A multi-criteria decision-making approach to rank supplier selection criteria for hospital waste management: A case from Pakistan

Locating a disinfection facility for hazardous healthcare waste in the COVID-19 era: a novel approach based on Fermatean fuzzy ITARA-MARCOS and random forest recursive feature elimination algorithm

Hazardous healthcare waste (HCW) management system is one of the most critical urban systems affected by the COVID-19 pandemic due to the increase in waste generation rate in hospitals and medical centers dealing with infected patients as well as the degree of hazardousness of generated waste due to exposure to the virus. In this regard, waste network flow would face severe problems without taking care of hazardous waste through disinfection facilities. For this purpose, this study aims to develop an advanced decision support system based on a multi-stage model that was combined with the random forest recursive feature elimination (RF-RFE) algorithm, the indifference threshold-based attribute ratio analysis (ITARA), and measurement of alternatives and ranking according to compromise solution (MARCOS) methods into a unique framework under the Fermatean fuzzy environment. In the first stage, the innovative Fermatean fuzzy RF-RFE algorithm extracts core criteria from a finite set of initial criteria. In the second stage, the novel Fermatean fuzzy ITARA determines the semi-objective importance of the core criteria. In the third stage, the new Fermatean fuzzy MARCOS method ranks alternatives. A real-life case study in Istanbul, Turkey, illustrates the applicability of the introduced methodology. Our empirical findings indicate that "Pendik" is the best among five candidate locations for sitting a new disinfection facility for hazardous HCW in Istanbul. The sensitivity and comparative analyses confirmed that our approach is highly robust and reliable. This approach could be used to tackle other critical multi-dimensional problems related to COVID-19 and support sustainability and circular economy.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10479-022-04822-0.

System dynamics model: developing model for supplier selection with a focus on CSR criteria

The complexity and significance of decision-making in selecting suppliers highlight the need for a systematic and transparent approach. The more organizations rely on suppliers, the more harmful the direct and indirect consequences of poor decision-making are. This study attempted to identify factors affecting supplier selection and develop a system dynamics model for supplier selection by taking into account social corporate responsibility (CSR) practices. This model aims to increase CSR practices when selecting suppliers and thus help supply chain members gain competitive power and satisfy customer demands optimally. The system dynamics model for supplier selection was developed by considering profitability, productivity, social transparency, and customer satisfaction. To this end, first, the indicators affecting supplier selection were identified. Then, a cause–effect model was extracted by surveying subject-matter experts. Finally, the system dynamics model was developed. The final output of the third stage was a dynamic model of a supplier selection system that considers CSR practices. The results showed that profitability increases only by implementing the policy of reducing the average distance between suppliers and increasing the number of suppliers. This issue causes lower costs, reduced delivery time due to reduced average distance between suppliers, and increased suppliers, resulting in increased customer satisfaction and increased demand.

Supplier selection in healthcare supply chain management during the COVID-19 pandemic: a novel fuzzy rough decision-making approach

Due to the high necessity of medical face masks and face shields during the COVID-19 pandemic, healthcare centers dealing with infected patients have faced serious challenges due to the high consumption rate face masks and face shields. In this regard, the supply chain of healthcare centers should put all of their efforts into avoiding any shortages of masks and shields as these products are considered as primary ways to prevent the spread of the virus. Since, any shortages in these products would lead to irrecoverable and costly consequences in terms of the mortality rate of patients and medical staff. Therefore, healthcare centers should decide on best supplier to supply required products, considering technical, and sustainability measures. Dynamicity and uncertainty of the pandemic are other factors that add up to the complexity of the supplier selection problem. Therefore, this paper develops a novel decision-making approach using Measuring attractiveness through a categorical-based evaluation technique (MACBETH) and a new combinative distance-based assessment method to address the supplier selection problem during the COVID-19 pandemic. Due to high uncertainty, vague and incomplete information for decision-making problems during the COVID-19 pandemic, the developed decision-making approach is implemented under fuzzy rough numbers as a superior uncertainty set of the traditional fuzzy set and rough numbers. Extensive sensitivity analysis tests are performed based on parameters of the decision-making approach, impacts of weight coefficients, and consistency of results in comparison to other MCDM methods. A real-life case study is investigated for a hospital in Istanbul, Turkey to show the applicability of the developed approach. Based on the results of MACBETH method, job creation and occupational health and safety systems are two top criteria. Results of the case study for five suppliers indicate that supplier (A1) is the best supplier with a distance score of 3.308.

An Approach for Ranking of Hospitals Based on Waste Management Practices by Analytical Hierarchy Process (AHP) Methodology

In this study, the analytical hierarchy process (AHP) technique has been used to assess waste management practices of different hospitals in the city of Prayagraj (India). Based on AHP analysis, hospital 3 was ranked as the most promising sustainability hospital with a weight value of 0.2788 with strict abidance to Bio-medical waste management (amendment), 2018 rules and regulations. Regular monitoring is needed to improve the waste management in hospitals substantially, and hospital 6 is ranked lowest among the surveyed hospitals.

Safe distance-based vehicle routing problem: Medical waste collection case study in COVID-19 pandemic

In addition to the increasing population and rapid urbanization, the amount and variety of medical waste are rapidly increasing due to the coronavirus disease (COVID-19) pandemic affecting the whole world. COVID-19 does not only increase the amount of medical waste produced, medical wastes generated in the care of COVID-19 carries a high risk of transmission as well. In this regard, the safe and effective management of medical wastes has become a serious health and safety issue. This research aims to determine the safest and shortest transportation routes for medical waste vehicles. The safety scores used in this study were obtained in our previous study. The resulting safety scores were used in a multi-objective traveling salesman problem for deriving two objective functions, which are based on safety scores and total transportation distance. A conciliating solution was obtained by solving this linear programming model. The proposed model faced by health institutions in Istanbul has been applied for a specific district. According to the obtained results, suggestions for the direction of medical waste vehicles have been proposed.

Environment and sustainability approach to manage sweet bakery waste product

Globalization and environmental regulations force organizations and producers to adopt sustainability in every aspect of their business. The concept of sustainability in manufacturing is now achieving maturity; however, there is still an opportunity to explore sustainability in perishable food items. The growth of population worldwide increased the amount of waste produced by the food industries. Enterprises worldwide use procedures to overcome the disposing of perishable waste into landfills, which has noticeable impacts on the environment and the business itself. However, these procedures may not be sufficient and lead to disturbance of the ecosystem. Therefore, the purpose of this article is to develop a framework to conduct experiments using Design of Experiment (DOE) to produce fertilizer using expired doughnuts from a well-known sweet bakery company in the United Arab Emirates. Firstly, we will develop a framework, implement waste management on perishable products such as doughnuts, and apply environmental, economic, and social development through recycling and composting it into fertilizers to be used for agriculture needs. Secondly, to study the impact of different parameters such as water, sand, doughnuts in different percentages on plant growth and survival. Results show that wasted doughnuts are suitable for fertilizer and the best plant due to interaction between all three factors: commercial fertilizer percentage, doughnuts percentage, and doughnuts size.

Healthcare waste management assessment: Challenges for hospitals in COVID-19 pandemic times

With the spread of the new Coronavirus, there was an increase in the generation of contaminated waste. Thus, healthcare waste management (HCWM) became even a greater challenge in hospitals due to Coronavirus easily spread. In this context, it was necessary to create tools that could aid healthcare facilities in evaluating their HCWM. Therefore, the objective of this article was to elaborate a support tool that helps in identifying the shortcomings of hospitals' HCWM. For this purpose, the Health Service Waste Management Index was developed based on the selection of indicators in the area. The index was applied to six hospitals in the state of Minas Gerais, Brazil. Its application meet the purpose of this research, since the results in the form of an index objectively summarize the reality of the HCWM in healthcare facilities. From the six hospitals investigated, four were classified as highly efficient. However, even though most of them were well evaluated, they still have difficulties with properly training their employees, which can be even a worse problem during a pandemic, when every precaution is extremely important to reduce the spread of the disease. Therefore, beyond this article contribution related to sustainability by demanding the hospitals to check which points of HCWM should be improved, it also adds academically by developing a tool with indicators that evaluate operational, human, economic and environmental factors in an innovative way.

Multi-period evaluation and selection of rural wastewater treatment technologies: a case study

Rapid population growth and agricultural development are generating a considerable amount of effluents, which poses threats to the quality of rural water resources as well as sanitary conditions. However, with a range of rural wastewater treatment (WT) technologies available, one major problem facing the practitioners is which to choose as the most favorable option suited to specific areas. In this study, a novel decision-making framework is proposed to evaluate and select the optimal alternative in rural areas of Xi'an within multiple consecutive time periods. Firstly, an evaluation index system is constructed and picture fuzzy numbers (PFNs) are used to represent both evaluation levels and experts' refusal due to limitation of knowledge. Secondly, fuzzy analytical hierarchy process (FAHP) is applied to derive weights of criteria, which enables experts to assign fuzzy numbers to express their preferences for comparison judgments. Thirdly, evidence theory is utilized to obtain the aggregated values from multiple time periods. Finally, based on the belief intervals obtained, sequencing batch reactor (A₄) is determined as the optimal rural WT technology in Xi'an from 2006 to 2020, whereas the membrane bio-reactor (A₂) is the last option. The effectiveness of the proposed framework is further validated by comparative analysis. This research can hopefully serve as useful guidance for the assessment of rural WT technologies in various regions.

A fuzzy evaluation and selection of construction and demolition waste utilization modes in Xi'an, China

The inadequate reuse and recycle of construction and demolition waste (C&DW) has been identified as a major issue, as it implies the depletion of natural aggregates, massive occupation of landfill and inefficiency of construction industry. However, a holistic view involving economic, technical and comprehensive dimensions has rarely been adopted for C&DW utilization evaluation against both qualitative and quantitative criteria. In this study, we propose a framework in a heterogeneous group decision-making environment to solve the C&DW utilization mode selection problem by integrating the Choquet integral and the elimination and choice translating reality (ELECTRE) method with two data forms, that is, interval-valued hesitant fuzzy numbers and real numbers. Firstly, an evaluation index system is constructed to assess multiple representative C&DW utilization modes in Xi'an, China. Secondly, a novel method is proposed to apply the Choquet integral for aggregation of evaluation values and fuzzy ELECTRE for outranking of C&DW utilization modes after the heterogenous evaluation data are unified into interval numbers. Thirdly, to illustrate the application of the proposed framework, this paper evaluates four typical C&DW utilization modes based on a case study in Xi'an, China, and the result shows that the most preferable mode is A₃ (off-site crushing, roadbed backfilling). Finally, a comparative analysis is conducted to verify the effectiveness of this framework. This study presents useful findings to C&DW practitioners and can help avoid intuitive selection among available C&DW utilization modes.

Occupational health and safety-oriented medical waste management: A case study of Istanbul

The outstanding pace of technological development around the world coupled with increasing population and rapid urbanization have brought along an ever-increasing demand for healthcare services. This trend results in an increasing amount and variety of medical wastes. Accordingly, the issue of effective collection, transportation and disposal of medical wastes, specifically in large cities, has become a critical concern from the viewpoint of urban logistics and holds great importance in terms of safety. This study aims to determine the safety of hospitals in their medical waste management function. The study involves the determination of medical waste management steps, establishment of a hierarchical structure, and weighting of the criteria within the established hierarchical structure by means of the analytic hierarchy process method. Afterwards, the extent to which these criteria are adopted in hospitals was evaluated by the medical waste management officers of those hospitals, and safety scores were obtained for each hospital by associating the results with the weighted values obtained by the analytic hierarchy process method. The model proposed for medical waste management problems encountered by healthcare institutions in Istanbul was implemented for a specific region of Istanbul province, and the obtained results were analyzed. Evaluation of the opinions of the healthcare officials for determination of the medical waste management safety scores showed that the "collection" criterion has significantly higher importance than the "temporary storage" and "transportation" criteria. "The effect on hospital personnel" sub-criterion of the "collection" criterion had the highest score. This revealed the importance of the collection process that takes place between storage and transportation, for evaluating the human waste-based risks.

Proposal of indicators for healthcare waste management: Case of a Brazilian public institution

Healthcare waste (HCW) management represents a big challenge for managers around the world. Segregation is a fundamental action to allow the risk management inherent to each type of wastes. HCW indicators may favour the understanding of the waste management system status. The aim of this paper is to evaluate the HCW indicators applied in a Brazilian public institution, seeking to improve the management system and suggesting methods of applying this tool as an alternative of continuous improvement to the management process. Wastes were weighed every trimester for seven consecutive days, between of 2012 to 2017. The data represent daily, monthly and quarterly averages of the waste generated. Group B (chemical) and Group E (sharps) indicators had statistical non-significant data, suggesting very distant results from the stipulated goal. The generation rate was 355.3-500.7 kg.day^-1 including all types of waste. Considering the approximate values of the non-infected wastes, which may be discarded in a landfill, the percentage represents about 75% of all HCW generated. The other 25% need to be treated at cost of $US0.76kg^-1. An effectively dangerous portion of the infectious waste would be approximately 6%. Failures in segregation could represent, in addition to the health risks, unnecessary expenses of the generating establishments. HCW indicators have good potential to provide adequate risk management in health service environments.