Ranking of hospital waste management criteria using multi-criteria decision-making approach in selected hospitals

Improper management of hospital waste has become a major concern in many developing countries. The present study was conducted with the aim of ranking the health-environmental and management criteria of hospital waste using the multi-criteria decision-making approach of ANP-TOPSIS.

This research is a qualitative study. After identifying and determining the health-environmental and management criteria of hospital waste, the validation of criteria was done using the Delphi method and using a questionnaire. SPSS software was used for data analysis. In order to weight the criteria and sub-criteria, the Analytical Network Process (ANP) technique and Super Decision 2.2 software were used. Then, TOPSIS method was  used to evaluate and prioritize the identified sub-criteria.

Totally, 11 criteria and 44 sub-criteria were validated by Delphi method. Results indicated that “the participation of nursing assistants in separating infectious and non-infectious waste” (by weight of 0.705), “the participation of nurses in waste disposal” (by weight of 0.659), and “decontamination using hydroclave method” (by weight of 0.633) were found to be the first three main controlling health-environmental sub-criteria in waste disposal, respectively. Also, the sub-criteria of “participation of nurses in educational programs”,  and “participation of nursing assistants in educational programs”, and “changing the purchasing chain in reducing waste production” were identified as the most effective management criteria in reducing waste production, with scores of 0.778, 0.748 and 0.718, respectively.

Based on the obtained results, encouraging employees to participate in waste separation and management training, modifying the purchasing process with an emphasis on reducing hospital waste production, as well as regular and continuous monitoring can improve the effective implementation of waste management practices in hospitals.