Reducing misclassification of medical waste: nudging stakeholders to reduce waste misclassification in a novel simulated operating room built environment.

BACKGROUND: The OR generates over 30% of a healthcare facility's total waste, with more than 60% classified as regulated medical waste (RMW). Municipal waste (MW) is commonly incorrectly classified as RMW, resulting in unnecessary costs and environmental burden. As such, this pilot study aimed to determine if interventions that provide visual cues for waste classification and improve ergonomics in the operating room (OR) can improve waste sorting accuracy.

METHODS: In groups of two to four, participants were tasked with quickly solving tangram puzzles while periodically given simulated medical waste to dispose of into either a MW container or a RMW container. Groups first engaged in a control simulation, followed by an intervention simulation where educational signage and the novel adapted waste bin was placed in the OR. Sorting accuracy was assessed, and participants completed a post-participation survey.

RESULTS: 23 participants took part of this pilot study. The proportion of correctly classified waste increased between control (53%) and intervention (88%) conditions, p < 0.01. Cost (n = 21) and sustainability (n = 20) were highly cited reasons why it might be important to correctly dispose of waste. Participants cited location of the containers (n = 13), time issues or OR stress (n = 10), and confusion in waste classification (n = 13) as barriers to accurate waste sorting.

CONCLUSION: Participants had significant improvement in OR waste classification accuracy after the implementation of educational signage and a novel adapted bin system. These strategies can be employed to increase waste sorting accuracy in the OR or be used as an educational tool during trainings to improve staff understanding of proper waste disposal.