SHM Converge Scientific Abstract ePoster Gallery-Preventing Loss of Inpatient Metered-Dose Inhalers: Reducing Environmental Impact and Healthcare Costs

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This quality improvement project at MaineHealth Maine Medical Center aimed to reduce waste from inpatient metered dose inhalers (MDIs), which contribute to both financial cost and greenhouse gas emissions because of their hydrofluoroalkane propellant. The team used premature re-dispensation as a proxy for lost or misplaced inhalers and measured outcomes through electronic medical record reports.<br /><br />In 2024, 2,719 MDIs were prematurely re-dispensed; in 2025, this decreased to 2,519, a 10% reduction. Albuterol inhalers showed the clearest improvement, with 18% fewer premature re-dispensations in 2025, corresponding to an estimated 422 kg less CO2e and $2,319 in savings. Premature re-dispensation during patient transport between units also declined from 45% in 2024 to 41% in 2025.<br /><br />The project used a multi-level approach, including provider education, an educational campaign to discourage automatic continuation of PRN albuterol at admission, a “Ticket-to-Ride” initiative to improve inhaler tracking during transfers, and an order practice advisory (OPA). Survey feedback suggested strong awareness and acceptance: 75% of respondents knew about the initiative, 64% learned about inhalers’ environmental impact from it, and only 9% found the alert annoying. The OPA appeared to have a sustained positive effect on reducing albuterol re-dispensation, while the Ticket-to-Ride effort had a less clear impact and may need continued reinforcement.<br /><br />Overall, the project shows that educational and technological interventions can reduce inpatient inhaler waste, lower costs, and decrease environmental harm without compromising care.

Asset Subtitle

Matthew Fasolino

Meta Tag

Author List Elizabeth L. Herrle, Kassim Sembatya, Katherine Liu, Matthew Fasolino

Category Research

Concept Quality Improvement Methods

Concept Premature Redispensation

Concept Metered-Dose Inhaler

Concept Proxy Measure

Concept Provider Education

Distinguished Non-Finalist

Presenter Organization MaineHealth

Presenting Author Matthew Fasolino

Track Quality Improvement

Keywords

inpatient metered dose inhalers

MDI waste reduction

premature re-dispensation

hydrofluoroalkane propellant

greenhouse gas emissions

albuterol inhalers

order practice advisory

Ticket-to-Ride initiative

provider education

MaineHealth Maine Medical Center

Quality Improvement Methods

Premature Redispensation

Metered-Dose Inhaler

Proxy Measure

Provider Education