Improving environmental sustainability in outpatient clinics: Lessons from a waste audit

Background: The healthcare industry is the second leading contributor of waste in the United States. While there are multiple examples of medical waste audits in the literature, few were conducted in outpatient settings. The objective of this study was to utilize a waste audit to identify key waste generators in an outpatient practice and start immediately reducing waste and greenhouse gas emissions. Materials and methods: This was a cross-sectional, observational study wherein waste from a total of 31 randomly selected encounters from December 2020 through June 2021 in the Physical Medicine & Rehabilitation Sports and Spine clinics of an academic center was collected and weighed, and key waste generators were identified. Results: The outpatient surgical center produced the most waste per patient encounter (1,758 g), followed by in-clinic procedure visits (379 g per encounter). Clinicians who performed in-clinic procedures using prepackaged procedure kits produced an estimated 819.5 kg more waste annually than those who selected individual sterile components for their procedures. Discussion: By identifying and developing interventions that target key waste generators, such as reducing the use of pre-packaged injection kits, we demonstrate how outpatient offices can immediately reduce waste. In doing so, we demonstrate the significant potential environmental savings of such measures. (c) 2021 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)