Improve waste-handling, container utilization and management process.
All PIM content was independently developed and reviewed to be vendor-, product-, and service provider-neutral.
Audit the waste stream handling and management system to understand and identify operational efficiencies from the point of waste generation to the waste dock/area.
Project Talking Points
Understanding the waste stream handling and management system will:
- Identify opportunities to standardize and properly label and color-code all waste containers. Properly labeled and color-coded waste containers are an essential step in proper waste stream segregation and staff training/education.
- Identify opportunities to ensure all waste stream containers are strategically placed. Standardization of container placement is an essential step in proper waste stream segregation and staff training/education.
- Identify staff waste stream disposal habits/practices. Understanding these practices will allow for a process improvement analysis, which could identify labor efficiencies surrounding waste disposal and opportunities to enhance proper waste stream segregation.
- Ensure staff are following hospital PPE standards. Identified gaps in PPE practice standards allows for re-training opportunities and improvements in worker health and safety.
- Require the evaluation of all waste stream routes from point of generation to waste dock/area, which could lead to identifying efficiency and standardization opportunities. For example, waste stream pickup routes may be able to be shortened and/or combined. Efficiencies within this area could allow for future waste stream program expansion (i.e., adding a recycling route).
Triple Bottom Line Benefits
Understanding the waste stream handling and management system will drive value across the triple bottom line by:
- Ensuring materials are being properly segregated into the least costly waste stream
- Enhancing regulatory compliance and mitigating the potential of receiving associated fines.
- Driving labor efficiency and freeing up this labor to drive value elsewhere in the organization.
- Effective waste management operations ensures the right materials are going into the right places, which reduces waste, increases recycling, and ultimately minimizes the environmental impact of waste management.
- Different pollution abatement techniques are used depending on the waste type, so proper waste segregation ensures waste types will receive proper treatment before release into the environment.
- Increased staff and patient satisfaction, via a reduction in hallway congestion and noise; safer handling; improved operations and a more effective program.
- The proper use of PPE and segregation techniques not only ensures happier staff, but also creates a safer, healthier environment for everyone.
- Respecting employees time and ensuring their actions drive value – not just the waste handlers, but everyone who generates trash
Quality and outcomes — Metrics are in development. If you have suggestions, please contact us or participate in the discussion below.
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- Create a green team subcommittee to be accountable for the development and on-going maintenance of this initiative.
- Prepare for the audit by:
- Developing an accountability matrix that identifies who has responsibility for each waste stream and have them participate in audits where that waste is generated.
- Having a list of departments to visit and who will have responsibility to make any changes should they be needed.
- Developing a checklist for the number of containers needed and labels. One option too is to pre-order containers and labels and supply them as needed when “en route” during the audit using a “flat cart”.
- Before you get started, reach out to waste/recycling vendors to take advantage of their expertise around containers, sample labels, training programs, etc
- Audit all waste streams to identify efficiency and standardization opportunities. Things to look for:
- Color-coding and labeling of waste containers. Are they the right colors and does every container have a label?
- Placement of waste containers. Consider removing waste containers if there are simply too many. Container placement should depend upon where the waste is generated, so ask the users where containers should be placed.
- Waste disposal habits/practices. Look in the containers, are the right things going in the right containers? Take pictures of proper and in-proper segregation, note this on your check sheet and utilize these pictures for training purposes. Identify and set up in-service waste training in identified opportunity areas.
- Process improvements. Work with the housekeeping supervisor in all areas to determine pickup locations, and handling/transportation routes (point of generation to the utility/holding rooms to the trash dock).This can be an opportunity for LEAN Process Improvement (i.e., identifying areas that can be serviced with equal quality, but with less pickups).
- Utility room assessments. During the assessment take note of opportunities surrounding standardization of room layout, color coding, labeling, placement and right-sizing of containers and opportunities for education/training posters. For example:
- Are containers right-sized to normalize/optimize the number of pick-ups when a waste handler/housekeeper enters to remove waste?
- Consider co-mingling of color-coded bags that can be sorted at the trash dock. This may be more effective in the long run with fewer containers in each utility room, and fewer trips to the trash dock. However, make sure you check with your authority having jurisdiction, as not all hospitals will allow this. Building the case to allow for co-mingling of color-coded bags is that the waste bag is the primary container and that resolution strategies for leaking bags, ripped/torn bags, etc. are established
- During the audit process, review PPE standards to ensure compliance with safety measures.
- Start from the point of waste generation and work towards the dock.
- Re-educate staff if incompliance with PPE standard is observed.
- Compile report findings, develop recommendations and confirm action plans.
- Present findings, recommendations and opportunities to Green Team.
- Begin implementation of identified opportunities. An education program should be implemented in conjunction with the launch of the identified opportunities so staff understands why these changes are being made.
- Develop a semi-annual or annual review process to ensure implemented changes are holding the gains.
- Ensure trash dock space and work flow is maximized.
Realizing trash docks are often faced with congestion and space constraints work with your waste vendors and internal facilities/engineering department to maximize the trash dock layout and space. The most efficient layout depends on your specific situation/constraints. It is best however, to have all waste collection occur within a common space to maximize staff and vendor efficiency.
- Identify containers, compactors, bailers, etc. that maximize the space/layout, safety, workflow and allow for easy vendor access.
- Ensure all proper spill containment measures are in place and PPE is available on the dock.
- Install pressure gauges and/or compactor monitoring systems to maximize container/compactor pulls. For further information on this subject see the Equipment Utilization PIM.
- Ensure the dock is clean, well lit and is posted with the proper educational and safety materials. Education/safety materials can cover proper segregation, emergency contact information, etc.
- Waste vendors offer de-odorizing systems for trash compactors, which will help reduce odors and the dock should be equipped with a cart/container washing station.
- Outdoor docks can also be equipped with heat lamps to prevent icing in the winter months. Just ensure these heat lamps are only utilized during the winter months and are equipped with motion sensors.
Regulations, Codes and Standards, Policies
- OSHA’s Bloodborne Pathogens Exposure Control Plan rule specifies some handling requirements for RMW. The Healthcare Environmental Resource Center is a comprehensive compliance center.
- National Fire Protection Agency (NFPA) Life Safety Code dictates the size of trash containers for health care occupancies (Joint Commission Environment of Care tends to follow these standards).
- The Department of Transportation (DOT) specifies some handling requirements for containers that will be on the road.
- The CDC’s Guide for Selecting, Evaluating and Using Sharps Disposal Containers
Cross References: LEED
Cross References: GGHC
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