Healthcare waste management processes and transition towards a circular economy

The new Waste Directive 2018/851/EU strengthens the role of waste prevention and emphasizes recycling to facilitate the transition to a circular economy. So far, it has not been legislatively necessary for the Czech Republic to look at waste from a broader perspective, especially in healthcare, where the waste management is perceived as a separate process suitable for outsourcing. With the new directive and the transition to a circular economy, the waste management process becomes part of strategic management processes. These processes are partially systematically covered by the standards of the environmental management system, used mainly in the industrial sector. The optimal solution is a reassessment of the entire waste management of the medical facility and the inclusion of the principle of waste prevention in the decision to purchase a product or service. The necessary condition for the successful implementation of the circular economy is to minimize negative impacts on health and the environment while maintaining the economic sustainability of such a solution. Setting up generally sustainable management of medical facilities thus goes beyond current clinical practice. The health technology assessment model provides several domains that complement life cycle analysis and health impact assessment, including a health risk assessment method. The outputs of the above analyzes and evaluations cover the maximum scope of public interest in healthcare. A practical approach is developing a system of methodologies based on the methods mentioned above, which respect the whole chain of strategic processes of healthcare facilities and involve maximum stakeholders in the evaluation process. We test the approach on a pilot facility in the project SS01010276 ‘Sustainable healthcare waste management: economically feasible minimization of impacts on health and environment' supported by the Technology Agency of the Czech Republic within the Environment for Life Program. Key messages The approach aims to add value to traditional waste management approaches and integrate the long-term interests of key stakeholders using the overlapping outcomes of respective assessments. A sustainable approach to healthcare waste management must be developed with the involvement of all key stakeholders and concerning their interests within their position in the assessment process.