Medication Waste and Returns in a General Hospital: amount, sources, reuse potential and associated costs

Abstract

Medication waste in hospitals is an increasing problem. The total environmental burden of the Dutch healthcare sector is approximately 11 megatons of CO2 per year. Medication waste has both financial and environmental impact. This study aims to map out medication waste from returned medication in the hospital setting by recording returned medication and conducting interviews with hospital staff. Over a period of 14 days, the amount, associated costs, reuse potential, sources and the causes were analyzed of returned medication at a large general hospital on two different locations. This was done on all wards at both locations from the Dijklander hospital, The Netherlands. The total costs of the returned medication were estimated at €885,000 with an average return amount of 429,000 units of medication annually. This resulted in a yearly medication waste of around 444.6 kg. The main causes of the medication not being reusable and thus wasted were as follows; external medication brought into the hospital, the source of the medication not identifiable, no medication name, dosage and/or expiration date visible on the medication units and less than four returned medication units from the same batch. The most important determinant of the returns was the patient being discharged from the hospital. Returned medication could later be reused or labeled as waste depending on if the criteria for reuse were met. Returned medication waste was primarily due to poor communication about return criteria and expectations, lack of protocols that could contribute to reducing waste, insufficient time amongst healthcare staff and human error. Based on these findings, recommendations are made to improve inventory management and return policies by clarifying return policies for hospital staff, implement protocols and enhance communication between healthcare professionals to prevent medication waste. Our study contributes to reducing medication waste and provides practical guidance for hospitals aiming for cost savings and implementing sustainability policies.