Waste reduction: ways to get leaner and greener in the SPD

Healthcare Purchasing News, April, 2008 by Julie E. Williamson

Waste reduction and environmental stewardship is a topic that's gaining momentum with healthcare organizations, and for good reason. Statistics show that healthcare organizations are, figuratively speaking, drowning in their own waste stream.

According to the Nightingale Institute for Health and the Environment, healthcare with its dizzying array of products and technologies--generates one of the most complex waste streams in American industry (perhaps as many as ten or more). Although waste disposal costs vary across institutions, it's been estimated that solid waste or trash (such as paper and cardboard boxes) costs roughly two to six cents per pound for disposal. Regulated medical waste--that is deemed infectious or biohazardous--can run anywhere from 19 to 40-plus cents per pound for disposal, and hazardous waste, which includes chemicals, some types of batteries, mercury, solvents, etc., costs from $1 to $6 per pound for disposal. When one takes into consideration that, at a conservative estimate, U.S. hospitals generate more than 6,600 tons of waste each day as the byproduct of providing quality, round the clock patient care, the associated costs of managing that waste is enough to make virtually any healthcare worker's head spin.

Not surprisingly, surgical services tops the list of healthcare's largest waste contributors, representing both an ecological and economical incentive for facilities to make a concerted, coordinated effort to tap it for significant waste reduction.

While reducing and, whenever possible, eliminating waste in the operating room is a sound strategy--and one that will garner significant, if not immediate, benefits, it's important that those surgical services-focused waste reduction efforts extend to Central Service as well. While CS may not be a revenue-generating department, it's nonetheless one that can contribute greatly to the facility's overall waste stream. Unfortunately, like many other departments, CS is one that often pays too little attention to the impact its waste has on the bottom line and the environment. Because environmental services or facilities management is usually in charge of waste disposal, the impact of the waste (financial or otherwise) often goes unnoticed by those who actually generate it.

"Every department needs to be more aware of the waste it generates and how that waste can be minimized," stressed Tom Badrick, sustainability coordinator for Legacy Health Systems, Portland, OR. "There are always ways to make a positive impact, but it takes a commitment and a solid plan. It isn't really a struggle getting people to think about [waste reduction]. The challenge is putting the ball in motion and actually doing it."

Badrick is one who's more than willing to accept such a challenge. For the past six years, it's been his job to "green up" LHS, which is comprised of six hospitals on five campuses, 11 primary care clinics, and numerous specialty clinics, and is the largest Oregon-based not-for-profit healthcare organization. In light of its ongoing efforts and well-documented success, LHS has become a nationally recognized leader in environmental achievement and green consciousness, and even earned the 2007 H2E Sustained Environmental Leadership award from Hospitals for a Healthy Environment. In fact, the recycling program has become such a model for success that it generates savings in excess of $300,000 each year through disposal fee avoidance alone, and is even generating money for the health system thanks to its extensive recycling initiatives. At the heart of the organization's recycling program is its own impressive 8,600 square-foot recycling center where waste from each LHS facility is transported and diligently sorted.

Badrick has become so proficient at waste reduction and recycling, he even assists other hospitals and Portland-area neighborhoods with their own efforts.

Although waste reduction can take on many different forms and shouldn't be viewed as a one size fits all process (or one that can be successfully implemented overnight), Badrick and other industry insiders did highlight several key ways CS and purchasing departments can start making a difference now.

Read on to learn how to take the plunge and start tackling your department's waste stream.

Start at the top: Pay-offs of selective purchasing

It's often said that what is up must also come down, and that's certainly true with waste. Experts stress that the most successful waste reduction efforts are those that target waste both upstream and downstream.

Minimizing upstream waste requires thoughtful purchasing and partnerships with vendors who share in the facility's waste reduction goals--or, in the very least, don't work against the efforts. Of course, product standardization can also go a long way. After all, the fewer number of products entering the facility and taking up space on the shelves also translates into less transport and packaging waste on the backend.

"Everything that goes out as waste came in through contracts," noted Sarah O'Brien, champion coordinator for Hospitals for a Healthy Environment (H2E), Lyme, NH. "Waste reduction starts with purchasing."