WASTE MANAGEMENT STARTS AT THE PURCHASING PROCESS Assit. Prof. Dr. Alparslan Kapısız, N.S. Elif Baş, Hafize Çil Trabzon Fatih State Hospital, Trabzon, Turkey İntroduction: Medical and hazardous wastes, known as types of waste produced from healthcare, are disposed of with specific methods. In addition to the risk they pose due to their infectious nature, they are usually disposed of by the ‘incineration ’method, which results in the release of mercury, methane gas, ash and dioxide end products that are harmful to the environment and human health. Therefore, the first two steps of the waste management hierarchy, namely ‘Prevention ’and ‘Reduction’, are of great importance. In addition to the factors related to patients and staff in the amount of waste, the purchasing and supply policy adopted by the institution is also quite effective. Classical purchasing management is based on the product containing high quality at a suitable price, in the right place and time. However, ‘Green Supply Chain Management’, which focuses on the environment and human health, includes new policies required to ensure environmental sustainability. Purpose: The purpose of our study is to evaluate our hospital's purchasing approach in terms of waste management. Method: The reasons for the periodic increase in medical and hazardous wastes, which are monitored with the support of information systems, will be determined and the effect of the adopted purchasing management approach will be evaluated. Findings: The factors affecting the increase in hazardous wastes have been determined. The reason for the increase in hazardous wastes during the beginning of the waste managementstudy and the ongoing 4 monthsisthe meticulous provision of correctseparation practices. The data supporting the issue is that hazardous waste deliveries were made in units where no hazardous waste production was seen in previous periods and parallel to the decrease in the amount of medical waste. However, in the following periods, the amount of hazardous waste did not maintain its expected stability and experienced fluctuating increases. The reasons for these changes were examined and the situations that had an effect were evaluated. The first of the reasons determined within this scope is that some total parenteral nutrition products tear during use. The relevant product is destroyed due to a high rate of tearing and perforation (1/3) while being prepared for the patient. Since the amount of a single product is 1500 ml, it seriously affects hazardous waste. Although the company sent a new one instead of the defective product; all of the remaining products were replaced due to their effect on the amount of hazardous waste and the fee paid for its disposal, and the increase in hazardous waste due to the reason was prevented. Another factor was determined as the use of toners that were not refilled. Before January 2024, the empty toners finished by the units were sent back to the company via the inventory unit and refilled. Afterwards, a purchase was made through a tender that did not include a condition for the refilling of toners and the empty toners were separated as hazardous waste by the inventory unit. This situation increases hazardous waste and will be taken into consideration in new purchases since it is contrary to the reverse logistics activity that supports green purchasing. The last factor that was determined to have an effect on the increase in the amount of hazardous waste is the use of a drug that can be used as a ‘bag ’in the ‘vial ’form on the grounds that it is more convenient. The product that is sent to disposal in the bag form for 10 grams is thrown away in the empty vial form for 180 grams. Since it is a frequently used drug, this situation has a serious effect on increasing the amount of hazardous waste. In the follow-ups on changes in the amount of medical waste, the increase in the amount of waste per case in the Hemodialysis Unit was examined and it was determined that the dialyzer brand used was changed. The reason for the change was that the cost of the previously used product was higher than the newly purchased product. However, there is a 200 gr difference in the total amount of waste between the empty and used versions of the two products. This increase, which is due to the new product itself, affects the hemodialysis unit, where an average of 1000 sessions are performed monthly, as an increase of 200 kg of monthly medical waste. Conclusion: The classical purchasing approach is still adopted in most institutions, especially within the scope of cost-benefit analysis. However, the impact of the purchased materials on the waste area should be taken into consideration due to both their impact on the environment and human health and the costs paid for their disposal, and the green supply management chain approach should be taken into consideration.