111309-psv-presentation.pdf

8/16/2019 111309-psv-presentation.pdf

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Waste Management

at Providence St. Vincent’s Medical

Center


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Providence Recycles


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What’s in Your Garbage

The equivalent of 5.5Volkswagens of trash leave

St. Vincent’s Campus 6 day•Paper

a week•Cardboard•Plastic

•Sterile Wrap •Medical Waste

•Food Scrap

•Disposable Dishware


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Composition of Hospital

Waste


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Providence St. Vincent

Waste Sort

Waste Sort

Trash Collection for Waste Sort


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Commingled Recycling

Material diverted from

Trash Chutes

Recyclable material waiting to be sorted

at Warehouse


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Issue:Contaminates in the recycling


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Issue:Hazardous items in Recycling


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Warehouse improvements

• 2005 processed 35 Supersacks per week

• 2008 processed 110 Supersacks per week

• 2008 added 3 vocational staff

• 2008 purchased a new baler to processadditional recycling.

• All this being done with down turn in

recycling markets.


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What else can be recycled???


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What else can be recycled???• Cardboard

• Paper, shreddedonsite and recycled

by Iron Mountain

• Glass, Tin cans,Block Styrofoam,

Used cooking oil.

• Food waste &Compostable

Fiber…


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Providence Composts


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Setting the Stage• Started as ‘byproduct’ of a

project with Wash. County

Recycle at Work program• Waste sort revealed 23%

was food waste and

composta e er • Food waste compactor was

required to comply with

regulatory environment.

• Grant funding was made

available by the Portland

Metro region. Funded 75%

of total project cost.


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Project Costs


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Composting Program• Team formed:

Nutrition, EVS, Garden

and Grounds.

• Hands-on training +

• Currently putting 3+

tons of pre and post

consumer food waste,

compostable fiber andyard debris per week in

our compactor.


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Composting

Benefits• Increased recycling

• Financial gains, savings

on disposal cost of $47

per ton @ 3 tons per

week = $564 per month.

• Reduction of material

going to a landfill that

creates methane (a greenhouse gas).


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Program Impact:

2008 Waste Stream Costs

SUMMARY

YTD lbs. YTD Tons % Costs* $/lb $/Ton

Solid Waste 2 774 880 1 387.4 46.1% $164 919 $0.06 $118.87

Recycling 2,576,831 1,288.4 42.8% -$167,914 -$0.07 -$130.33

Reg Med Waste 663,845 331.9 11.0% $317,129 $0.48 $955.43

Haz W 600 0.3 0.0% $1,500 $2.50 $5,000.00

Total 6,016,156 3,008.1 100% $315,634 $0.05 $104.93


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Program Impact:

Practice GreenHealth & H2E

Environmental Awards

• 2005 Partner Recognition

• 2006 Partner for Chan e

• 2007 Partner for Change and Making MedicineMercury Free

• 2008 Environmental Leadership Award• 2009 Environmental Leadership Award

• Check out Practicegreenhealth.org


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Lessons Learned:Development of Administrative Support

• Understanding and communicating program impact on

environmental sustainability is critical. – Found that the business case (although compelling) is often secondary

motivation for administration.

• Real support for innovative and system wide sustainability

efforts came when the decision makers were brought to the

table.

– Sustainability Council, created 2006 – Composed of managers, administrators and green team chairs.


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Lessons Learned:Communication is Key to Success

• Communicating to staff

– Staff education

• In-service Presentations – Video

•

• Newsletter

– Green Teams

• Community Outreach

– BBQs, Zero Waste events

– Media spots, KATU news segment


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Staff Training

• Make staff aware of facility’s RMWreduction goals.

• Retrain current staff with agreedupon definition of RMW.

• Train new employees about wastesegregation procedures as part of

employee orientation.

• Consider making “compliance with

hospital waste management

policies” part of every job

description.


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In-services & Communication

Collections & Shipping


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= 3

A = 48

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Problem Identification & Resolution Plan• You WILL encounter mistakes.

• Conduct tours of trash areas monthly. Take a digital camera!

• Develop a mechanism to report concerns or issues (e.g. photo alongw wr en repor o ssue an respons e oor ep un .

• Re-educate promptly.

Hold in-service with responsible

unit to explain problem and proper segregation technique.

• Engage a nurse leader to help communicate program.


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Training: Where does it go!


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Training: Where does it go!


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Training: Limit free flowing liquids


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Signage


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Lessons LearnedSetting the Stage for Success

• Importance of Effective Signage

– Post signage above or on RMW containers outlining types of waste are to bedisposed of as RMW

– Use large font and bullet format, preferably in color

– Consider MULTIPLE LAGUAGES to ensure optimal communication.

• Importance of Container Size and Placement – RMW containers should be covered to reduce solid waste. – Remove red bags from under hand-washing sinks, non-critical care patient

areas, hallways and other areas where people are likely to dispose of solid

waste.

– Remove red bags from patient rooms where possible

– Where there ARE red bags, locate a solid waste container directly adjacent so

staff make conscious disposal and segregation decisions.


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New Trends and Technologies


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Reusable Sharps Container

ProgramsBenefits

• Reduce waste

• Improve worker safety through decreased needle-sticks

• Save money

– Eliminate purchase cost of new containers;

– Decrease waste costs by not paying for container weight

– Decrease labor costs associated with collectin and re lacin

containers

• More timely pick-up

Service Includes

• Audit

• Container installation

• On-site pick-up and replacement

• Mechanical mechanism to empty

• Reused 500 times w/ proper disinfection

• 10-30% potential reduction in needle-sticks

Tips

• Check out hauler—ask for

recommendations

• Work with hauler to adjust pick-uptiming/container replacement

• See if you can include final disposal cost

for old sharps containers in contract

• Work with hauler to determine staging areafor sharps containers


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Reusable ContainersBoulder Community Hospital – Case Study

• Invested in hard cases - $120,000 one time

cost.

• Reduced disposable blue wrap purchase

, ,

or $190K in savings.

• This does not include reduction in waste

costs.

• Manufacturers of surgical equipment are

now required to provide the durable

container as part of the equipment purchase.


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Single Use Device ReprocessingBenefits

• Increasing # of disposable products in healthcare

• Formulation hasn’t necessarily changed, but profit margin has.

• Hospitals used to sterilize onsite through CSR—then FDA cracked down.

• Third party preprocessors emerged.

• Nearly half (45.2 percent) of all hospitals with more than 250 beds reuse

, . .

How – “Third Party Reprocessing”

• Sterilize used, unused but open or expired materials for reuse in patient caresettings

• Strictly regulated by FDA

• TPRs incur liability from faulty devices• No reported deaths from using reprocessed devices—per FDA database.

• ‘Single-use’ is a labeling designation determined by original equipmentmanufacturers (OEMs) and not required by the FDA


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Why Should Hospitals

Track Waste Data?

• Establishes baseline to measure success• Helps identify inefficiencies

• e ps ent y potent a cost re uct ons

• Helps set priorities for waste reduction

• Helps identify procurement priorities

• Provides justification for environmental programs


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• Using Green Teams, Sustainability Councils

and other employee teams to develop annual

sustainability goals

Hospital Waste ManagementPlanning & Goal Setting

• Accountable individuals and departments toimplement

• On-going measurement and tracking

• Reporting annually, written and presentation to

top administrators


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Providence Portland Area

Sustainability Goals2008 – 2010 Areas of Focus

Solid Waste Diversion

Goal: Increase recycle rate to > 50%

Strategies: Landfill avoidance through programs addressing red bag, haz waste, e-wste

(cost savings)

Supply Chain Initiatives

Goal: Increase environmental Friendly purchasing when cost and quality components

line up

Strategies: Reprocessing initiatives including surgical services, sharps containers;

Partner with PHS system supply chain initiatives and Novation (GPO)

Environmental Management Plan

Goal: Department level assessment of process, waste stream and impact

Strategies: Conduct assessment


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Providence Portland Area

Sustainability Goals2008 – 2010 Areas of Focus, Continued

Healthy Food Initiatives

Goal: More local and organic food sourcing

Goal: Incorporate best practices in green healthcare design & construction

Energy Conservation

Goal: Develop system initiatives– partner and raise local awareness

Communications Plan

Goal Internal: Endorsement of statement of goals, annual report, internet site

Goal External : Reporting and media opportunities


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• Environmentally Preferred Purchasing Policies

– That address reduced packaging – less waste tohandle

–

Hospital Waste ManagementPolicies to Support

devises – recyclable, compostable, etc. – That address reuse and remanufacturing

– That address issues of cost differential for

preferred products by including “total life cycle”cost of products (including those externalized) in

analysis.


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Contact Information

Mike Geller

Regional Sustainability Coordinator

Providence Health &Services

503-216-4099

Michael. eller rovidence.or

111309-psv-presentation.pdf

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