Developing a behaviour identification method for healthcare waste management: a case study of hospital waste management in Australia

Background: Healthcare generates millions of tonnes of waste each year, with some of this waste not getting disposed of in its most appropriate streams. Due to the importance of correct sorting and transporting of generated waste, human behaviour plays a crucial role in the waste disposal process. Thus taking a behavioural science approach to the challenge of healthcare waste management has potential to value-add to existing research and practice efforts. A fundamental step in applied behaviour change projects is the identification of specific behaviours that can have positive impact. To support this, this project developed a new method to comprehensively identify and map the often interconnected waste management behaviours in a healthcare setting. Methods: To develop the new behaviour identification method, previous work on ‘waste flow diagrams’ was extended and overlaid with principles of behavioural science, clearly defining the identified behaviours with regards to their actor, action, target, context and time. The method was applied to the management of waste generated in the perioperative area in a large, metropolitan, public hospital in Australia. Results: Applying the developed method to the management of waste from the described hospital setting identified 184 specific, interconnected waste management behaviours performed by thirteen actor groups (including anaesthetists, surgeons, nurses, technicians, cleaning staff). Conclusion: This project has applied established principles of behavioural science to traditional waste flow diagrams and thereby developed a new behaviour identification method. The developed method lays the groundwork for future behaviour prioritisation work, which can be followed by an investigation of influences on behaviour performance. Ultimately, this process can support the design of a targeted behaviour change intervention to improve healthcare waste management.