Solid Waste

Prevent it first! The best management is no management – thinking creatively about ways to prevent its generation – extending its life, switching from disposable to reusable item, reducing toxicity of a material or increasing opportunities for recycling by moving towards plastics with a good market and away from materials like chlorinated plastics (PVC) and styrofoam, both tough to recycle.  Complement any “back door” activities by working simultaneously in Environmentally Preferable Purchasing with Practice Greenhealth and with the organization's Group Purchasing Organization.

Municipal waste is also referred to as solid waste, black bag waste, clear bag waste and nonregulated medical waste.  This is the “stuff” that makes up the vast majority of health care material and much of it is no different than wasteone would find in a hotel or other business in that there is a tremendous amount of paper, plastic and food waste.

Waste Monitoring

All waste should be transported as if it’s potentially infectious. Train workers to use protective equipment and safe handling for recyclables and waste materials alike.  All waste must be scanned for radioactivity, as well, to ensure that no contrasting agents or other low level radioactive material sneaked by without proper cooling.  Lead lined barrels or other appropriate storage can be identified for proper storing until within acceptable levels, as deemed by the radiation safety officer, and ready for removal as regular waste.

HIPAA

The Health Insurance Portability and Accountability Act Of 1996 (HIPAA) requires that healthcare facilities protect patient confidentiality.

At first glance, it might appear that HIPAA rules would not involve environmental considerations.  But health care facilities generate large quantities of paper records, and much of that paper will sooner or later need to be discarded, adding significantly to the two billion pounds of paper and cardboard waste that U.S. healthcare facilities generate every year.

• Understand the basic requirements for information privacy under HIPAA.
• Determine whetherthe organization complies with HIPAA requirements.
• Develop confidential document disposal policies for the organization that are both environmentally responsible and fiscally prudent.
• Ensure that the organizations “meets the intent” of HIPAA by ensuring the privacy of patient information.
• Understand the HIPAA does not necessarily mean shredding.
• Before taking steps to secure confidential information, inventory the HIPAA related information (patient IV bracelets, medication vials, IV bags) and prevent the generation wherever possible.  For example, avoid printing multiple reports and reduce the amount of confidential information

Choosing a Vendor/Partners

Partnering on waste and material removal and recovery is of extreme importance.  Due diligence is critical on a number of fronts.  A facility is infinitely responsible for proper management of the waste it generates.  Identifying responsible and compliant business partners is a very important step in ensuring best management of material.  Finding a great deal with “joe and his truck” is a bad idea.  If it seems too good to be true, it definitely is.  Do not cut corners on materials and wastes, especially when hazardous materials are concerned.  Consider visiting all treatment, recycling, transfer and disposal sites.  When considering a waste vendor, consider:

• Equipment rental and maintenance
• Final destination of all material types
• List of permits for each location
• Permits for transport company
• Reporting Options
• Performance Indicators for services (pick up time etc..)
• Educational and training needs including Department of Transportation requirements
• Protocol for improper disposal or segregation problems.
• Payment terms
• Grounds for Termination

Resources

The Green Guide for Health Care’s Waste Management section gives guidance on waste profile, segregation and disposal.  Refer to the Version 2.2 Operations Section at www.gghc.org.