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.
- 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.
- 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.
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