The NorCal brachytherapy waste audit: A simple, validated, toolkit for clinician led waste reduction.

Brachytherapy Pub Date : 2025-03-01 DOI:10.1016/j.brachy.2025.01.002

Claire C Baniel, Katie E Lichter, Melissa A Frick, Jaclyn Wu, Eniola Oladipo, Yufan Fred Wu, Aneesh SwamyS, I-Chow Hsu, Nicolas Prionas, Erik S Blomain, Elizabeth A Kidd, Mark K Buyyounouski, Glenn Rosenbluth, Osama Mohamad, Hilary P Bagshaw

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Abstract

Purpose: The healthcare system is resource intensive, and many opportunities exist to reduce medical waste. Brachytherapists performing inherently resource intensive procedures are well poised to initiate the transition to sustainable, climate-smart care. The authors developed a quality improvement-based (QI) NorCal Brachytherapy Waste Audit Toolkit to guide medical waste reduction in brachytherapy procedures and provide climate health education.

Methods and materials: The NorCal Brachytherapy Waste Audit Toolkit was validated through brachytherapy waste audits conducted at 2 neighboring hospitals between 2021 and 2023. Waste was categorized into biohazardous waste, nonbiohazardous waste, and anesthesia waste and was weighed and cataloged after each procedure using a standard template by auditors not involved in the brachytherapy case. Findings were analyzed for key drivers of waste production and high impact interventions were selected.

Results: Postaudit results demonstrate biohazardous waste reduction of greater than 50%, elimination of over 90% improper biohazardous waste sorting, cost savings ($4.22/kg) and a reduction in landfill waste by over 20%. The Toolkit was made public online and over 18 months, was accessed by 34 distinct individuals from 21 healthcare organizations across 7 countries and led to waste reduction projects in multiple specialties including radiation oncology, emergency medicine, and pediatrics.

Conclusion: A QI-based NorCal Brachytherapy Waste Audit Toolkit may help radiation oncologists and healthcare teams beyond radiation oncology reduce waste and contribute toward environmentally sustainable healthcare.

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Brachytherapy

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