Hospital Waste Management at the Hospital under the Jurisdiction of the Medical Service Department Bangkok Metropolis Administration

Objectives: 1) To develop a waste management system with the concept of a circular economy and participatory approach to resolve problems in the hospitals under the Medical Service Department (MSD), Bangkok Metropolitan Administration (BMA); and 2) To study the results of the development of a waste management system through the circular economy concept and participatory problem solving in the MSD hospitals.

Materials and Methods: This study is an action research with an aim to develop a waste management system with the concept of a circular economy and participatory problem solving in the MSD hospitals. This also includes the application of one group pretest-posttest of the waste management system. The samples consist of 1) the personnel involved in the waste management from Nursing Department, General Administration Department, Infection Control Nursing Department, and the Hospital Environment and Safety Committee. Purposive sampling was used consisted of 5 people from each large-sized hospital and 4 people from each medium-sized hospital, with a total of 36 samples. 2) Participants in group discussion comprises of 12 heads and assistant heads of collaboration teams from the hospitals who can be a representative to answer the research questions. The research tools for data collection were 1) a data recording form of the MSD hospitals; 2) a waste recording form 3) a cost and revenue recording form derived from waste management. Data were gathered as follows: 1) the meeting was conducted to provide knowledge and understanding of how to collect and record waste data; 2) collect the information of waste management consisted of the amount of each type of waste, and 3-month of revenue and expenses of waste management before the implementation of the new model; 3) The educational activities were organized to provide knowledge in waste management including  brainstorming sessions to identify the concept of waste management with the use of circular economy and participatory approach to resolve problems. The ideas were collectively developed before implementation; 4) the waste management system was tested for 1 month in the MSD hospitals; 5) the data were collected after the implementation of the new waste management system; 6) the waste management data for 3 months were collected to be analyzed with descriptive statistics which are mean, percentage, and ANOVA.

Results: the findings showed that 1) the effective waste management in the MSD hospitals requires the concrete participation and collaboration between internal and external departments together with private sector in order to achieve the efficient waste management in terms of waste reduction, standards of clinical waste management in accordance with regulation and legislation, and no environmental impact. This also includes converting recycled waste into value-added materials by upcycling and the resulting products can be commercially and socially beneficial; 2) the results of the development of waste management system in the MSD hospitals were: 2.1) the amounts of waste before and after the implementation of the waste management model with the circular economy concept in the MSD hospitals in 3-month period were not different. 2.2) the waste management expenses on pre- and post-implementation of the waste management model in the MSD hospitals in 3-month were not different.

Conclusion: the development of the effective waste management system with the circular economy concept and participatory problem-solving in the MSD hospitals, BMA requires a clear policy and the collaboration between internal and external organizations including public sector and private sector.

Keywords: hospital waste, hospital waste management