Exit Strategy

Yes, a soiled utility room can be exciting—that is, if you oversee a facility’s materials and waste program. Ask any healthcare sustainability lead about their challenges, and space will certainly be on the list. With the increased complexity of healthcare waste and best management practices, the configuration of the soiled utility room and back door storage areas can improve or impair a program.

Sustainability leads “make it work” with a given space, where it’s likely multiple material segregation was not a reality during its design.

How can designers plan for smoother waste material operations and make the case for equal time to back door management? How does a designer or facility manager demonstrate the return on investment of smoother operations? After all, hospitals are generating more than 26 pounds of waste material per bed per day, according to the Practice Greenhealth 2011 Sustainability Benchmark Report, so they need an exit strategy. 

Designers will benefit from access to sector benchmarks on materials and wastes. And while sustainability leads may have a good understanding of the types and amounts of materials generated, collaboration with the design team can help identify healthier and more efficient solutions.

At the HEALTHCARE DESIGN.11 Conference in Nashville, this topic was discussed in the roundtable session titled “Designing for Sustainable Operations.” The integrated team included Ignatius Tsang, AIA, NCARB, director of facilities planning, national facilities services, Kaiser Permanente; Breeze Glazer, M.Arch, LEED AP BD+C, research knowledge manager, healthcare sustainability, Perkins+Will; and myself as director, sustainable operations, for Practice Greenhealth, a membership-based not-for-profit that works with healthcare and businesses to improve the environmental performance of the sector. 

The group provided some background to get the discussion underway by sharing material and waste facts, defining various material streams, reporting volumes and costs per unit of each, and describing some strategies underway at Kaiser Permanente. 

Designers benefit from having knowledge of healthcare materials and wastes, including understanding: 

• The types of materials generated;
• The volume of materials—how much of each type;
• The varying costs per unit for proper removal; and
• The best approach for each material stream.

Location, location, location

The soiled utility room is a very important staging area for materials and wastes. Gone are the days of two or three waste streams. Hospitals are now relying on multiple bin types, including regulated medical waste (RMW), battery collection, hazardous pharmaceutical waste, chemotherapy, nonhazardous pharmaceuticals, single-stream recycling, and many more. To prepare for the session, various bin sizes were gathered and Perkins+Will mocked-up what a soiled utility room could look like for today’s waste segregation and storage requirements.

This is important as some unit configurations are creating pods with more but smaller soiled utility rooms, a real challenge for managing the various types of materials.

Exit strategy

Regardless of facility size, focus is required at the back door.  Inching out a bit more room for compactors (the equipment that compacts the waste and then is switched out by the hauler), balers (like the one you see in grocery stores that compacts boxes or other materials into cubes), compost storage, pharmaceutical waste collection, and other carts/bins can help with compliance and ease pickup and efficiency.