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June 20, 2007

Reducing Medical Waste

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;297(23):2583-2584. doi:10.1001/jama.297.23.2583-b

To the Editor: In his Commentary on reducing waste, Dr Bush1 has adapted the methods of the Toyota Global Production System to construct a thoughtful analysis of health care resources. Applying a “manufacturing model” to hospital-based services, he proposes remedies to the generation of waste, defined here as the misallocation of time and product. However, among the 7 categories of waste, absent is any mention of its more common definition: the generation of disposable materials. The “waste of stock on hand” alludes to materials excess,1 but only as a miscalculation of required inventory, implying that every product purchased will be used. Persons watching unused products hit the trash bin as expiration dates lapse recognize the difficulty in maintaining a tight alignment between purchases and use.