Target- (or goal-) setting is the first step toward creating and implementing measurable action plans. Goals not only provide direction; they also motivate and encourage staff to participate by creating a common purpose.
Setting reasonable waste generation targets requires understanding current generation rates. Without a known starting point, you can experiment with the target-setting tools from a what-if perspective, but your ability to set realistic targets will be limited.
Setting waste targets is a subjective endeavor requiring an organization's decision-makers to understand, anticipate, and address the potential challenges and issues. For example:
- The way an organization categorizes waste streams depends on how it manages that waste. For example, construction and demolition (C&D) waste is considered solid waste, but if it is recycled, then it's categorized as recycling. Fluorescent bulbs, if not recycled, are categorized as hazardous waste.
- Reaching your targets depends on staff participation and requires effective, ongoing training and education for staff (as opposed to, for example, insulating equipment to save energy).
- Starting a composting program, a comprehensive donation program, a C&D recycling program, or any of a number of other sustainable waste initiatives requires a supporting service provider in your area. These services often do exist, but may require some research to identify and locate the provider that best fills your organization's need.
With these considerations in mind, we encourage all health care facilities to set ambitious targets that are reasonably achievable for the organization. Consider the following as primary objectives for target-setting.
Reduce RMW. Regulated medical waste (RMW) disposal is up to 10 times more expensive than solid waste disposal or recycling. If more than 15 percent of a facility's waste is going into red RMW bags, set a basic performance target of 15 percent or just under. The next step is determining which improvement measures to implement to reduce RMW to advance targets of 4-6 percent. For example:
- Start a reusable sharps container program.
- Use suction canister fluid management systems.
- Remove red bags from patient rooms.
- Implement a â€œknow where to throwâ€ staff training program to ensure that waste materials are placed in the proper containers.
- Start a program to "remanufacture" or reprocess single-use devices.
Recycle More. Recycling cardboard will only enable you to reach a 15 percent recycling rate. Most HIPAA vendors recycle shredded paper (it's a valuable commodity) so include that volume/weight in your recycling mix. A comprehensive paper and cardboard program, along with toner cartridges, metals, universal waste recycling, and a few other "basic" programs will enable you to reach a 20 percent recycling rate. Sample strategies include:
- Place beverage container recycling bins in convenient areas in the dining room, break rooms, and conference rooms.
- Start a recycling education program to increase participation.
- Ensure cardboard is being separated and not mixed with trash. Consider having Central Stores return flattened cardboard from supply runs.
Manage Regulated Hazardous Wastes. This category of waste includes hazardous pharmaceutical waste and universal wastes (mercury-containing waste, fluorescent bulbs, electronics, batteries, PCBs and ballasts, etc.). Managing RCRA (Resource Conservation and Recovery Act) hazardous wastes according to handling and disposal regulations is not optional. Set a goal of properly managing these wastes. Action plans can include ways to minimize the amount of dangerous chemicals used in the first place (e.g., procurement policies). Sample strategies include:
- Audit pharmaceutical drug disposal practices to ensure that hazardous chemical drug waste is not being drain-disposed.
- Audit universal wastes and set up recycling programs (100 percent of this waste is potentially recyclable).
- Consider a solvent chemical recycling system for alcohol, xylene, and/or formalin.
Benefical Reuse for Surplus.This category includes any item or material that is no longer needed in the hospital but has value to someone else. Furniture, office supplies, construction materials, medical supplies and equipment, and so much more! The best way to understand your opportunities is to audit your waste, and definitely as your waste handlers. Sample strategies include:
- Start an in-house "Trading Post" to list items available or wanted for internal distribution.
- Identify non-profit organizations in your communtiy—Goodwill, Salvation Army, Habitat for Humanity, etc.—to understand what they will take and not-take and a process to provide swift and efficient pick-up of surplus.
- Medical equipment and supplies donation. Remember to ask why there is so much surplus in the first place and try to reduce the waste in the first place.
Its numerous categories and subcategories make managing waste in a health care facility quite a complex endeavor. Some waste types are highly regulated (hazardous waste, regulated medical waste, sharps, etc.) and thus more expensive to manage. Other waste streams actually have the potential to generate revenue (paper, cardboard, equipment). Making sure that a facility's programs are set up in a simple and clear way ensures that wastes are disposed of properly and saves operating funds. In many cases, the savings achieved are enough to justify the resources required to hire a sustainability manager to implement and manage a comprehensive program.
Download the waste target-setting tool. It can help an organization:
- Determine baseline waste generation percentages for each waste stream.
- Identify a cost per pound (or ton) for every waste stream. Some costs may have to be estimated, and that's okay. An informed estimation is better than nothing.
- Explore the impact of shifting waste streams from one category to another on the facility's total waste spending.
- Use the tool to set target goals for short-term (annual) and long-term strategic planning.
- Optimize total waste spending and potentially create new programs with the savings.
Review the Tool. Instructions are included on the first tab. Explore the impact of shifting waste streams from one category to another. The cost per ton (or pound) of each waste and the total volume of waste generated are held constant. See what happens to the bottom line if waste is shifted from one cost bucket to another (e.g., from regulated medical waste (RMW) to recycling). This exercise will highlight the benefit â€even from a purely financial perspectiveâ€ of implementing a waste management plan.
Set Goals. The table below summarizes target-setting guidelines for the main waste categories. The tool uses subcategories that are particularly important to list separately because of cost, regulatory, or operational considerations.
|Target-Setting Guidelines for Common Health Care Waste Categories|
|CATEGORY||BASIC PERFORMANCE||INTERMEDIATE PERFORMANCE||ADVANCED PERFORMANCE|
|C&D (bulk MSW)||5.00%||3.00%||0.00%|
|C&D (bulk recycling)||0.00%||2.00%||5.00%|
|Regulated medical waste||13.50%||9.00%||5.00%|
|Total to check||100.00%||100.00%||100.00%|
Use the target-setting tool every year to set new target goals based on the facility's strategic plan. As new technologies and opportunities become available, the target-setting process will change. If the supporting services are not available today, signal to the marketplace that the facility wants composting, C&D recycling, take-back programs, or other sustainable waste programs. It's a journey, so the important goal is to move forward.