Evaluating the Emergency Department’s Generation of Biohazardous (Red-Bag) Waste

Stanford Health Care Main Campus generated 5,423 tons of waste in 2022. Not all waste is created equal. Non-infectious waste that is sorted into the biohazardous (red-bag) waste bin increases the use of waste management supplies, increases the need for specialized labor to manage the waste, and increases energy used to treat the waste before disposal. Stanford Health Care’s biohazardous (red bag) generation is more than double the industry target, driven largely by overuse of the biohazardous (red-bag) waste bins in high-acuity areas. Red-bag waste at Main Campus is disinfected in an autoclave that uses steam from the natural-gas powered steam plant on campus. While this is a better alternative than incineration, overgeneration of red-bag waste contributes to air pollution and carbon emissions directly on campus. Dr. James Marvel has a plan to minimize red-bag waste in the Emergency Department through collaborative process improvement.

The team will conduct a baseline waste audit in the Emergency Department to analyze 24 hours of landfill and biohazardous waste. The team will also evaluate waste bin profiles for each room type and will streamline bin placement and engage staff on accurate sorting to disincentivize over-use of biohazardous waste bins. The team will then use waste audit findings to prioritize waste reduction interventions such as supply waste avoidance and switching to reusables.

The ED is a major waste generator in the hospital. The baseline waste audit will inform the team about opportunities to minimize waste and improve sorting, while providing valuable data and findings that peers may reference to help guide waste reduction in other Emergency Departments.

Jean Reyes, MSN, MBA, RN
Patient Care Manager, Stanford Health

Lauren Klingman, MD
Resident Physician, Stanford University Department of Emergency

Co-Leads the ED Green Team

Course director for Impact of Climate Change on Human Health at Stanford

Elected Environmental Committee Chair for the Wilderness Medical Society

Started a resident elective program focusing on healthcare as it relates to climate change