The medical waste audit. A framework for hospitals to appraise options and financial implications.

: The generation, handling, and disposal of medical wastes involve virtually every department in the hospital. To enhance coordination, managers must comprehensively describe the total system and specify the roles of key functions and individuals. Hospitals produce about 77 percent of the approximately 500,000 tons of regulated medical waste produced annually in the United States. The amount produced by different hospitals varies, primarily because of differences in "waste-management practices." The Environmental Protection Agency is trying to develop a greater understanding of the types of medical wastes that are infectious, methods of transmission, and the likelihood of transmission in the handling and disposal of waste within the hospital environment. To ensure that medical waste is being handled and treated in the most cost-effective manner and with the least health risk to employees and the community, hospital administrators must undertake a comprehensive appraisal of the activities associated with the generation, handling, and disposal processes. A "medical waste audit" requires the following steps: Generation profile to identify origination points, categories or types of waste, and associated generation rates. Inventory of handling practices, including existing regulations, procedures and protocols, training programs, definitions regarding waste segregation, and documentation. Review of current disposal practices and existing and developing alternatives. Cost analysis