Waste Stream Spotlight Healthcare Waste Management
Jun 27, 2015
Waste Stream SpotlightHealthcare Waste Management
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Sasha Laferte
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2. Q&A at the end, tweet questions using
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Meet Your Presenter• Steven Todisco, HEM, CHMM, Six Sigma Greenbelt
• Triumvirate Environmental - Corporate Healthcare & Pharmaceutical Program Director
• 12 Years Experience• Healthcare Hazardous Waste Management• Pharmaceutical Waste Management• Incident Command, Emergency Response
• Cell Phone: 339-226-0524• Email: [email protected]• www.Triumvirate.com
Our Key Message
With the right methodology, education and resources, a hospital could
improve it’s waste management plan, where the annual savings could pay for
one out of every four years.
Overview
Solid, 60%
Hazardous 4%
Universal; 1%
Pharma; 1%
Medical, 30%
Recycling; 4%
Who Is This For?
Healthcare Waste
Generators
Simple & Safe
Compliance
Healthcare Directors
Cost Savings &
Sustainability
Healthcare Leadership
Citations & Public
Relations
On a 1 – 5 Scale: How confident are you with the compliance
with your waste programs?
What Will You Learn?
Who is regulating you & Regulator Focus
Waste Stream Specifics and Nuances
Where our opportunities are
Did you Know?
Federal
EPA
OSHA
Joint Commission
State
Your state agency (DEP,
DEC, etc.)
Dept. of Health
Health & Human
Services
Local
MWRA
Local Fire Department
Bureau of Narcotics
Enforcement (BNE)
Where is their focus?
No / Missing Col-lection
Pharmaceutical Waste Man-
agementIncreasing Re-cycling Totals /
Waste Reduction
Narcotic Collec-tion
Improper Drain Disposal
The Opportunity….• Hospitals with revenue of $1 billion or more report
spending (0.15%) of their total annual revenue managing disposal of waste.
• That equates to about $1.5 million in waste management spend for every billion in revenue.
• Top institutions track at 20-25% below that number
Hazardous Waste
Waste Stream Spotlight – Hazardous Waste
Waste Stream Spotlight – Universal Waste
Waste Stream Spotlight -Pharmaceutical Waste
Waste Stream Spotlight – Medical Waste
Laboratory Waste: • (Histology, Microbiology, Cytology, Chemistry,
Hematology, Pathology / Gross Pathology)• Solvents• Acids, • Methanol• Thin Prep, Sure Path• Clinical Analyzer• Hand Slide Staining, Automatic Slide Staining
Hazardous Waste RCRA – (40 CFR Part 260 – 282)
Facilities / Engineering Waste:• (Paint Shop, Carpentry Shop, Buildings & Grounds,
Mechanics Shop, Plumbing Shop, Electrical Shop, Boiler Plant)
• Oil Based Paints, Paint Thinners, Rags• Lead Solders• Oil, Oily Debris, Oil filters• Glycols, chiller fluids• Wastewater Treatment Chemicals• Spray Paints
Hazardous Waste RCRA – (40 CFR Part 260 – 282)
Research Generated Waste:(Clinical Research & Non-Clinical Research)
• Halogenated & Non-Halogenated Solvents• Non Routine Waste
• Characteristic• Ignitable• Corrosive• Toxic • Reactive
• Listed• U-Listed Waste• P-Listed Waste
Hazardous Waste RCRA – (40 CFR Part 260 – 282)
Bio-Medical Engineering:• Universal Waste, Non-Regulated
Material, Recyclables • Batteries• Electronic Scrap• Scrap Metal
Hazardous Waste RCRA – (40 CFR Part 260 – 282)
Lab Pack in Progress:• Review your Waste
Shipments• Refine your process• Assess on a container by
container basis
90 / 180 Day Clock:• Maintain oldest dates• Ship in most appropriate size
containers• Use Generator Size to your
advantage
Lab Pack in Progress / 90 or 180 Day Clock
Universal Waste
Waste Stream Spotlight – Hazardous Waste
Waste Stream Spotlight – Universal Waste
Waste Stream Spotlight -Pharmaceutical Waste
Waste Stream Spotlight – Medical Waste
• Batteries:• Lead Acid, Ni-Cad, Ni-MH,
Lithium, Mercury• Pesticides• Mercury Containing Equipment:
• Thermometers, Thermostats, Gauges, Switches, Sphygmomanometers
• Bulbs (Lamps):• Straight Bulbs, U-Tubes,
Circulars, HID
Universal Waste – (40 CFR 273.9)
• By the Pound or By the Drum?
• What containers have I been shipping in?
• Streamline Disposal or Recycling Vendors
• Maximizing Light Bulb Storage
Universal Waste – (40 CFR 273.9)
Pharmaceutical Waste
Waste Stream Spotlight – Hazardous Waste
Waste Stream Spotlight – Universal Waste
Waste Stream Spotlight -Pharmaceutical Waste
Waste Stream Spotlight – Medical Waste
Fact Finding Mission• Generator Size &
Generator State• Formulary & Non-
Formulary Characterization• Reverse Distribution
Pharmaceutical Waste – (40 CFR 260 - 282)
Operational Components• Satellite Accumulation Area• Waste Stream Finalization• Container Selection
Pharmaceutical Waste – (40 CFR 260 - 282)
Education & Training• Nursing, Environmental
Services, Pharmacy• Bonus Education
• Pyxis, Omnicell, • Labeling & Signage• Color Coded systems
Pharmaceutical Waste – (40 CFR 260 - 282)
• DOT Shippable Containers or Palletizing
• Avoid Extra Supplies (Over pack containers)
• Education means generating the correct waste
• Automate the process
• Custom Pre-Printed Labels or Signage
• LQG versus SQG (1 bucket or more)
• Bring Nursing Education in the loop
Pharmaceutical Waste – (40 CFR 260 - 282)
Resource Conservation and Recovery Act (40 CFR 260 - 282)
Po
ten
tial
fo
r H
arm
Extent of Deviation from Requirement
Regulated Medical Waste
Waste Stream Spotlight – Hazardous Waste
Waste Stream Spotlight – Universal Waste
Waste Stream Spotlight -Pharmaceutical Waste
Waste Stream Spotlight – Medical Waste
What’s in a name?
• Regulated Medical Waste (e.g., NY, RI)
• Infectious Waste (e.g., CO, NE, NV)
• Biomedical Waste (e.g., CT, FL, GA. ME, WA)
Regulated Medical Waste
Treatment Standards
• Incineration
• Autoclave, Chemical
Treatment, Microwave,
Electrical
• Recycling
Regulated Medical Waste
General Terms:
• Pathological waste: Tissues, organs, body parts, and body fluids removed during surgery and autopsy.
• Human blood and blood products: Waste blood, serum, plasma and blood products.
• Cultures and stocks of infectious agents (microbiological waste): Specimens from medical and pathology laboratories. Includes culture dishes and devices used to transfer, inoculate, and mix. Also includes discarded live and attenuated vaccines.
Regulated Medical Waste
General Terms
• Contaminated sharps: Contaminated hypodermic needles, syringes, scalpel blades, Pasteur pipettes, and broken glass.
• Isolation waste: Generated by hospitalized patients isolated to protect others from communicable disease.
• Contaminated animal carcasses, body parts and bedding: From animals intentionally exposed to pathogens in research, biologicals production, or in vivo pharmaceuticals testing.
Regulated Medical Waste
• Single vs. Multi Touch containers
• Storage Space
• Streamlining Waste shipments
• Reusable containers versus
Disposable
• Medical Waste / Sharps Recycling
Regulated Medical Waste
SummaryHazardous Waste
Universal Waste
Pharmaceutical Waste
Regulated Medical Waste
The Challenges…..1. Not having a plan… Inability to access correct or complete data relative to
their own total spend
2. No idea how much they actually spend
3. No idea where they waste management programs begin or end
4. No idea where their budgets for waste management reside in the hospital
5. Do not link waste management costs to key performance metrics
6. Struggle to resolve internal resource costs with vendor resource costs
7. Their service providers use irrelevant metrics to determine their costs
8. Service providers are typically motivated to increase waste management costs
Recap• With the right methodology,
education and resources, a hospital could improve it’s waste management plan, where the annual savings could pay for one out of every four years.
Action Plan
Gap Analysis
Develop a Plan
Data Tracking
QUESTIONS?
Thank You For Attending!
Cell Phone: (339)226-0524
Email: [email protected]
Website: www.triumvirate.com
Steven Todisco, HEM, CHMM, Six Sigma GreenbeltTriumvirate Environmental - Corporate Healthcare &
Pharmaceutical Program Director
Thank You For Attending!Check out other webinars here:www.triumvirate.com/training/events
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