Clinical Waste Reduction

Slide #1 Introduction

·         Change project

o   Reduction of clinical waste

o   Reduction of operational costs

o   Improving the quality of service

The emergency department of healthcare organizations such as hospitals and clinics record a lot of waste in its operations. The wastes have some negative effects that lower the progress of the organization. For instance, it results in high operational costs and poorer services offered to clients. This project, therefore, seeks to implement a strategy for waste reduction through the Hospital Inpatient Waste Identification Tool.

Slide #2 Understanding waste

·         Resource or activity with no additional value on a clinical process

·         Examples

o   Wastage of materials

o   Over-staffing a particular duty

o   Work repetition

In this clinical context, waste can be any resource or activity that has no addition to the organization.  For instance, clients may be forced to undergo a process twice, or two different methods with similar outcomes resulting in wastage of the departments, and organizational resources. Additionally, overstaffing a particular area, or providing more resources towards a specific source are all instances that result in wastage (Shivalli&Sanklapur, 2014).

Slide #3 The Hospital Inpatient Waste Identification Tool

·         Identifies areas of wastage

o   Clear articulation of waste types

o   Frontline staff approach

o   Qualitative analysis

This tool helps identify areas where wastage occurs most hence guides the implementation strategy. The frontline staff approach principle ensures that waste is identified and the data collected by the clinical staff who provide direct patient care. Nurses and physicians are examples of frontline clinical staff. The second principle is the clear articulation of waste types (Shivalli&Sanklapur, 2014). This ensures that proper identification and recording of waste according to their form on a one-page worksheet is done for better understanding. The qualitative analysis principle involves the assessment of a particular or patient process with a documented waste potential for more straightforward implementation.

Slide #4 Context for the change

·         The Clinical Emergency Department

·         Reasons for plan implementation;

o   Overstaffing

o   Allocation of excess resources

o   Long waiting times

The clinical emergency department has been, for an extended period, been experiencing plenty of wastages. For instance, the department is often overcrowded with staff while at the same time materials and other allocated resources have been going to waste due to excess, and clients have been waiting in line for long periods (Yang, Lam, Low, & Ong, 2016; Chan et al., 2014). The wastages have significantly lowered the department’s performances. Therefore, changes have to be made in the department for better results and economic advantages.

Slide #5 Persons affected by the change

·         Patients

·         Nurses

·         Physicians

·         Clinicians

·         Leaders and other stakeholders

This waste reduction plan will bear positive effects on different persons associated with the health care organization’s emergency department. Firstly, patients will experience improved services once the changes have been implemented. Secondly, nurses will be motivated to work better once their duties have been streamlined and wastages reduced in the department, which will improve patient outcomes. Leaders and stakeholders will experience reduced operating costs while surplus finance may be channeled to address other organizational issues (Resar, Griffin, Kabcenell, & Bones, 2011).

Slide #6 Persons to approve the changes

·         The CEO

·         The Chief Operating Officer

·         Board of directors

The CEO, COO or the board of directors are in charge of approving changes that affect how a health care organization carries out its activities. As the heads of the organization, they must seek out and implement changes that will impact positively on the organization’s operations. They must critically analyze new proposed changes and innovations before making informed decisions.

Slide #7 current practices for the intended changes

·         There are no current remarkable clinical waste reduction practices in the organization (Resar et al., 2011)

·         Efforts to reduce waste are unsystematic

·         Emphasis on only operational and administrative efforts for waste reduction

Resar et al. (2011) state that despite organizations across the United States initiating waste reduction projects, their efforts pay more attention to administrative and operational waste. Additionally, most efforts are unsystematic.

Slide #8 Resources Needed

·         Task-Appropriate Leaders

·         Employee Trainers

·         Funding

For successful change implementation, task-appropriate leadership is necessary, which implies selecting a change implementation leadership team that understands the importance of the project and can clearly articulate it to the affected employees. This should help lower resistance to the proposed. Secondly, employee trainers are essential to help train the affected individuals on the new or suggested changes. The management must then set aside funding for the processes mentioned above if the required outcomes of the project are to be met (Fulop, Walters, Perri, & Spurgeon, 2012).

Slide #9 Timeline

·         Step 1. Strategy and Planning Phase of the Change Management Plan

o   Consider: Organizational Culture

o   Approval processes

o   Existing Processes and Technologies

o   Success criteria and desired outcomes and Timelines

·         Step 2. Configuration and Testing

o   Highlight organizational and technology changes

o   Align organizational processes with new technology

o   Testing, approvals, and sign-offs

After an analysis of the Hospital Inpatient Waste Tool has been conducted, and cost-benefit analyses carried out, discussions must then be held with the relevant people and teams around the project overview, requirements as well as the relevant timing milestones. Since change is difficult to implement, and will more than likely be met with resistance, one must consider the organizational culture at the health facility, the approval process, present technologies and processes and the required outcome for a change. On the other hand, since the healthcare facility requires new technology that will help in mapping and scheduling, it is important to understand the changes, as well as align the existing processes to the technology (Fulop, Walters, Perri, & Spurgeon, 2012).

Slide #10 Timeline Cont’d

·         Step 3. Product Training

o   Train Personnel on the new technology

o   Create exposure to enable support and contact

·         Step. 4 Communication Plan and Roll Out

o   Execute the Communication Plan

o   Initiate new services

o   Re-communicate

For change to be effective, it is necessary that individual who will be affected by the new processes undergo training to understand the functionality of the new process. This creates exposure to the new system which garners support for the new improved system among healthcare practitioners. Finally, a communication plan is created to all stakeholders as the system is fully rolled out which in effect initiates new services which help with the reduction of waste


Chan, Y., Lo, S., Lee, L., Lo, W., Yu, W., Wu, Y., . . . Chan, J. (2014). Lean techniques for the improvement of patients’ flow in the emergency department. World Journal of Emergency Medicine, 5(1), 24-28.

Fulop, N., Walters, R., Perri, & Spurgeon, P. (2012). Implementing changes to hospital services: Factors influencing the process and ‘results’ of reconfiguration. Health Policy, 104(2), 128-135.

Resar, R., Griffin, F., Kabcenell, A., & Bones, C. (2011). Innovation Series 2011: Hospital Inpatient Waste Identification Tool. Cambridge: Institute for Healthcare Improvement.

Shivalli, S., & Sanklapur, V. (2014). Healthcare Waste Management: Qualitative and Quantitative Appraisal of Nurses in a Tertiary Care Hospital of India. The Scientific World Journal, 2014(1), 1-6.

Yang, K., Lam, S., Low, J., & Ong, M. (2016). Managing emergency department crowding through improved triaging and resource allocation. Operations Research for Health Care, 10(1), 13-22.


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