?
Conclusion:
The intervention group demonstrated superior performance compared to the control group across all key sorting categories, with fewer errors, more items sorted correctly, and significantly reduced the misclassification of general waste as biohazardous. These findings indicate the intervention and signage provided during the intervention group were highly effective in enhancing waste sorting accuracy and compliance with waste management protocols.