development, piloting and implementation of a health care risk waste information system in gauteng

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Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land Affairs Affairs DEVELOPMENT, PILOTING AND DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG SYSTEM IN GAUTENG

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DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG. Gauteng Department of Agriculture, Conservation, Environment and Land Affairs. How the business consultant described it. How the customer explained it. How the project leader understood it. - PowerPoint PPT Presentation

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Page 1: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

DEVELOPMENT, PILOTING AND DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH IMPLEMENTATION OF A HEALTH

CARE RISK WASTE INFORMATION CARE RISK WASTE INFORMATION SYSTEM IN GAUTENGSYSTEM IN GAUTENG

Page 2: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

experiential and picture based learning

How the How the customer customer

explained itexplained it

How the How the project leader project leader understood itunderstood it

How the How the programmer programmer

wrote itwrote it

How the How the business business

consultant consultant described itdescribed it

How the How the analyst analyst

designed itdesigned it

How the How the project was project was documenteddocumented

What What operations operations installedinstalled

How the How the customer was customer was

billedbilled

How it was How it was supportedsupported

What the What the customer customer

really neededreally needed

Page 3: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Project LeaderProject Leader

Linda Godfrey - CSIR Division of Water, Environment and Linda Godfrey - CSIR Division of Water, Environment and Forestry TechnologyForestry Technology

Co-AuthorsCo-Authors

Eric Nørby - RambøllEric Nørby - Rambøll

Andrew Smith - CSIR Division of Information and Andrew Smith - CSIR Division of Information and Communication TechnologyCommunication Technology

Paul Furniss - Gauteng Department of Agriculture, Paul Furniss - Gauteng Department of Agriculture, Conservation, Environment and Land Conservation, Environment and Land AffairsAffairs

Page 4: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Presentation OutlinePresentation Outline• IntroductionIntroduction• Background to Health Care Risk Waste Background to Health Care Risk Waste

Information System (HCWIS)Information System (HCWIS)

• Approach to Development: Approach to Development: – Pre-Development Pre-Development – Development Development – Piloting Piloting – ImplementationImplementation

• Future DevelopmentFuture Development• Lessons Learnt Lessons Learnt • ConclusionsConclusions

Page 5: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Background to Health Care Risk Waste Background to Health Care Risk Waste

Information SystemInformation System (1)(1)

• A component of a broader strategy: A component of a broader strategy:

Strategy for the Sustainable Management of HCRW Strategy for the Sustainable Management of HCRW in Gautengin Gauteng

• Overall objective:Overall objective: Sustainable Health Care Waste Sustainable Health Care Waste Management in Gauteng, established within the Management in Gauteng, established within the frames and principles of the National Waste frames and principles of the National Waste Management strategy, covering the full health Management strategy, covering the full health care waste stream from “cradle-to-grave”.care waste stream from “cradle-to-grave”.

Page 6: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Background to Health Care Risk Waste Background to Health Care Risk Waste

Information SystemInformation System (2)(2)

• EExecuted by the CSIR and Danish-based company xecuted by the CSIR and Danish-based company RambøllRambøll

• Funded by DANIDAFunded by DANIDA

• Consultation with all relevant government departments Consultation with all relevant government departments during developmentduring development

• Initiated in the Gauteng Province in September 2001Initiated in the Gauteng Province in September 2001• Reporting to system voluntary until promulgation of Reporting to system voluntary until promulgation of

regulations in September 2003 regulations in September 2003

Page 7: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: Pre-DevelopmentPre-Development

Establishing a conceptual model:Establishing a conceptual model:

Aims and objectives of the system Aims and objectives of the system

– what was required from the system?what was required from the system?

– who will be required to report to the system?who will be required to report to the system?

– what data and how often the data would need to what data and how often the data would need to be submitted to the system? be submitted to the system?

AssumptionsAssumptions made in order to be able to address made in order to be able to address aims and objectives of systemaims and objectives of system

LimitationsLimitations

Information needsInformation needs

Page 8: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: Pre-DevelopmentPre-Development

Aims and objectives:Aims and objectives:

Developed through consultation with GDACEL, Developed through consultation with GDACEL, DDEAT, DWAF, DoHEAT, DWAF, DoH

Two primary aims: Two primary aims:

– Monitor trends in monthly amount of HCRW Monitor trends in monthly amount of HCRW transported and treated in the Provincetransported and treated in the Province

– Assess available treatment capacity in the Assess available treatment capacity in the ProvinceProvince

Page 9: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: Pre-DevelopmentPre-Development

AssumptionsAssumptions (1) (1)

• HCRW is weighed within the Province HCRW is weighed within the Province • HCRW treatment facilities report waste tonnages HCRW treatment facilities report waste tonnages

received per generator and identify relevant received per generator and identify relevant transportertransporter

• HCRW transporters report waste tonnages HCRW transporters report waste tonnages removed from Province for treatment in another removed from Province for treatment in another ProvinceProvince

• Only major generators (> 10 kg per day) to be Only major generators (> 10 kg per day) to be identified. Minor generators to be grouped identified. Minor generators to be grouped together as “small generators”together as “small generators”

Page 10: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: Pre-DevelopmentPre-Development

AssumptionsAssumptions (2)(2)

• Measures are defined to enforce reporting. Measures are defined to enforce reporting. • All HCRW containers are clearly marked with All HCRW containers are clearly marked with

generator name and registered unique number.generator name and registered unique number.• Data is submitted to GDACEL electronically in a Data is submitted to GDACEL electronically in a

pre-determined format. pre-determined format. • The HCWIS is managed and operated by suitably The HCWIS is managed and operated by suitably

qualified GDACEL personnel.qualified GDACEL personnel.

Page 11: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: Pre-DevelopmentPre-Development

Limitations Limitations

• Not a tracking system Not a tracking system • Does not incorporate a hazardous waste manifest Does not incorporate a hazardous waste manifest

systemsystem• Verification of data limited to a cross-check Verification of data limited to a cross-check

between serviced generators and list of between serviced generators and list of generatorsgenerators

• Only health care risk waste tonnage data Only health care risk waste tonnage data captured on system captured on system

Page 12: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: Pre-DevelopmentPre-Development

Information needsInformation needs

• Collect only urgently needed dataCollect only urgently needed data• From fewest role players in HCRW generation, From fewest role players in HCRW generation,

transportation, treatment chaintransportation, treatment chain• Use collected data effectively Use collected data effectively

Output: framework document outlining Output: framework document outlining objectives of system, data requirements objectives of system, data requirements

for system and role players. for system and role players.

Page 13: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Transport out ofGauteng only

Static information annually or bi-annually: Capacity, address, contact etc.

HCRW generatorHCRW transporter HCRW treatment

facilities

Monitor trendsin monthly

HCRWamounts

Plan HCRWtreatmentcapacity

Report Stateof the

Environment

Dissemination

Performenforcement,licensing etc.

600(+10,000)

5(+5)

2(+60)

Reporting

Other HCRWrelated tasks

National WISInternational

reporting

DEAT

Tasksdependanton HCWIS

GDACEL

Verification

HCRWrelated tasks

DoH

Registrationinformation

HCRWinformation Monthly HCRW

amounts per generator

Feedback

HC

WIS

Registration

Data Capture

Data Submission

Data Entry

Verification

Reporting

Page 14: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: DevelopmentDevelopment

Design of the systemDesign of the system

1) Registration1) Registration• All HCRW generators, transporters and treatment All HCRW generators, transporters and treatment

facilitiesfacilities• Initially only medium – large generators to register (>10 Initially only medium – large generators to register (>10

kg generated per day). kg generated per day). • 80/20 principle80/20 principle

2) Reporting 2) Reporting • Generators - none Generators - none • Transporters - tonnage removed from provinceTransporters - tonnage removed from province• Treatment facilities - tonnage received for treatment in Treatment facilities - tonnage received for treatment in

provinceprovince

Page 15: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: DevelopmentDevelopment

1) Registration Process 1) Registration Process • Generator, transporter or treatment facility Generator, transporter or treatment facility

submits details to GDACEL on a registration form submits details to GDACEL on a registration form • Unique identifier assigned to generator, Unique identifier assigned to generator,

transporter and treatment facility. transporter and treatment facility.

GeneratorGenerator ABC HospitalABC Hospital GPGPGG-00-001-00-001

TransporterTransporter ABC ABC TransportersTransporters GPGPTT-00-001-00-001

Treatment Treatment FacilityFacility

ABC ABC Treatment Treatment

FacilityFacilityGPGPFF-00-001-00-001

Page 16: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Waste Generator IDWaste Generator ID

Page 17: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: DevelopmentDevelopment

2) Reporting Process (1)2) Reporting Process (1)

• Static data and dynamic dataStatic data and dynamic data

• Reporting options: Reporting options:

– On-line (internet reporting)On-line (internet reporting)

– Electronic data captureElectronic data capture

– Paper data capturePaper data capture

• Reporting frequencyReporting frequency – monthly/quarterly– monthly/quarterly

• Data committed to system after verification Data committed to system after verification by WIS Officerby WIS Officer

• Cannot be deleted or alteredCannot be deleted or altered

• Transparency of dataTransparency of data

Page 18: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Data Upload PageData Upload Page

Page 19: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: DevelopmentDevelopment

2) Reporting Process (2)2) Reporting Process (2)

• Waste Information System (WIS) Officer: Waste Information System (WIS) Officer: – Monitoring reporting Monitoring reporting – Verification and committing of dataVerification and committing of data– Extraction of reportsExtraction of reports

• Verification of dataVerification of data– Information from previous years Information from previous years – Knowledge of the reporterKnowledge of the reporter– Experience Experience – Comparison with other reporters Comparison with other reporters – Common sense Common sense – Generator informationGenerator information

Page 20: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Reporting cycleReporting cycle

HC

WIS

data

base

Reminders,receive reports,

feedback

Passverification

Yes

Requestclarification

No

Predefinedreports

Reporting,dissemination etc.

Responsibilities of DACEL HCWIS Officer General DACEL Staff

Page 21: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Pre-defined Reports: Pre-defined Reports:

Page 22: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Example of Pre-defined Report: Example of Pre-defined Report: Comparison Between HCW Tonnage Generated and Comparison Between HCW Tonnage Generated and

HCW Tonnage Treated in Gauteng (Pilot) in 2002HCW Tonnage Treated in Gauteng (Pilot) in 2002

AugustSeptember

OctoberNovember

December

0

50

100

150

200

250

300

350

Tonnage

Months

Generated Tonnes for 2002

Treated Tonnes for 2002

Page 23: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Example of Pre-Defined Report: Example of Pre-Defined Report: Waste Generation and Treatment per Metropolitan Waste Generation and Treatment per Metropolitan

Municipality (Pilot)Municipality (Pilot)

Joha

nnes

burg

Tshw

ane

Ekurh

ulen

i

Met

swed

ing

Sedib

eng

Wes

t Ran

d

0

50

100

150

200

250

300

350

400

450

Tonnage

Municipality

Generated Tonnes for 2002

Treated Tonnes for 2002

Page 24: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Example of Derived Report: Example of Derived Report: Monthly Provincial Treatment Capacity Vs. Monthly Monthly Provincial Treatment Capacity Vs. Monthly

Provincial Generation Rate Provincial Generation Rate

0

50

100

150

200

250

300

350

400

Tonnage

January March May July September November

Months

Tonnes for 2002

Tonnes for 2003

Monthly Treatment Capacity

Page 25: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: DevelopmentDevelopment

2) Reporting Process (3)2) Reporting Process (3)

• System data verificationSystem data verification

• Mass balance not possible because generators Mass balance not possible because generators do not reportdo not report

Page 26: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: PilotingPiloting

• August 2002 – August 2003 August 2002 – August 2003

• Involved four treatment facilities, one transport Involved four treatment facilities, one transport company and waste information officercompany and waste information officer

• User’s manual and training programmesUser’s manual and training programmes

• Provision of support materialsProvision of support materials

Page 27: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Approach to Development: Approach to Development: ImplementationImplementation

• During piloting, all “bugs” and problems were During piloting, all “bugs” and problems were notednoted

• Version 2 launched in June 2003 – minor changesVersion 2 launched in June 2003 – minor changes

• All reporters visited again and introduced to new All reporters visited again and introduced to new versionversion

Page 28: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Future DevelopmentFuture Development

• Enforcement of reporting – September 2003Enforcement of reporting – September 2003

• WIS Legislation: WIS Legislation:

• Objectives of the WIS Objectives of the WIS • Identification of persons required to report Identification of persons required to report • Registration of persons required to report Registration of persons required to report • Reporting requirements Reporting requirements • Access to information Access to information • Penalties Penalties

• HCWIS is a platformHCWIS is a platform

• Waste stream schedules eg. Hazardous wasteWaste stream schedules eg. Hazardous waste

Page 29: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Lessons LearntLessons Learnt

• Some problems and challenges: Some problems and challenges:

• Confidentiality of information and disclosure of Confidentiality of information and disclosure of information to competitorsinformation to competitors

• Poor understanding of information requirements Poor understanding of information requirements eg. mixed loads eg. mixed loads

• Reporting of information voluntaryReporting of information voluntary

• Poor computer literacy Poor computer literacy

• Access to and maintenance of resources (Internet, Access to and maintenance of resources (Internet, hardware) etc. hindered reportinghardware) etc. hindered reporting

Page 30: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Conclusions Conclusions

• HCWIS component of HCWM strategy and HCWIS component of HCWM strategy and platform for broader waste information system platform for broader waste information system

• Simplicity is keySimplicity is key

• Initial aims and objectives have been met Initial aims and objectives have been met

Page 31: DEVELOPMENT, PILOTING AND IMPLEMENTATION OF A HEALTH CARE RISK WASTE INFORMATION SYSTEM IN GAUTENG

Gauteng Department of Agriculture, Conservation, Environment and Land Gauteng Department of Agriculture, Conservation, Environment and Land AffairsAffairs

Thank YouThank You

All documents available at the following url: All documents available at the following url:

http://www.csir.co.za/ciwm/hcrwhttp://www.csir.co.za/ciwm/hcrw