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The current health care environment can best be characterized as uncertain, unfamiliar, ambiguous, unexpected, untraveled, and amorphous. All administrators and managers are facing a tremendous challenge in managing available human, technological, materiel, and fiscal resources to accomplish their organization's mission. They must be able to assess organizational environments, identify strategies to align the organization and the environment, implement these strategies, and continuously evaluate the outcomes of those strategies. Therefore, health care administrators and managers must adopt a management perspective that is responsive, dynamic, comprehensive, systematic, and both process and outcome oriented. Such a perspective is strategic management.

The steps involved in conducting a waste stream analysis for a health care organization have been described. The development of a corporate position on the organization's stewardship of its environment can be the major result of such an analysis. This position would communicate to the community the organization's commitment to the environment and would be used as policy guiding corporate decisions that affect the environment. As a result of the corporate policy, a health system waste management program could be developed. This program would consist of standardized policies and procedures, educational requirements for employees, roles and responsibilities' defined in job descriptions, public education programs, recycling programs, and capital equipment acquisition. Additionally, such a program would promote economies of scale. A waste stream analysis is only as good as the information it contains. Making it of sufficient priority within the organization ensures that adequate time and personnel are allocated to complete the analysis in a precise manner. A well completed analysis is a major component of the larger issue of an organization's responsibility to its environment.