h2e -- cost savings through red bag reduction janet brown, medical waste manager beth israel, new...
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H2E -- Cost Savings Through H2E -- Cost Savings Through Red Bag ReductionRed Bag Reduction
Janet Brown, Medical Waste ManagerBeth Israel, New York, NY - February 2003
NO SPACE - NO TIME - NO MONEYNO SPACE - NO TIME - NO MONEY
REALITY
AwardsAwards
• 2002 AHA/EPA H2E Partners for Change Award
• 2001 US EPA Region 2 Environmental Quality Award
• 1999 Health Care Without Harm’s Honors for Contribution to a Mercury-free Environment
• 1999 - AHA/EPA Waste Minimization Work Group
• 1998 Health Care Without Harm Environmental Health Award
• 1998 Citizens’ Environmental Coalition’s Activist Award
Commitment to Environmental Commitment to Environmental Management -- Why bother?Management -- Why bother?
Saves Money Ethical Responsibility Public Health Impact Environmental Impact Liability/Regulatory Compliance Safety/Employee Engagement Press Coverage/Awards Patient Satisfaction Corporate Identity
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
1,800,000
Petrie Singer PACC KHD TOTAL
BeforeAfter
RMW Reduction Cost Savings in Dollars Per Year
Environmental ImpactEnvironmental Impact
• The EPA has reported that medical waste incinerators are major sources for both mercury and dioxin in the environment.
• Health Care facilities generate double the amount of plastics than other municipal institutions.
Liability/Regulatory ComplianceLiability/Regulatory Compliance
• Occupational exposure
• Perception -- Fear of hospital waste
• Cradle to grave responsibility
• Implications of Fresh Kills Landfill closure and export of waste to other states.
• JCAHO, OSHA, EPA, DEC and DOH.
• Negative press.
SafetySafety
• Staff Knowledge– Compliance– Reduced Occupational Exposures– Reduced lost
work days– Reduced liability
Employee EngagementEmployee Engagement
• Environmental commitment is everyone’s responsibility.
• % incentive for proper segregation and waste prevention initiatives.
• Development of corporate identity.
• Employee’s are part of the solution and feel positive that their work is appreciated.
• Safe environment shows we care.
Why Reduce Red Bags First?Why Reduce Red Bags First?
• Red Bag Waste is at least 5x more expensive than NRMW.
• No other waste management program will save as much as RMW reduction.
• Savings in RMW reduction will pave way to future programs.
• RMW reduction can justify more costly programs
Red Bag Reduction PlanRed Bag Reduction Plan
• Calculate Potential Cost Savings*
• Present to Administration
• Shared Savings Program
• Designate a Waste Manager
• Cement Administrative Support
• Define RMW through Infection Control Committee
• Define Pathological and Cytotoxic Drug Waste.
• Facility Survey
• Standardization
• Signage
• Education
• Monitoring
• Maintenance
• Reporting
* See Laura Brannen’s cost savings calculation aid attached.
Common ObstaclesCommon Obstacles
• Red bagging IV bags• Overfilled Red Bag• Poor Placement of
Waste Containers• Foley Bags/diapers• Housekeeping
commingling waste• Isolation Waste
• Fear of Waste• No Time to Segregate!• Poor Signage
Red Bag Waste removal is five times more expensive than regular wasteRed Bag Waste removal is five times more expensive than regular waste
What Goes in the Red Bag Anyway?What Goes in the Red Bag Anyway?
• Blood, products of blood, anything caked, soaked or dripping in blood.
• Suction Canisters containing any fluid.
• Cultures and stocks of infectious agents
• Pathological waste, placenta• Items saturated with the following
fluids as defined by OSHA: vaginal fluid, semen, pleural fluid, cerebrospinal fluid, synovial fluid, pericardial fluid and amniotic fluid in addition to any fluid visibly contaminated with blood.
• Waste from patients isolated with highly communicable diseases as per CDC.
• Blood-tainted waste
• IV bags and their tubing
• Urine, vomit, feces, diapers
• Nonbloody gloves
• Items tainted (versus soaked) with the fluids listed.
• Nonbloody drapes, packaging, personal protective equipment
Questions? Call Waste Manager at 420-2442
YES RED BAG ME NO - USE REGULAR GARBAGE
And Don’t Forget...And Don’t Forget...
• Change bag ordering to reflect usage.
• Spot check both red and clear bags!
• Walk those floors!• Keep on Educating!• Reward Success!• Be patient….
• Pat yourself on the back.
• Maintain program and start planning your next program - recycling, bulbs, mercury phase out...
Reusable Sharps ContainersReusable Sharps Containers
• Eliminated incineration of 2,700 containers/month at one site alone
• Safer for user and staff• Reduced cost • Nicer looking
container
Disposable vs. Reusable Sharps ContainersDisposable vs. Reusable Sharps Containers
• Nurses were responsible for changing containers
• Containers often overfilled.• Containers often removed without
being closed properly.• Disposable filled containers were
stored in the soiled utility rooms• Too many employees handling
sharps containers.• Beth Israel incinerated
approximately 2,700 disposable sharps containers per month at one site alone!
• Vendor offered a full-service sharps management service.
• One dedicated person for handling sharps.
• Much fewer incidents of overfilled containers.
• Nicer looking container• Reduced needle sticks associated
with waste• Elimination of 2,700 containers
per month!• Reduced liability• Positive feedback from staff.
Disposable Reusable
Successful ProgramsSuccessful Programs
• Simplicity
• Economically Viable
• Communication
• Support
• Employee Incentive
Taking our commitment to Taking our commitment to the next levelthe next level
• Environmental commitment should be maintained like any other service line.
• Corporate and executive-wide support would generate a stronger community-wide commitment.
• Commitment to an environmental agenda throughout Continuum has to mean more than having a waste manager.
Next LevelNext Level
• Implement an Environmental Management System
• Environmental leadership Committee
• Environmentally Preferable Purchasing
• Energy Conservation• Mercury phase-out• Expanded and
increased recycling• Green cleaning• Green building• Surplus sharing
