Use of the value-focused thinking methodology to understand health care waste management under the perspective of occupational and environmental health

Abstract

The increasing generation of healthcare waste has greatly accelerated the concern about its potential negative environmental and public health effects. In this sense, the application of decision-making methods and techniques at a strategic level has become increasingly indispensable for the management of health units. This article aimed to understand the challenges in healthcare waste management (HCWM), the main mechanisms of action and values. The Value-Focused Thinking methodology was used to evidence important gaps and propose improvements in the context of decision on occupational safety and environmental protection, leading to the creation of alternatives not seen previously and guaranteeing the good ideas would be converted into actions. The structure was developed by semi-structured questionnaires, observation lists and interviews, conducted to expose the values of the main stakeholders (managers, health professionals, and cleaning professionals) of 10 public health units selected in Caruaru (Brazil). As a result, the investigation evidenced four fundamental goals for the decision context: improvement in work and environmental safety; improvement in HCWM practices; improvement in resource management; strengthening of the stakeholder communication network. From the analysis of the attributes associated with the fundamental goals, it was possible to identify actions that should be implemented with a higher priority and, in the short term, aiming at obtaining positive results, especially in the management practices and the safe management of health waste. The study resulted from an investigation that awakened the participants about aspects little questioned in everyday life. Implementing actions to segregate and recycle materials, with data monitoring and sharing, will increase the population's trust and the environment's and professionals' safety. The alternatives derived from the VFT method consider the perspectives of key stakeholders in HCWM, helping decision-makers and policymakers develop more assertive and grounded management strategies.