The U.S. healthcare system is a major generator of greenhouse gas emissions, with operating rooms contributing an estimated 30 percent of hospital waste. That’s why a team in the Department of Radiation Oncology at UCSF collaborated with Stanford residents to create a waste audit toolkit to reduce the amount of medical waste being shipped to landfills.
Katie Lichter (photographed, above), a resident physician in Radiation Oncology at UCSF, worked with the team. “Traditionally, waste audits require manually weighing landfill and biohazardous waste (red bag) whereas, with AI tools, it can quantify and estimate the amount of waste through the simple use of photos,” she said.
Lichter recently presented the team’s findings at the 2023 American Brachytherapy Society’s Annual Meeting held in late June. “This study demonstrates the potential of using artificial intelligence and machine learning tools to efficiently track and manage red bag waste in an operating room setting,” she said.
Lichter said the tool will estimate the amount of waste based on the volume of the bag filled and report on the “appropriate” and “inappropriate” disposal of waste. “It will flag anything in red bag waste bins that should not be there,” Lichter said. “Items could include foley bags, unsoiled towels or gowns, suture supplies, patient immobilization foam, etc.”
Katie Lichter, MD, MPH
This is important because disposal of red bag waste often has toxic by-products from its incineration entering the air and water streams. Steam autoclaving is standard in California, but incineration may be used in other states. In either case, both processes may result in it being two to three times more expensive than landfill costs. Thus, ensuring appropriate disposal of OR items waste is key.
While the average OR waste audit can take 15 to 20 minutes, the AI platform can complete the audit in approximately one minute. Through feedback provided by the platform, the department was able to eliminate improper sorting of red bag waste, resulting in the eliminating of red bag waste in more than 90 percent of cases and providing a potential savings of $4.22 per kilogram of waste. Additionally, landfill waste was reduced by 20 percent.
The platform’s ability to gain granular visibility into waste contamination, enhance staff education, and enable instant communication across teams makes it a valuable tool for healthcare facilities looking to improve their bottom line and become more sustainable. The implementation of the technology could lead to significant cost savings, reduced environmental impact, and improved patient safety in brachytherapy operating rooms.
“This tool can be used to target waste reduction in all operating rooms for any type of procedure,” Lichter said. “Additionally, it can be used on a hospital-wide level.”
Lichter said people are excited to start waste audits at their home institutions. “Many other programs are using the waste audit toolkit that we made in collaboration with Stanford residents to guide this process – we are excited to collaborate with healthcare professionals around the nation to reduce waste expenses."
Sustainability Director for UCSF and UCSF Health, Gail Lee, said proper waste sorting in the OR can reduce the expense of unnecessarily processing waste. "Those resources can then be reallocated to other patient care services," Lee said.
