The Key Organizational Factors in Healthcare Waste Management Practices of Libyan Public Hospitals

This study aims to investigate factors contributing to healthcare waste management practices among Libyan public hospitals. The organizational culture and structure are proposed to have their effect upon hospital organizational units in charge of healthcare waste production by a theoretical review to develop two main hypotheses. Hence, this study used the stratified random sampling technique to select respondents such as top management officials, heads of departments, and administrators who work in all the hospitals located in the south of Libya, from whom data was collected. The data for the study was gathered via a survey questionnaire from Libyan public hospitals in the country’s southern region. A total of 210 questionnaires were distributed and 171 usable responses were received, yielding a 70% response rate. Though the findings of the study show some inconsistency, the two dimensions of the culture examined in this study are found to have a positive relationship and significant influence on the management practices of health waste. Besides, it shows the positive relationship between organizational structure and healthcare waste management practices (HWMP). However, the findings of this study suggested that nurses and cleaners’ practices should critically consider structure dimensions such as formalization as well as moderating variables such as hospital location and type of services supplied on the interactions to improve the management of healthcare waste in Libya’s public hospitals.

An assessment tool for healthcare waste management in Brazilian municipalities during the COVID-19 pandemic

The COVID-19 pandemic has put healthcare waste management (HCWM) systems under pressure worldwide. In Brazil, where municipalities routinely experience challenges in ensuring suitable disposal of healthcare waste (HCW), the pandemic has made this even more challenging. Therefore, the creation of tools and methods to help in municipal HCWM during the COVID-19 pandemic is of utmost importance. This article presents the development of a tool to evaluate HCWM in Brazilian municipalities during the pandemic. Following guidelines of health agencies, 56 indicators and 18 criteria were selected to create a tool called the municipal healthcare waste management assessment index (iMHWaste). These indicators and criteria were divided into operational, environmental, political–economic, educational and social groups. Each group considers essential aspects for sustainable management, safety and reduced spread of coronavirus. The analytic hierarchy process was used to assign the weights attributed to the groups and criteria. The indicators can be measured according to a standardized rating scale proposed for each one. These elements were aggregated with a weighted linear combination, into an equation that allows the calculation of the iMHWaste. The index is rated on a scale of 0–1. The index was applied in a Brazilian municipality considering a pre-pandemic HCWM. With the identification of the municipality’s management weaknesses, it was possible to identify the main actions that should be prioritized in the transition from traditional HCWM during the pandemic.

Healthcare waste management processes and transition towards a circular economy

The new Waste Directive 2018/851/EU strengthens the role of waste prevention and emphasizes recycling to facilitate the transition to a circular economy. So far, it has not been legislatively necessary for the Czech Republic to look at waste from a broader perspective, especially in healthcare, where the waste management is perceived as a separate process suitable for outsourcing. With the new directive and the transition to a circular economy, the waste management process becomes part of strategic management processes. These processes are partially systematically covered by the standards of the environmental management system, used mainly in the industrial sector. The optimal solution is a reassessment of the entire waste management of the medical facility and the inclusion of the principle of waste prevention in the decision to purchase a product or service. The necessary condition for the successful implementation of the circular economy is to minimize negative impacts on health and the environment while maintaining the economic sustainability of such a solution. Setting up generally sustainable management of medical facilities thus goes beyond current clinical practice. The health technology assessment model provides several domains that complement life cycle analysis and health impact assessment, including a health risk assessment method. The outputs of the above analyzes and evaluations cover the maximum scope of public interest in healthcare. A practical approach is developing a system of methodologies based on the methods mentioned above, which respect the whole chain of strategic processes of healthcare facilities and involve maximum stakeholders in the evaluation process. We test the approach on a pilot facility in the project SS01010276 ‘Sustainable healthcare waste management: economically feasible minimization of impacts on health and environment' supported by the Technology Agency of the Czech Republic within the Environment for Life Program. Key messages The approach aims to add value to traditional waste management approaches and integrate the long-term interests of key stakeholders using the overlapping outcomes of respective assessments. A sustainable approach to healthcare waste management must be developed with the involvement of all key stakeholders and concerning their interests within their position in the assessment process.

Management of Healthcare Waste in Healthcare Emergencies

Proper management of waste in healthcare emergencies is key to preventing spread of infections within an emergency. The risks of poor waste management are varied with the risks of spreading infectious diseases being the most important to consider. Chemical pollution should also be considered as water sources can easily be polluted. Careful thought and planning including a risk assessment should be carried out and the results should be publicized to create a common understanding of the problem at hand. This will also inform the methods to be used for the management of waste. Training of healthcare workers is key to creating common understanding of the problem at hand. The different types of waste to be generated should be well understood and methods to manage it should be well thought out before implementation. The decision on the different methods used to manage waste should be informed by the risk assessment and the available resources. However effectiveness to deal with the waste produced should be considered above all factors. Proper healthcare waste management is imperative to preventing further infections that might not be part of the original healthcare emergency. Planning to manage waste is a process that requires information before implementation.

Application of Hazard Analysis of Critical Control Points (HACCP) Method to Describe Critical Points in Healthcare Waste Management of Razi Hospital in Ghaemshahr, Iran During COVID-19 Pandemic in 2020

Background: During the outbreak of COVID-19 in developing countries such as Iran, the management of healthcare waste has become a very important issue. It is necessary to investigate the risk of virus transmission through direct contact, inhalation, and environmental pollution to reduce transmission risk. The Hazard Analysis of Critical Control Points framework is used to simplify quick responses of waste management for facing the novel infectious disease. Objectives: The aim of this study was to use risk analysis frameworks to describe hazard critical control points (HACCP) and make recommendations and corrective actions for staff who work in healthcare facilities and communities experiencing the COVID-19 outbreak. Methods: In the present descriptive-analytical study, a team of environmental health experts identified the critical control points of healthcare waste produced in Razi Hospital and divided them into three categories and six steps. A tested and verified hazard analysis flow diagram was prepared to determine critical points in different steps of healthcare waste management. Critical control points were identified and analyzed by the team at each step. Recommendations and corrective actions were made for each control point. Results: The production rate significantly increased from 580 to 1,733 kg per day, probably caused by the increased use of disposable waste during the pandemic. Transportation, disinfection, and storage appeared to be associated with an individually high level of transmission risk of COVID-19 virus. Also, direct contact with infectious waste was often associated with a high risk of virus transmission. In the final disposal of healthcare waste, people were exposed to a lower level of risk. Conclusions: Training staff in different wards of the hospital to use proper personal protective equipment (PPE), hand washing, disinfectants, and ventilation could reduce the risk of COVID-19 transmission through healthcare waste. Using the HACCP method for providing recommendations and corrective actions could simplify responses to reduce the transmission risk of COVID-19 during pandemics.

Multi-Objective Optimization for Healthcare Waste Management Network Design with Sustainability Perspective

Healthcare Waste Management (HWM) is considered as one of the important urban decision-making problems due to its potential environmental, economic, and social risks and damages. The network of the HWM system involves important decisions such as facility locating, inventory management, and transportation management. Moreover, with growing concerns towards sustainable development objectives, HWM systems should address its environmental and social aspects as well as its economic and technical characteristics. In this regard, this paper formulates a novel multi-objective optimization model to empower companies in making optimized decisions considering the economic, environmental, and social aspects. Within the proposed model, the first objective function aims to minimize the transportation costs, processing costs, and establishment costs. The second objective function aims to minimize environmental risks and emissions related to the transportation of waste between facilities. The third objective function aims to maximize job creation opportunities. Formulating these three functions, an Improved Multi-Choice Goal Programing (IMCGP) approach is proposed to solve the multi-objective optimization model, which is then compared with the Goal Attainment Method (GAM). Finally, to show the applicability and feasibility of the proposed model, an illustrative example of healthcare waste management is analyzed, and the results are discussed.