Tools for Identifying Materials Management Problems

Evaluating the Current Status of Your Healthcare Facility

Prior to implementing change, you will need to become better informed and raise awareness of the issues by conducting an evaluation of the current situation. To conduct this evaluation, you will need to be familiar with definitions of hospital waste. Our glossary can help you become familiar with this terminology. Please be aware, however, that definitions of some of these wastes can differ from state to state. For example, not all states define Regulated Medical Waste exactly the same way.

Generally, there are two major aspects to examine in auditing a hospital facility: Procurement Practices, and Waste Management Practices.

  1. Procurement:
    Proper procurement practices can help to reduce the amount of packaging, find alternative non-toxic products (latex, mercury, PVC), and reduce the use of disposable items.
  2. Waste Management:
    Waste segregation can drastically reduce the volume and toxicity of the waste stream. It is a necessary component of recycling, and requires some training and education. Waste segregation will reduce the amount of materials incinerated, since only Pathological Wastes must be disposed of by incineration, according to the Centers for Disease Control guidelines. Medical products which are made of PVC plastic (#3) should especially be segregated and NOT incinerated because they can produce dioxin-like substances, which are endocrine disruptors and carcinogens.

The first step may be to form a Hazardous Waste Management Committee to conduct a survey of hospital practices. Discuss how employees will be informed about the activities of the committee, whether advanced notice of inspection will be given, how you can gain support and cooperation for your efforts from staff, and to whom the results of the survey will be reported.

Check with your state Department of Environmental Protection, or similar agency, for regulations concerning disposal of medical wastes. You may need to check with state and Federal OSHA representatives as well, who deal with regulations around worker safety issues. In addition, your local waste water treatment facility (Publicly Owned Treatment Works, POTW) will have regulations regarding hazardous wastes in the wastewater system.

Evaluate the awareness and knowledge of the hospital staff regarding the hazards of handling various types of waste, handling of toxic substances, accident and spill training,etc. Find out what the current institutional policies are and the existing regulations regarding waste disposal and handling of hazardous chemicals.

An audit can be as simple as following the flow of trash within various areas of the hospital, looking into trash containers, finding out where red bag waste is disposed of, and visiting the landfill where the trash hauler takes non-incineration waste. This is the "quick and dirty" method. Always be aware of your own safety if you decide to examine waste and trash receptacles. Wear protective equipment. Or, a consultant can be called in for a formal, more comprehensive assessment. If you do not have the support or resources to conduct a complete facility audit, you may wish to focus on particularly problematic substances first. For example, you could begin with a mercury audit.

Below are some resources to assist you in this process. In addition, talk to other facilities that have conducted similar audits or implemented waste management plans, to avoid pitfalls they may have encountered.