Conduct a waste assessment.
All PIM content was independently developed and reviewed to be vendor-, product-, and service provider-neutral.
Whether your facility is getting ready to implement a waste reduction program or you’re improving a pre-established program, a waste assessment is a valuable tool for understanding your waste stream. A waste assessment provides a snapshot of what and how much is being discarded, as well as how it is being disposed. This information should provide the basis for planning waste reduction programs, improving waste management practices in your facility and managing waste disposal contracts.
Project Talking Points
- If you are planning to implement or expand a waste reduction program, a waste assessment will establish the baseline conditions at your facility and help identify opportunities for waste minimization or recycling. The results of the assessment should provide a starting point for setting improvement goals.
- A waste assessment can allow hospital personnel to ensure that waste is being disposed of in the proper containers and to proactively identify improper waste segregation, which is particularly important for regulated medical waste, pharmaceutical waste, and hazardous waste. Conducting periodic visual inspections of waste containers encourages staff to be accountable for their actions and conveys the important message of “Know Where to Throw.”
- A waste assessment can help monitor the effectiveness of waste reduction and recycling programs. Conducting periodic visual inspections of waste containers will reveal if recyclable commodities are being improperly segregated and allow you to better target outreach, communication and training programs.
- An assessment should occur before implementing any waste reduction and/or recycle program, expanding a current waste reduction/recycle program, renegotiating a waste contract and to ensure regulatory compliance.
Triple Bottom Line Benefits
- Cost benefits: Conducting a waste assessment identifies expense reduction opportunities, allows for the better management of cost variances and creates an opportunity to design better budget models. Cost saving opportunities are typically associated with accounting errors, invoice errors, contract re-negotiations, waste reduction, reduced waste hauls, fuel surcharges, etc. that are typically uncovered during a waste assessment.
- Environmental benefits: Reducing waste generation reduces the volume of waste sent to landfills as well as the emissions related to transporting and processing waste. These reductions lessen the hospital's environmental impact.
- Health and safety benefits: Waste assessments can lead to increased regulatory compliance and enhancements to patient and staff safety.
Quality and Outcomes: Metrics are in development. If you have suggestions, please contact us or participate in the discussion below.
If you have suggestions for purchasing considerations, or suggested sample contract language for any product or contracted service, please participate in the discussion below.
1. Identify all waste streams produced by the hospitals operations. Typical health care waste streams include:
- Solid waste
- Regulated Medical Waste (RMW)
- Recycled materials
- Reused items
- Universal waste
- Hazardous waste
- Pharmaceutical waste
- Chemotherapy waste
- Pathology waste
2. Conduct a thorough review of all waste stream invoices to help provide insight into waste collection and disposal practices related to pick up-frequency, weights, volume and costs.An effective waste assessment should reveal where in your facilities these wastes are generated and how they are being disposed of at the point of generation. The types of waste generated will vary by department, so it is important to include all departments in your assessment.
- Partner with your waste stream vendors as they can help your facility conduct a records review by providing paper or electronic documentation of waste disposal records, such as tipping slips, manifests, invoices and receipts, and other records or forms. They may also provide valuable insight by sharing observations about waste collection and disposal practices. For example, during the records review, waste haulers can provide information on hauling frequency, weight of waste being disposed, cost of waste hauling, including container rental fees, transportation fees, landfill tipping fees, and other monthly fees associated with waste hauling or management.
- Consider working with your finance department to receive a copy of all waste stream invoices to cross check the waste vendor reports. For more information on waste stream invoice reviews see the Establish baseline for current waste generation and program for ongoing waste metrics reporting PIM.
3. Review all applicable waste management policies. Once you conduct the facility walkthrough, you can then compare actual compliance against your polices and identify improvement opportunities.
4. Conduct a facility walkthrough for a visual inspection of waste disposal practices and process. The purpose of the facility walk-through is to identify:
- The types of waste being disposed of
- The sources of waste
- The location of all regularly placed waste containers and the size of these containers
- That the correct types of waste are being placed in the correct containers
- What materials, if any, are being recycled or reused
- Whether waste collection from each area is scheduled or on demand
- Encourage hospital department and staff participation in the walkthrough of their department either by conducting a visual inspection of waste disposal locations during the assessment or by providing information to those conducting the walk-through. Discuss compliance status, generation rates and what they might need to improve the system. This will be important to understanding your facilities waste.
- Interview random staff to gain insight into their level of waste stream understanding, excitement levels and their improvement ideas.
5. Ensure the following points are assessed during the facility walkthrough:
- RMW generation: It should be expected that some areas of a hospital generate a greater volume of RMW than others. For example, surgery areas, emergency rooms, and cardiac catheterization labs frequently generate a higher volume of RMW than compared to endoscopy and gastroenterology areas. However, RMW container placement should be evaluated in each department to ensure containers are adequately sized (neither too small nor too large) and properly placed to ensure proper waste segregation. Are red bag containers in every patient room and/or exam room? Many facilities have removed red bag containers in areas where the likelihood of generation is small. Small bags can be stored under the sink for the occasional item.
- Identifying recyclable items: Though a variety of items are commonly used throughout a hospital, a waste assessment should include identification of department-specific wastes that can be recycled. For example, blue wrap (polypropylene) is often generated in large quantities in surgical areas and operating rooms, providing an opportunity to easily segregate this material at the point of generation. Polypropylene is recyclable in some markets; therefore, this may represent an opportunity for waste reduction in your facility. Evaluate wastes in other departments with a similar objective: what materials are generated here in large quantities that can be recycled or reused?
- Managing hazardous and universal wastes: When conducting a facility walk-through, you should also look for waste streams that require special handling—such as hazardous or universal wastes—and ensure procedures are in place to properly manage disposal of these materials. This may require you to not only evaluate what is being put into solid waste and RMW containers, but also what may be going down the drain. This aspect of a waste assessment enables you to proactively identify compliance issues and implement the appropriate corrective measures.
- Assess waste containers for every waste stream: Are they well placed, right-sized, color coded, and have the appropriate signage? If there are too many or not enough containers, make note to address this significant problem.
- Are the right training and educational signage placed throughout the facility in places such as the dirty utility rooms and staff lounges?
- Ensure confidential containers/shredders are strategically placed throughout the facility and that confidential materials are not being placed into other waste streams.
6. Once the facility walkthrough is complete create an action plan/accountability matrix to achieve the identified improvement opportunities.
The Maine Healthy Hospitals Project document provides an area by area assessment tool identifying opportunities surrounding source reduction, recycling, container placement, education and training and helpful hints by hospital department.
Regulations, Codes and Standards, Policies
- Waste assessments are not required by law, but as mentioned earlier, assessments will help identify regulatory improvement opportunities, if any exist.
Cross References: LEED
LEED 2009 For Existing Buildings: Operations & Maintenance
- Materials & Resources Credit 6: Solid Waste Management: Waste Stream Audit
Cross References: GGHC
GGHC v2.2 Waste Management
- Prereq 1 – Waste Management Plan
- Prereq 2 – Waste Generation Profile & Measurement
- Credit 1.1 – 1.3 Solid Waste & Material Management Indoor Chemical Contaminant Reduction – Laboratory
- Credit 2.1-2.2 – Regulated Medical Waste Reduction
If you have any information or resources to contribute, please contact us or participate in the discussion below.
- AHE TOOL: Waste Management – Types of Waste Streams [Waste Management - Type of Waste Streams_1.pdf]
- AHE TOOL: Selecting a Waste Vendor [Selecting a Waste Vendor_1.pdf]
- AHE TOOL: An Ounce of Prevention – Waste Reduction Strategies [An Ounce of Prevention - Waste Reduction Strategies_1.pdf]
- AHE TOOL: Hospital Waste Reduction Planning and Program Implementation [Hospital Waste Reduction Planning and Program Implementation_1.pdf]
- EPA WasteWise has a free waste ReTrac Tool but Regulated Medical Waste is not included in this tool as it is not healthcare specific.
- Ask your vendor. Many integrated waste vendors have waste management programs to help you track your total waste management program
- Practice Greenhealth’s Greenhealth Tracker Tool is an online tool created specifically for healthcare. There is a fee to use the tool.
- Key Green Solutions. A sustainability software tool in the marketplace that tracks waste, water and energy. There is a fee to use the tool.
- EPA created the Waste Reduction Model (WARM) to help solid waste planners and organizations track and voluntarily report greenhouse gas (GHG) emissions reductions from several different waste management practices. WARM is available both as a Web-based calculator and as a Microsoft Excel spreadsheet (The Excel-based version of WARM offers more functionality than the Web-based calculator.
- Self-Assessment Manual for Proper Management of Medical Waste, as prepared by The Self-Assessment Project Partnership between the California Department of Health Services and the California Healthcare Association
- The Maine Healthy Hospitals Project document provides an area by area assessment tool identifying opportunities surrounding source reduction, recycling, container placement, education and training and helpful hints by hospital department.
- Hazardous Waste
- Measurement and Reporting
- Solid Waste
- Source Reduction
- Strategic Operations
- Waste Minimization
- Measurement and Reporting
- Optimize Operations
- Waste Reduction
- Source Reduction
- Waste Minimization
- Environmental Services
- Comment, and please add information, tools, or additional resources you think should be added to the PIM.
- Write a case study or a PIM to contribute to the Roadmap (links are to instructions).