美国的医疗保健系统产生了大量的全球垃圾。皮肤活检是皮肤科医生经常执行的一项手术，可以提供一个可行且可扩展的机会，用于在皮肤科诊所减少废弃物的干预措施。开发并实施一个系统性框架，以减少皮肤科诊所中皮肤活检盘的浪费。这项质量改进研究在一个机构内的四个门诊诊所站点之间进行，时间是从2021年10月到2022年4月。选择产生最多皮肤活检盘浪费的诊所进行干预。在皮肤科诊所中进行的废物审计，在干预前后量化了在每个皮肤活检盘中浪费的用品数量。参与者包括皮肤科住院医生、教员、护士、医疗助手和诊所经理。提供关于气候变化和医疗保健的教育材料，并标准化活检盘的设置，以减少浪费的用品。皮肤科诊所使用的废弃物皮肤活检盘用品（纱布块、酒精棉片、棉签和粘合绷带）在干预前后的数量。在斯坦福癌症研究所的98个皮肤活检盘的四个门诊皮肤科诊所中进行的废物审计显示，在干预前，100%的皮肤活检盘在目标门诊皮肤科诊所中有超过2个浪费的用品，每个皮肤活检盘平均（SD）有10.1（3.4）个浪费的项目。在基于质量改进的干预后，只有16%的皮肤活检盘有超过2个浪费的用品，并且每个盘子的平均（SD）浪费用品数量降至1.6（1.3）。这项质量改进研究的结果表明，通过与临床团队中的所有成员合作，包括医生、医疗助手、护士和诊所经理，在门诊皮肤科诊所中修改皮肤活检盘设置可能与减少浪费有关。这项研究提供了一个考虑不同因素在个别诊所环境中产生废物的框架，因此可以在其他皮肤科诊所中进行适应。

The US health care system generates substantial global waste. Skin biopsies are frequently performed by dermatologists and represent a practical and scalable opportunity for waste reduction interventions in dermatology clinics.To develop and implement a systematic framework for decreasing skin biopsy tray waste in dermatology clinics.This quality improvement study was conducted at 4 outpatient clinic sites within a single institution between October 2021 and April 2022. The clinic site with the greatest skin biopsy tray waste production was selected for intervention. Waste audits before and after the intervention quantified the number of wasted supplies per skin biopsy tray in dermatology clinics. The participants were dermatology residents, faculty, nurses, medical assistants, and clinic managers.Provision of educational materials about climate change and health care and standardizing biopsy tray setup to decrease wasted supplies.Quantity of wasted skin biopsy tray supplies (gauze squares, alcohol pads, cotton swabs, and adhesive bandages) before and after interventions.In waste audits in 4 outpatient dermatology clinics (comprising 98 skin biopsy trays), prior to intervention, 100% of skin biopsy trays had more than 2 wasted supplies within targeted outpatient dermatology clinics at the Stanford Cancer Institute with a mean (SD) of 10.1 (3.4) wasted items per biopsy tray. Following the quality improvement-based interventions, only 16% of skin biopsy trays had more than 2 wasted supplies and the mean (SD) number of wasted supplies per tray decreased to 1.6 (1.3).Results of this quality improvement study suggest that through collaboration with all members of the clinical team including physicians, medical assistants, nurses, and clinic managers, skin biopsy tray setup modifications may be associated with reduced waste in outpatient dermatology clinics. This study presents a framework that accounts for different factors in the production of waste in individual clinic settings, and thus can be adapted within additional dermatology clinics.