How To Conduct a Waste Baseline

Less Waste

Welcome!

Janet HowardDirector, Member Engagement, Healthier Hospitalsjhoward@practicegreenhealth.org866.598.2110www.practicegreenhealth.orgwww.healthierhospitals.orgwww.noharm.org

Why Waste?• US hospitals generate more than 5 million

tons of waste annually.• Landfills produce methane, six times the

global warming potential of carbon dioxide.• Incinerated waste produces greenhouse

gases, emit dioxin and heavy metals including mercury

• Pharmaceuticals are found in drinking water.• Food services alone makes up 25% of overall

health care waste.• US EPA and USDA have set a goal to reduce

food waste by 50% by 2020.• Health Care waste is complex – electronics,

protected health information, potentially infectious material.

• Joint Commission requires a hazardous material and waste management plan.

4

Why Waste

Less Waste

While some health care environmental impacts are hard to see, understand, or quantify, waste is different. The less waste challenge offers win-win strategies that will both improve environmental performance and offer cost saving strategies.

https://practicegreenhealth.org/sites/default/files/upload-files/hhi-booklet-waste-bu_v3.0_baseline.pdf

Less WasteReport baseline of pounds of solid waste, Regulated Medical Waste, Hazardous Waste and Recyclables on an ongoing basis. Continue tracking while implementing waste reduction programs.

Regulated Medical Waste Reduction

Reduce regulated medical waste to less than 10 percent of total waste or 8 tons per operating room per year.

Recycling

Achieve a 15 percent recycling rate

Achieve an 80% recycling rate for construction and demolition debris

GET STARTED GUIDES HOW-TO CONDUCT A BASELINERMWRECYCLINGC&D RECYCLING

DEFINING MATERIALS & STREAMSLESS WASTE TOOLKIT – CASE STUDIES, EPP SPECIFICATIONS, POSTERS, RECORDED HOW-TO AND MORE! HTTPS://PRACTICEGREENHEALTH.ORG/TOPICS/LESS-WASTE

Measure Details•Baseline: Report a waste baseline for:

• Solid waste, • regulated medical waste, • recycling and • hazardous waste• Pharmaceutical waste

Step by Step

Identify the team:

• Environmental Services• Waste Hauler• Purchasing or Accounts Payable• Facilities/New Construction• Laboratories

• Committees – Joint Commission, QualitySafety, Green Team, Wellness

Who Removes your material…..

Regulated Medical Waste Tissues from Surgery or autopsy Pathological Waste Sharps Waste Hazardous Pharmaceuticals Nonhazardous Pharmaceuticals Controlled Substances (if not sewered) Solid Waste Recyclables HIPAA Recyclables Electronics Food Waste (if separated from solid waste) Grease from Kitchen Laboratory Waste Facilities Management refrigerants, oils or other wastes Xrays (if you have them)

What’s Your Waste Profile?

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BASELINE – AKA WASTE AUDIT

Step by Step of Data Details for this Measure

Nonregulated Medical Waste, Solid Waste, Black Bag

Nonregulated Medical Waste or Municipal Solid Waste

WHAT IS IT?

Majority of the waste stream General Refuse including food, flowers,

packaging, nonrecyclable plastics, gloves, nonbloody instrumentation

HOW IS IT MEASURED?

Invoice Review• Compactor Review• Pick up frequency• Mini or smaller dumpsters• Review compactor weights!

SPECIAL CONSIDERATIONS

• No weights• Conversion Factors

Regulated Medical Waste or Red Bag Waste

• WHAT IS IT? (STATE by STATE REGS & OSHA)

• 2% to 50% of waste• Blood, products of blood, anything caked, soaked or

dripping in blood• Tissues from Surgery or autopsy, trace chemotherapy,

certain body fluids as defined by OSHA (see how to guide) • HIGHLY communicable diseases as per CDC, pathological

waste, sharps

HOW IS IT MEASURED?• Invoice Review, Vendor Reports

SPECIAL CONSIDERATIONS

• No weights• Conversion Factors• Treated Waste• Pharmaceuticals

Invoice Review

Recycling

WHAT IS IT?

Material that is segregated and processed as a commodity to make into a new product. Examples – Universal Waste, Corrugated boxes, HIPAA/confidential paper/PHI, mixed grade paper, mixed plastics, beverage containers, blue wrap, shrink wrap and composting.

HOW IS IT MEASURED? On-site weights to develop conversion (per bin, per toter) Compactor weights, bale weights

SPECIAL CONSIDERATIONS

• Universal Waste• No weights• Conversion Factors

• Markets and Recyclability

What is recycling?

Hazardous Material

WHAT IS IT? 1% of total waste (approximately). Materials that meet the definition as per EPA’s RCRA including mercury, formaldehyde, alcohol,

oil, degreasers, certain pharmaceuticals and cytotoxic drugs, lead and more.

HOW IS IT MEASURED?• Manifests, invoices and other reports.

• SPECIAL CONSIDERATIONS

• No weights• Pharmaceuticals• Spills• Electronics• Conversion Factors• Markets and Recyclability

What are Controlled Substances?WHAT IS IT?

• Category of pharmaceuticals listed by DEA as drugs of abuse.

HOW IS IT MEASURED?

• Depending on how it is discarded – if sewered, it isn’t measured.

• If rendered irretrievable and incinerated, the volume can be captured by

SPECIAL CONSIDERATIONS

• Most hospitals still sewer their wasted controlled substances.

• This is an emerging issue for sustainability teams• Seek guidance from Practice Greenhealth

Diversion versus recycling:

• Medical equipment donation, Furniture refurbish and reuse, Computers, Linens,Books; reusable pallets

• Fluid management in the OR; SUD reprocessing, Reusable Sharps containers.• Rigid cases for sterilization in the OR; reformulated OR kits to eliminate excess

supplies., • Reusable Linens: Surgical drapes, surgical gowns, incontinent products,

isolations gowns, scrubs.• Reusable Products Checklist: Totes for Internal Deliveries, shipping containers,

RMW shipping containers• Service ware: food service ware, Polystyrene (Styrofoam) elimination,

compostable and biodegradable products, and Food donation

• Communicate with vendors about regular reports• Work with Purchasing & Accounts Payable to the person who will be capturing the data.• Ensure that any and all wastes and materials are captured

• Kitchen oil• Batteries• Facilities, laboratories, HIPAA, bulbs, computers• Talk to Purchasing, Speak Environmental Services, Scrutinize those invoices!

• Set up a form, identify reporting committee or group, chart data

$0

$500

$1,000

$1,500

$2,000

$2,500

1 2 3 4

$0$20,000$40,000$60,000$80,000$100,000

$120,000$140,000$160,000$180,000$200,000

Cost/ton

Total Costs

Support is also available through our Data Coordinator on the Third Thursday of the Month at 2 EST

Christopher Bodkin603-491-6106Monday- Friday, 9:00am-5:00pm ETcbodkin@healthierhospitals.org

Data Submission Support

Thank you!!

Check out the Less Waste Pages:

–Case Studies–Get Started Guides–Recorded Webinars–Posters–Templates and more…..

Thank you

Janet HowardDirector, Member Engagement, Healthier Hospitalsjhoward@practicegreenhealth.org866.598.2110www.practicegreenhealth.orgwww.healthierhospitals.orgwww.noharm.org