To be useful, a waste assessment must be conducted properly. The
goals of a waste assessment should be to:
- Collect information
- Discover opportunities
- Enlist the support of area personnel
- Educate area personnel
The following multistep approach provides in-depth information
and serves the purpose of educating and enlisting the support of
the area department head. It also gives a barometric reading up
front of the level of commitment and issues the hospital will
face as implementation progresses in the specific area.
As potential for the program is assessed and implementation
proceeds, the assessment person should keep these four steps in
mind: Plan, Do, Check, and Act. They represent a successful
management process in total quality management, which is becoming
a common strategy for hospitals.
A. Initial Contact
The assessment person should contact the department head, explain
his or her role and describe the hospital's commitment to waste
reduction and recycling and the simple benefits it offers, such
as better utilization of health care dollars. The assessment
person should establish the important link between high-quality
health care and the environment.
A typical introductory conversation should include the following information:
A conversation such as the preceding sets the stage for a
collaborative effort because it does the following:
(Clearly indicating the assessment person's identity, role, and
responsibility): "Hello, my name is _______________, and I am the
coordinator for the hospital's recycling team."
(Indicating what is going to happen and what is needed from the
department head): "The hospital is planning to start recycling in
all departments over the next year, and we are in the process of
working with each department to see how this can best be done.
I'd like to meet with you and explore some possibilities for
environmentally responsible waste management options in your
area. That is a fancy way of saying, I'd like to talk to you
about recycling and some simple shifts you might be able to make
that would help the hospital save money and resources."
(Seeking the department head's support and buy-in): "Recycling
will help cut costs and make an important contribution to the
community's environmental quality. Your input is vital to this
process, because this is your work area and you are the expert
when it comes to understanding the dynamics of activity, space
issues, and so on. For a recycling program to work, it must be
convenient and designed with the specific user in mind."
(Explaining when the change will take place and how the
department head fits into the schedule): "We have three months to
put all our plans together before the hospital recycling programs
will go facility-wide. I would like to meet with you in the next
two weeks if possible. I'll bring a floor plan of your area, so
that we can discuss specific strategies for further improvements
in managing waste from your department and I can take notes and
learn from you."
The assessment team will be working with the department over a
long period of time. Creating a recycling program goes far beyond
placing containers and collecting materials; it is an ongoing
problem-solving process that requires good relationships and
skills. Here are some do's and don'ts to remember when conducting
a waste assessment.
- It identifies up front the fact that changes need to be made
to make the best use of hospital resources and that the hospital
fully supports this effort.
- It identifies that the input of the manager of that area is
valued and needed, and recognizes that creating a sustainable
system designed to meet the waste needs of the staff of that unit
without compromising patient care or impinging on current
work styles is the assessment person's primary objective.
- It anticipates but does not invite resistance. If there is
resistance, the assessment person should listen carefully to the
concerns and take notes if necessary. The department head's
concerns should be considered in later planning. Through
effective and positive communication, resistance can be turned
into collaboration. In many cases, resistance does not come from
a lack of interest in recycling, but rather from other problems
that a specific department has experienced that need to be
Do's and Don'ts of Conducting a Successful Waste Audit
|Think it through.
|Create a planned approach that is logical and can be easily explained. Be flexible--you will be working with lots of people for whom this is not the highest priority. Be aware of and sensitive to the needs and concerns of different departments.
|LISTEN to everyone--do not ignore anyone--often the best suggestions come from the most unexpected sources.
|Have a careful and consistent method to document your findings.
|Protect yourself; don't take short-cuts if you are sorting trash as part of your assessment--wear protective gear (eye protection, gloves, etc.)
|Don't let your enthusiasm carry you away... focus it and it will be contagious.
|Know your own biases--don't assume you know the outcome before you look carefully at the problem.
|Don't be discouraged by a "no can do" attitude or resistance on the part of other employees.
|Don't be pushy--seek out cooperation--make it convenient for those who have to help you Don't expect this to happen over night--set realistic timelines, even just to get the waste assessment done.
|Don't ignore the housekeeping staff or trash handlers--they can provide the most intimate knowledge of what is thrown out--seeking their input early on will help get their support for later implementation.
|Don't ignore clinical staff; they often handle the materials last before they are thrown out. Don't sort through people's trash without their permission--you are not a trash cop and do not want to be perceived as one.
B. First Meeting
- Accompanied by the department head, and with a floor plan in hand, the assessment
person should review the current use of the area and types of waste generated,
asking such questions as:
- What do they do in this area/department?
- Is there an employee lounge?
- Do staff eat meals here, or is it used more as a conference room?
- Are there administrative areas? lab areas? patient care areas?
- Hours of usage of the area should be identified: Is it primarily a day shift area? evening? night? 24 hours a day?
- What current systems are in place?
- Trash cans: location? size? number?
- Recycling containers?
- Sharps containers, red bag waste containers?
- Are there any specific types of equipment that generate special wastes (for
example, copy machine, fax machine, X-ray equipment, EKG, carpentry
- What opportunities currently exist for staff development?
Note the resources for information dissemination.
- Are there regularly scheduled staff meetings or in-service meetings? (These are ideal times to schedule a solid waste/recycling in-service program to teach staff about the current program and opportunities for expansion.)
- What other communication routes are in place in that department? Computer notebook? memos? bulletin board? communications book?
C. Follow-Up Phone Call to Schedule Another Meeting
The purpose of this meeting is to review findings and brainstorm about
implementation needs, including:
- Number of containers
- Types of materials to be collected
- Designation of a contact person and scheduling of an in-service (include off-shift staff as well)
- System to update new employees about the program and procedures
- System to ensure that per diem staff and agency (outside staff) are made aware of the waste system
- A feedback system to discuss future improvements or deal with breakdowns
- A time line for implementation
- Make the necessary interface with other departments (housekeeping, environmental services) to establish the system change (collection)
The plan should next be transformed into action. Set a goal for a starting date, educate
affected staff about their responsibilities, and obtain appropriate equipment and
signage. As soon as the hospital staff responsible for collection are prepared, an
implementation day should be scheduled for the department. In preparation for the day
notices should be posted explaining when the program will begin and what it will
incorporate. This should be done in conjunction with in-service training.
On that day:
This may include a hospital-wide contact as well as a department contact.
- The collection containers should be installed and the signs posted.
- Sites should be inspected to ensure that the containers are placed at the preagreed locations and that adequate signs are in place.
- The name and phone number of a contact person should be prominently posted.
Follow-up visit. Shortly after implementation, the:area should be
checked informally to see how things are going. Feedback should
be elicited. One idea is to do an informal survey of the
department or to leave a comment sheet in the area for a week or
so. Concerns and suggestions should be noted. The assessment team
and department should problem-solve together and plan
improvements to the system as needed.
Changes should be made as needed. Periodic assessments
(semiannually or quarterly) are useful to assess the system and
update it to meet the needs of the users. Provide feedback to the
department on the program's successes to keep motivation high
among staff. Be prompt in responding to their suggestions because
their continued participation is critical to the program's
Hospital Area Waste Assessment Data Form
Area Wastes Generated Containers Storage SD,SP,HD,E
Problems and Solutions:
Area Waste Assessment Form (part 2)
Obtain blueprint of area
Note how areas are used (times, activities, personnel)
Note storage areas & potential storage areas
Fire code Issues:
Look up--find the sprinklers, heat sensors, smoke detectors
Look around--find the areas of egress
Look down--note traffic flow patterns
Check with Facilities Mgt. to verify smoke & heat detector & sprinklers
When is waste collected from this area?
How often? (scheduled vs. on demand), What times?
By whom? (note chain if handled more than one time, e.g., housekeeper to trash person)
E--Means of Egress