title: A total quality management approach to healthcare waste management in Namazi Hospital, Iran.
abstract: BACKGROUND
  Healthcare waste comprises all wastes generated at healthcare facilities, medical research centers and laboratories. Although 75-90% of these wastes are classified as household waste posing no potential risk, 10-25% are deemed to be hazardous, representing a potential threat to healthcare workers, patients, the environment and even the general population, if not disposed of appropriately. If hazardous and non-hazardous waste is mixed and not segregated prior to disposal, costs will increase substantially. Medical waste management is a worldwide issue. In Iran, the majority of problems are associated with an exponential growth in the healthcare sector together with low- or non-compliance with guidelines and recommendations. The aim of this study was to reduce the amounts of infectious waste by clear definition and segregation of waste at the production site in Namazi Hospital in Shiraz, Iran.
  
  
  METHODS
  Namazi Hospital was selected as a study site with an aim to achieving a significant decrease in infectious waste and implementing a total quality management (TQM) method. Infectious and non-infectious waste was weighed at 29 admission wards over a 1-month period.
  
  
  RESULTS
  Before the introduction of the new guidelines and the new waste management concept, weight of total waste was 6.67 kg per occupied bed per day (kg/occupied bed/day), of which 73% was infectious and 27% non-infectious waste. After intervention, total waste was reduced to 5.92 kg/occupied bed/day, of which infectious waste represented 61% and non-infectious waste 30%. The implementation of a new waste management concept achieved a 26% reduction in infectious waste.
  
  
  CONCLUSIONS
  A structured waste management concept together with clear definitions and staff training will result in waste reduction, consequently leading to decreased expenditure in healthcare settings.
authors.affiliation: Department of Community Medicine, Shiraz University of Medical Sciences, Shiraz Medical School, P.O. Box 71345-1737, Shiraz, Iran. askariam@sums.ac.ir
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Askarian
authors.forename: Peigham
authors.initials: P
authors.lastname: Heidarpoor
authors.forename: Ojan
authors.initials: O
authors.lastname: Assadian
mesh_terms: D017408:Guidelines as Topic; D006256:Hazardous Waste; D006268:Health Facilities; D006761:Hospitals; D006801:Humans; D007318:Inservice Training; D007492:Iran; D008506:Medical Waste / Q000032:analysis*; D017744:Medical Waste Disposal / Q000379:methods*; D016730:Program Development; D017749:Total Quality Management; D018505:Waste Management / Q000379:methods
chemical_list: D006256:Hazardous Waste; D008506:Medical Waste; D017744:Medical Waste Disposal