Supplementary Material for: Reduction of waste mass in used hemodialysis circuits by QCC activity

Introduction: The improvement of waste management constitutes a critical component of green nephrology initiatives. Hemodialysis circuits represent a substantial proportion of medical waste generated in dialysis units, yet standardized industry protocols for optimizing the disposal of discarded hemodialysis circuits remain underdeveloped. This study aimed to validate the effectiveness of Quality Control Circle (QCC) methodology in reducing the total weight of discarded hemodialysis circuits.
Methods: A multidisciplinary QCC task force was established with the explicitly defined objective: "Reduce residual fluid volume in discarded hemodialysis circuits." The QCC methodology was systematically implemented to drive process improvements. Residual fluid mass from decommissioned hemodialysis circuits served as the primary quality metric, with comparative analyses conducted pre- and post-intervention.
Results: Implementation of QCC interventions resulted in a 29.7% reduction in mean circuit mass, decreasing from 0.64±0.015 kg to 0.45±0.012 kg (p<0.01) across the sampled hemodialysis apparatus.
Conclusion: The implementation of QCC activities has significantly reduced residual waste from hemodialysis circuits, leading to environmental conservation and lower waste disposal costs. QCC serves as an effective management tool for hemodialysis units to promote the concept of green nephrology.