A Green Quality Improvement Project: Sustainable Waste Disposal in a Geriatric Admissions Unit

Introduction: Following COP26, the NHS pledged a ‘Net Zero’ health service by 2040. Incineration of clinical waste has a negative impact on the environment whilst also being extremely costly. NHS Grampian spends over £1m annually on disposal of clinical waste, whilst 20% of the waste incinerated is unsuitable for that waste stream. An excess of clean plastic packaging from visors, used when managing respiratory viruses, was a particular contributor in our unit. To improve sustainability, the aim of this quality improvement project was to reduce unnecessary disposal of plastic packaging in clinical waste streams by 80% in our Geriatric Assessment Unit.

Method: Using PDSA methodology, data was collected regarding the number and location of clinical waste bins and how many contained plastic visor packaging or any form of ‘non-clinical’ waste. Qualitative data highlighted that staff were aware of disposing waste in the wrong stream, however, struggled to find alternative waste bins located nearby. Selected orange bins were removed and black bins introduced at convenient points. Further PDSA cycles focused on staff engagement and education.

Results: Following PDSA Cycle 1, a baseline median of 57% of orange bins contained clean plastic packaging and 64% contained any form of non-clinical waste. Following staff education, clinical waste bins containing single use plastic dropped to 0%, whilst the percentage containing any form of non-clinical waste remained averaging 35%.

Conclusion: Making clinical waste bins less readily available reduces the amount of unnecessary clean plastic packaging entering clinical waste. We must counteract this through increasing access to general and recyclable waste bins to ensure waste is disposed of correctly. This may be achieved through the creation of “waste stations” in preparation areas, to facilitate readily available access to all waste streams at a single point if required.