Do you know how much waste your facility is generating? Literally tons, including solid waste, regulated medical waste, construction and demolition debris, recyclables, hazardous chemicals, electronics, and donation materials—practically everything that leaves your facility not walking on two legs! Even more importantly, do you know how much it costs to manage all those materials?

You cannot, however, manage if you don’t know what you have. You cannot set targets if you don’t know your benchmarks or where to start. To maximize your advantages in these areas, you must develop operations and financial action plans for improvement.

Practice Greenhealth has a Waste Data Tracking Tool (The Tool) to help you embark on a waste and environmental data collection and tracking program. The time spent initiating the project will yield a tremendous amount of information. Many new users report, “I didn’t know what I didn’t know!” The following is a step-by-step approach that will get you started and let you use the data year after year to improve your operations and environmental performance. (In full disclosure, Practice Greenhealth has a Waste Data Tracking Tool used by dozens of Partners. The Tool is included in membership. This article is about the benefits of collecting and understanding waste data, whether you use Greenhealth’s tools or your own.)

Waste 101: Understanding your waste

Hospitals generate masses of waste in almost every type of category imaginable. To complicate matters, waste management also tends to be very decentralized in hospitals. Therefore, a good place to start is with an understanding of the main categories of waste, where they are typically generated, and what department has responsibility for oversight of that waste stream, including contracts and invoicing. Typical departments responsible for operations include Environmental Services, Facilities, Purchasing, Infection Control, EH&S, Safety Office, and Lab Safety Office. Table 1 is a summary of the main waste categories, their definitions, treatment and disposal considerations. (Tip: Hang out at the trash dock for a while and you will learn a lot.)

Main Waste categories and Generation Information

Waste Type

Definition

Treatment and Disposal Issues

* Incineration should be minimized or eliminated to reduce environmental and health impacts

General Solid Waste (trash, garbage, clear bag waste, municipal solid waste)

Solid wastes that are not hazardous, infectious or recyclable. May include some food wastes, trash, and construction and demolition waste (although those too should be recycled)

Landfill or municipal solid waste incinerator*

Waste Reduction Programs:

  • Recycling

  • Reuse

  • Donation

  • Source Reduction

  • Reducing: buying and using fewer products in the first place — generating less waste.

  • Reusing: using a product again and again until it is no longer usable! Materials exchanges are a good resource or program for reuse.

  • Recycling: Refuse which is re-processed into new products.

Most recyclers take a range of recyclables. But it’s not unusual to have multiple vendors for recycling, reuse and donation

  • Objective: total cost of program should beat landfill costs (i.e. avoided landfill costs pay for the program)

Infectious Waste (RMW-regulated medical waste, red bag waste, bio-hazard)

Solid or liquid wastes that have a significant potential for transmitting infection or require special handling due to state regulations, and some federal regulations.

  • Requires treatment to kill pathogens, like autoclave, microwave, incineration*

  • 10 percent of total RMW is path waste that may require incineration* by regulation

Hazardous Chemical Waste (RCRA Hazardous Waste)

Solid or liquid waste containing flammable, toxic, corrosive or reactive chemicals. Also includes “special hazards” category, “listed” wastes. (e.g., lab chemicals, facility chemicals, pharmaceuticals regulated by RCRA)

Managed according to OSHA, EPA and local and state regulations and shipped off site for proper disposal.

Universal Waste

Waste that meets the RCRA definition of hazardous but can be recycled. E.g., batteries pesticides, and mercury containing items

Managed by a permitted hauler. http://www.epa.gov/epaoswer/hazwaste/id/univwast.htm

Table 2 is a summary of waste types by category and sub-category managed by The Tool. You may not generate every material, and you may have several “user defined” materials, but this is an excellent place to begin and define all the materials leaving your facility.

Waste Types—Categories and Sub-Categories.

Collect your waste data for invoices, manifests, and contracts

Inventory and collect waste data information. Sources may include invoices, forms, tipping slips, manifests, receipts, records, even scraps of paper! The good news is that someone in your facility has the information—and it often resides in Housekeeping, Facilities, Safety, Lab, or Accounts Payable. You just need to do a little digging. Not only may several different departments be involved in managing waste, but in some cases even those who have primary operational responsibility do not see the invoices, if they go straight to accounts payable. Setting up a system where all invoices are approved, entered into the Tool, and then paid may yield surprising results.

Compile the list of waste haulers/vendors. In general, your purchasing or accounts payable departments may be able to help you identify all the vendors that are currently removing materials from the facility. Contact the departments that are using this type of vendor and make them aware of your mission. Since you will be working with them later to gather more information, include them in your planning because ultimately they will gain kudos for saving money. This is an opportunity to streamline and standardize operations. For example, if you have multiple hazardous waste haulers in use, you may want to bid this contract and have one vendor service all areas.

Collect data for an initial assessment of your baseline

Collect your waste data in a spreadsheet. Practice Greenhealth’s Tool reports the cost per pound and ton of every waste material generated in your facility. Remember the objective is to minimize cost per pound for each waste stream, identify opportunities to reduce waste and increase waste reduction programs. Once you have a substantial amount of data (at least three to six months worth) you can begin to evaluate your generation rates and compare them to your own targets, to other facilities and health systems in order to set goals. Develop a table for your facility or health system to set targets similar to the one below. Table 3 provides a very wide array of acceptable data ranges that varies with regions of the country and availability of service options. Narrow your region’s acceptable ranges (talk to your “local” landfill and waste haulers for regional data), and, if you are outside of that range, you have opportunities to optimize your comprehensive waste management program.

Acceptable Data Ranges

Waste Stream

Avg. Disposal Cost per $40-$120 Avg. Disposal Cost perton

Avg. Disposal Cost pound $0.02-0.06 Avg. Disposal Costper per pound

Percent of total Waste-Target Goals Percent of total Waste-Target Goals

Municipal solid waste (MSW)

$40-$120

$0.02-0.06

Beginner: 70-75% Intermediate: 60-70% Expert: 50-60% Star <50%

Recycling (average for all recyclables’)

breakeven

Beginner: 10-15% Intermediate: 15-25% Expert: 25-35% Star >35%

Regulated medical waste (RMW)

$450-$1,000

$0.24-0.40

Beginner: 15-20% Intermediate: 12-15% Expert: 8- 12% Star <8%

Hazardous chemical waste

$1,000 or more

$0.50-$10

Recyclable Hazardous-Universal Waste, solvents, etc

varies

varies

Greenhealth hesitates to set targets because by law, you must manage your RCRA HW and universal wastes. It’s expensive so it is to your advantage to minimize to the greatest extent possible.

Benchmark after six months of data, set goals and action plans

Now you understand your data. You have been working with the haulers to gather complete data, you have completed an initial assessment—congratulations. Now is the appropriate time to set annual goals and action plans to achieve those goals. They obviously need to be reasonable and attainable. Practice Greenhealth has a great deal of information about developing action plans (http://www.practicegreenhealth.org/partners/10step-hcfp.htm) and they include kicking off new recycling programs and waste minimization of RMW or hazardous chemicals.

Decide on your target goal by a percentage of total waste or by a normalizing factor that works for you (waste per patient days, adjusted patient day, outpatient visits, etc). Reach out to Practice Greenhealth and your colleagues for best practice approaches to meeting those goals.

Remember your waste data is loaded with information to help you set your goals. In addition to hitting target generation rates, are you maximizing your container hauls? Hauling partially filled containers is not cost effective. Is your cost per pound reasonable, and is it consistent with your contracted rate? When you add tipping fee with transportation fees and other surcharges, you may be paying more than you think.

Communicating your goals, action plans, and successes

Reducing RMW or increasing your waste reduction programs is inextricably linked to staff participation in your programs. Let them know immediately why you have established these programs. Include the environmental considerations of not having these programs, your commitment to public health and the environment, your regulatory obligations, the cost considerations, and why their participation will make a difference. Include your goals and action plans in education programs from orientation to annual training programs. Develop posters and communication plans to constantly provide feedback. Include articles in newsletters. The importance of enthusiastic and regular communications cannot be overemphasized! HD

Laura Brannen is Senior Environmental Project Manager at Practice Greenhealth. For more information, contact lbrannen@practicegreenhealth.org or visit http://www.practicegreenhealth.org