Reducing Waste at the Bedside: A Resident-Led Project to Decrease Waste and Cost From Diagnostic Paracentesis

Background Physicians have a responsibility to reduce the environmental harms from health care waste. Residents contribute to waste during bedside procedures. Objective To calculate waste and estimated cost reduction with the introduction of a novel resident-designed paracentesis kit at a single academic center in Texas in 2023. Methods We calculated waste through observation of bedside diagnostic paracentesis performed by internal medical residents, tracking which components were discarded without use from the hospital-provided kit. Residents designed a novel kit containing only procedural essentials. We calculated possible waste reduction when using the novel kit, as well as potential cost savings by comparing the average cost of the current hospital kit across multiple medical equipment retailers to the summed cost of the components of the novel kit. Results Sixteen items were discarded without use from the commercially available kit, out of 29 total items. The estimated cost saving per diagnostic paracentesis was $95. Conclusions This resident-led development of a diagnostic paracentesis kit was successful in decreasing both waste and cost, while involving residents in improving the environmental impact of their practices.